Jesus Navarro, An Undocumented Immigrant, Denied Kidney Transplant Despite Willing Donor And Insurance Coverage

UCSF Denies Dying Immigrant Kidney Transplant Despite Donor And Insurance

Jesus Navarro had everything he needed to get a kidney transplant in the United States--private insurance and a willing donor, his wife, with a compatible blood type.

The one thing he didn't have was a green card.

It was the Oakland resident's undocumented status that caused officials at UCSF Medical Center to refuse to perform the necessary medical procedure needed to save Navarro's life from the kidney failure he began experiencing nearly a decade ago.

"UCSF's policy for financial clearance requires candidates to present evidence of adequate and stable insurance coverage or other financial sources necessary to sustain follow-up care long after transplant surgery," Recce Fawley, UCSF's executive director of transplantation, told the Contra Costa Times in a statement. "Immigration status is among many factors taken into consideration."

Even though Navarro was in the country illegally, he had private insurance from the 14 years he worked at the Pacific Steel foundry in Berkeley. He lost his job earlier this month as a result of an internal immigration sweep by the company; however, his insurance carrier is still covering him.

If he loses this insurance and ends up on the rolls of California's Medi-Cal program, which the Contra Costa Times said was likely, it would pay for his dialysis but--because he is in the country illegally--not the transplant itself or the drugs that would be necessary after surgery to prevent his body from rejecting the kidney. UCSF's lack of confidence in Navarro's ability to afford the drugs was at the crux of the hospital's decision to deny the procedure.

In the years since the Connie Frank Transplant Center was established in 1964, UCSF has performed more kidney transplants than any other hospital in the world.

Health care for undocumented immigrants has long been a contentious issues both in California and nationwide. In 1994, California voters passed Proposition 187, which would have prevented all illegal immigrants from using any publicly funded health care services had it not been subsequently deemed unconstitutional by a federal judge.

Republicans in the Arizona legislature last year considered a bill that would have required all hospitals in the state check a patient's immigration status before administering care.

According to a study by the United Network for Organ Sharing, undocumented immigrants in the United States donate significantly more organs than they receive. Transplant Week reports:

Immigrants who are in the U.S. without proper papers account for about 2 percent of all cadaver organs donated in the United States and receive just over one percent of all U.S. organ transplants, according to UNOS.

Last year, a similar case to Narvarro's made the news in New York City, an undocumented waiter was unable to get funding for a $100,000 kidney transplant from his brother, even though his government insurance was willing to pay for his dialysis to the tune of $75,000 annually.

"As a physician, it puts you in a real ethical dilemma," said Dr. Eric Manheimer, Bellevue's medical director, noting that a transplant would sharply reduce Angel's risk of death from complications. "The ultimate irony is it's cheaper to put in a transplant than to dialyze someone for the rest of their life."
"Here's the paradox: he could donate, but he can't receive," Dr. Manheimer said.

Correction: In the original article, it wasn't made explicit that the reason Medi-Cal wouldn't pay for Navarro's anti-rejection drugs was because he is an undocumented immigrant. For legal U.S. citizens, Medi-Cal covers the cost of the drugs for two years after the operation.

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