States find dialysis for illegal immigrants a costly dilemma

By Alan Zarembo and Anna Gorman Los Angeles Times Roughly 2,000 times over the past 17 years, Marguerita Toribio, an illegal immigrant from Mexico, has climbed into a cushioned recliner for the three-hour dialysis treatment that keeps her alive. She has never seen a bill. U.S. taxpayers have covered the entire cost of her treatment in California: more than $500,000 and rising, not including a kidney transplant in 1993. The kidney failed when Toribio briefly moved to North Carolina, which refused to pay for her anti-rejection drugs. She needed to go back on dialysis three days a week to clear toxins from her blood, but North Carolina didn't cover that, either. The best a social worker could offer was a prepaid plane ticket back to California. "When I came back here, I said, 'There is no way I'm leaving for another state again,' " said Toribio, now 29, before a technician poked two needles into her arm at the St. Joseph Hospital dialysis center in Orange, Calif. The number of patients is not large. In California, illegal immigrants account for about 1,350 of the 61,000 people on dialysis. Their treatment cost taxpayers $51 million last year. But dialysis stands out because it is often a lifetime commitment. The investment in a can easily top $1 million over time. A group of illegal immigrants sued Arizona in 2002 after the state attempted to cut off their dialysis. Heeding arguments that sporadic emergency treatments would jeopardize lives, a judge told the state to keep treating them while the case was decided. In a settlement last year, the state agreed to restore its policy of providing routine dialysis, but the settlement applies only to Arizona. Click on title for full article