Advocates want legislative reform for Medical Deportation. Where do Philadelphia’s 2023 Mayoral Candidates fall on the issue
The practice of deporting an immigrant patient who is critically injured or ill without consent is federally unregulated, but is not necessarily uncommon in PA.
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Editor's Note: Carlos Nogueras contributed reporting.
The practice of medical deportation is a newer phenomenon. One that has flown over the heads of federal and local authorities as this rather new routine goes largely unreported and sits on the thin line between a medical and political issue.
It is the private deportation of an undocumented immigrant patient who is critically injured or ill back to their country of origin, but for advocates, lawyers, and the several families this has or almost affected, it’s a fiscally-centered decision made by the hospital and the healthcare system as a way of eliminating any further costs for care and treatment, especially for a disease such as cancer.
“Immigrations and Customs Enforcement (ICE) is not involved. The Department of Homeland Security (DHS) is not involved,” said Adrianna Torres-García, Deputy Director of Free Migration, one of few immigration advocacy groups shedding light on the medical deportation phenomenon in Pennsylvania.
“But the hospital is acting as a deporter when they don't have that power. They're doing it against the family's wishes. It's either through coerced consent, or they just don't consent at all.”
She explained that through “coerced consent,” hospitals will not provide the information that people need to make a decision that's good for them. They won’t provide adequate language access or make people sign things that are in a language that they do not understand.
In PA, several patients in the last three years have almost been subject to being deported had it not been for the successful intervention by several local immigration advocates and organizations.
In early 2020, an undocumented Guatemalan immigrant — identified by his family as A.V. — suffered a serious and life-threatening brain injury after a motorcycle accident.
He was nearly medically deported by Jefferson Torresdale Hospital in Philadelphia, but because of interference by advocates and a local immigration organization — the Free Migration Project — A.V.’s deportation was averted, and he was later moved to a long-term care facility in the Philly region.
In March, the Free Migration Project, along with other organizations, including Pennsylvania Immigration and Citizenship Coalition, CASA Pennsylvania, and Make the Road Pennsylvania, fought and won on behalf of another immigrant patient who was facing the same fate A.V. once did.
A Dominican mother from Allentown, PA, known as S.C., has been in a coma since December 2022, following complications from surgery after suffering a brain aneurysm. In March 2023, the organizations announced that they had halted her deportation following productive talks with hospital management.
By law, hospitals must treat a patient, regardless of immigration status or ability to pay, until he or she is stabilized. Once that patient has been stabilized, hospitals usually will look for appropriate and suitable places for discharging, such as a rehabilitation facility, but all of that is determined by individual health insurance.
For immigrant patients who might not otherwise be covered, they are rejected by the facility, and their undocumented status does not allow for an outside charity to front the costs. Still, Torres-García stressed that it shouldn’t deter undocumented citizens from seeking care.
“This is not meant to scare undocumented people from accessing health care. What we're trying to do is educate people to understand and look at the signs and be able to act quickly when they or one of their family members is threatened with medical deportation,” she said.
“And to know that there are resources in Pennsylvania and in Philadelphia that they can access either from us or other organizations to stop this,” she underpinned.
In medical deportation, hospitals will charter private flights, but the transit itself will often only lead to further aggravation of their illness or death, she said. Some patients are sent back to their home countries, where they might be unable to obtain the care needed to treat what are usually very serious ailments.
It is ungoverned, unregulated, and done oftentimes without the consent of the patient or their family. And when it comes to transporting a patient internationally, there are no guidelines currently that require any follow-up on the patient, as opposed to transporting a patient domestically.
“That's why we're pushing for legislation, even just at the local level. That could be a starting off point for other locations to adopt and protect people. There's nothing telling hospitals ‘you can't do this.’ If someone is uninsured, the hospitals only have the obligation to treat until the person is stable. After that, there is no incentive to keep treating people with a chronic condition,” she said.
From the hospital's point of view, medical deportation makes sense as it is a large, albeit one-time expense that means the end of indefinite and high costs of continued hospitalization.
The deportation also allows for the opening of a new bed for the next patient, who is probably insured.
“There are ways in which this phenomenon can be legitimate. And that is medical repatriation. The same thing can happen to people who are traveling from other countries to the US. But the difference is consent. Because I am consenting to be transported and I'm asking to be transported, these families are vehemently saying no,” she said.
With the upcoming Mayor having limited authority to act fully on medical deportation, Torres Garcia pointed to City Council as being the body of government with the true ability to change things.
“I would expect more of council members because they are the ones that can pass legislation. Ultimately it goes to the desk of the mayor, and sure they can veto it,” she said. “But we are really approaching it and trying to educate all of the councilmembers, because they're the ones who have the power to take action on this,”
Back in June 2021, researchers in the Legislative Clinic at the University of Pennsylvania Carey Law School and Free Migration Project, authored a report on the use of medical deportations in the U.S., “Fatal Flights: Medical Deportation in the U.S.,” which is one of not too many readily available reports on the issue.
The authors, which include Toll Public Interest Fellow Erica V. Rodarte Costa, Jacqueline Monnat and Free Migration Project’s Executive Director David Bennion and Torres-García, write that medical deportation is rarely in the patient’s best medical interests and usually results in poorer health outcomes — or even death — for the transported patient.
Where do candidates fall on the issue?
Former Councilmember Cherelle Parker cheered the city’s current status as a sanctuary city in her statement to AL DÍA, saying, the municipal government has very limited ability to prevent the practice.
“When it comes to the unconscionable practice of these medical deportations, I will work with state and federal authorities and use the bully pulpit of the mayor’s office to bring leadership of area hospitals together to do everything we can to prevent this practice,” said Parker.
Former Councilmember Helen Gym has spent a career as a political organizer and educator, who knows all too well the fight for fair immigration, as she once won the first city budget line item, according to her statement, to establish a legal defense fund for immigrants facing deportation, that went on to attract national attention and matching funds from national and local foundations.
“Helen spent years fighting the racist deportation machine that tears family members from their children, breaks apart communities, and threatens the health and wellbeing of individuals in need of medical care,” Gym’s statement read. “She called for and successfully ended the City’s information-sharing agreement with Immigration and Customs Enforcement (ICE).”
Her statement also cited her 2017 citywide campaign to raise funds to support Pennsylvania applicants to the Deferred Action for Childhood Arrivals (DACA) program and increase access to legal assistance and 'know your rights' education for immigrant families.
According to her statement, they’re actions she’s committed to continue fighting for if elected, alongside grassroots organizations like Juntos, as well as local, state, and federal immigrant rights groups, lawmakers, and local hospitals
“No community member should move through the city or avoid seeking medical care out of fear of being senselessly torn away from their home and their loved ones. Every medical deportation is a policy failure. Under Helen’s leadership, Philadelphia will always be a sanctuary city — where schools, hospitals, and public safety officers support immigrants, and build trust with them — not threaten to deport them." the statement concludes.
Former Councilmember Allan Domb, said the state “100%” does not need to be involved with medical deportations.
"We are a country built on immigrants, laws — and compassion. Although there are only a limited number of circumstances where someone would be deported while medically unable to participate in the legal process deportation requires, I 100% believe we should not be part of any medical deportations,” he said.
He said he’d work with federal and state officials to ensure the practice does not occur in Pennsylvania.
“We need to have a strong, robust and most importantly, fair immigration process — and there's nothing fair about deporting people knowing it means almost certain death because they can't care for themselves due to illness,” Domb concluded.
“No matter your immigration status, every patient deserves life-saving treatment and every family deserves to have full consent over their loved ones’ care,” said Rebecca Rhynhart in a statement to AL DÍA.
She called medical deportations “inhumane” and said they should not be occurring today. One of few favorites for the Mayor’s job, she said it should be a first-term priority to take action that would prevent this from happening again.
“This practice may also be unlawful given that the federal government is the only entity with legal authority to forcibly relocate individuals,” she said.
The former City Controller added she’d work with local policymakers, advocacy groups, and experts on this issue to determine what roles and authority to play as mayor to end this practice in the first year of her administration.
She told AL DÍA, she supports the measures put forth by City Council to protect and inform families of their rights “in scenarios where they or their loved ones may end up at risk of medical deportation.”
“We should be connecting families who may be subject to this practice with resources to navigate or prevent this from happening by partnering with experts and advocacy organizations focused on this issue,” she said.
Rhynhart named the families and patients who are at risk of being impacted by this policy, as the most central stakeholders within this issue, and praised the work of the several organizations and community groups involved with preventing this practice, while calling on the federal government to use their “greatest power” and intervene.
“I view organizations and community groups advocating for more humane immigration policy as valuable allies in this conversation as well as local policymakers on city council who I would like to work with on advancing helpful policy in our city to protect the rights of individuals who may be targets of this practice,” Rhynhart said. “I view state and federal policymakers as having the greatest power to make an impact on putting an end to this issue.”
She concluded that health care providers and facilities are also crucial stakeholders and collaborators in order to determine how to best work together to prevent medical deportations.
“An additional stakeholder includes the companies that profit from and facilitate this immoral and unlawful practice when patients and their families do not consent and are subject to forcible relocation,” she said.
Other candidates, Amen Brown and Jeff Brown, did not return multiple comment requests from AL DÍA.