Citizenship often determines who gets medical care

Roughly 2,000 times over the last 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. Health services and other benefits available to illegal immigrants can vary by the state. Welfare, prenatal care or in-state college tuition might be available in one place and inaccessible across a state line. The disparities reflect the nation’s conflicting attitudes toward its estimated 12 million illegal immigrants. With limited federal guidance, states often are left to make their own decisions, frequently shaped by political winds.