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Hastings Center News

What Happens When Undocumented Immigrants Are Seriously Ill?

How do state and local health care systems care for seriously ill undocumented immigrants? This question is the focus of a collection of articles in JAMA Internal Medicine. Nancy Berlinger, a Hastings Center research scholar and coauthor of one of the articles, “The Illness Experience of Undocumented Immigrants Receiving Emergent-Only Hemodialysis.”

Berlinger is codirector of The Hastings Center’s Undocumented Patients project.

“Our health care system ensures access to emergency treatment for all, but some conditions require ongoing chronic treatment to prevent future emergencies and allow a patient to live a normal life,” says Berlinger. “Our research shows the grueling experience of dialysis under emergency conditions from the patient’s perspective. Some states have already made policy changes to include ongoing treatment for life-threatening chronic illness, including kidney disease, under their emergency Medicaid provisions.”

The article described a study of undocumented immigrants with kidney failure who did not have access to scheduled dialysis, and it concluded that they experience “significant physical and psychological distress that affects their families and their own ability to work.”

“This distress, coupled with higher costs for emergent dialysis, indicate that we should reconsider our professional and societal approach to ESRD [end-stage renal disease] for undocumented patients.”