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September 29, 2023

Philly hospitals would be unable to remove sick immigrants from U.S. without consent under proposed law

The legislation seeks to end 'medical deportations' – the practice of transferring the care of uninsured patients to their native countries

Government Deportation
Medical Deportation Philly Kate Frese/For PhillyVoice

New legislation in Philly seeks to end the practice of 'medical deportation,' in which hospitals remove uninsured, critically ill immigrants from the United States without their consent.

Hospitals in Philadelphia would be unable to engage in so-called "medical deportations" – the removal of critically ill, undocumented immigrants from the United States  – under legislation introduced in City Council on Thursday.

The bill would forbid hospitals from sending sick, uninsured immigrants back to their countries of origin without their consent. Instead, the patients and their families would be given greater control over the country in which they receive continued care.

Only the federal government has the power to depart people. But many American hospitals transfer critically ill, uninsured immigrants to physicians in their home countries when they fail to find a long-term care facility in the U.S. that will take them. Hospitals call this practice medical repatriation; immigration advocates have dubbed it medical deportation.

Under current law, when an uninsured people enter an emergency room, hospitals are required to stabilize them before planning for their discharges. There is no guarantee that a hospital will be able to provide longterm care for patients, but longterm care facilities often do not admit uninsured patients. 

Advocates with the Free Migration Project, an organization that provides legal assistance to immigrants, claim hospitals opt to repatriate patients to avoid the costs of ongoing care. Despite the high costs of flying critically-ill immigrants elsewhere, doing so may be less expensive than providing continued care. But immigration advocates say this practice often results in poorer health outcomes, or death.

A 2012 report from Seton Hall Law School and New York Lawyers for Public Interest concluded that practice is mostly unregulated and occurs "in the shadows." 

Under the proposed bill, Philadelphia hospitals would be required to attempt to determine immigrants' health insurance eligibility, minimize their health risks and explain the potential consequences for leaving the country, both orally and in writing, before attempting to repatriate them. Hospitals would be required to report any removal cases to the Department of Public Health and to City Council for review.

The legislation was introduced by Councilmember Jim Harrity, an at-large Democrat.

"This bill will put an end to the practice of international patient dumping," Harrity said in a release. "Patients and their caregivers should have the option to choose or decline medical repatriation and be given support to apply for emergency medical assistance if they choose to seek care in the United States. In (Pennsylvania), these patients have options and hospitals should give patients all of the information they would need to make decisions about their health." 

In 2020, a 40-year-old undocumented Guatemalan immigrant living in Philadelphia sustained major injuries to his legs, ribs and head after being hit by a motorcycle. He was taken to Jefferson Torresdale Hospital, which later attempted to send him to Guatemala without his or his family's consent. 

Claudia Martinez, the man's niece, said the hospital helped the family find other resources to keep him in the hospital after his community rallied.

"Thanks to that support, my uncle is alive today and has been able to receive treatments that improved his condition," Martinez said in a press release sent by Harrity's office. "My uncle would surely have died if he had been deported."

Earlier this year, immigration activists stopped Lehigh Valley Hospital-Cedar Crest in Allentown from conducting a medical repatriation of a 46-year-old woman who suffered a brain aneurysm last year and has been in a coma ever since, the Inquirer reported. The woman is now in a longterm care facility in Pennsylvania. 

In 2021, researchers at the University of Pennsylvania's Carey Law School found there are 350 airplane ambulances with the capacity to fly patients to other countries, and that one of them has flown more than 6,000 patients out of the U.S., often without any involvement by immigration courts or the Department of Homeland Security. 

"Medical deportation leaves families with an impossible choice – including mixed status families with U.S. citizen children and undocumented parents," said David Bennion, an immigration attorney and executive director of the Free Migration Project. "Do they stay together in a place they already left — sometimes decades ago, sometimes places they fled from in order to save their lives? Or do they face family separation, sometimes permanently? I don't wish that on anyone."