Imagine you’re an immigrant in the United States. Maybe you’re undocumented. Or maybe you’re a lawful permanent resident. One day, on your way to work, a drunk driver side-swipes you—sending your car somersaulting. You miraculously survive the accident, and the paramedics take you to the ER. Doctors work tirelessly to stabilize you.
When you awake, to your shock and horror, you find yourself not in the hospital where you had been, not surrounded by your loving family, but rather in a medical facility in your home country. What on earth happened?
This is a practice known as “medical repatriation.” It’s a topic not widely discussed in the news, because it often happens privately between a hospital and a foreign consulate—without any U.S. federal government involvement. In addition, hospitals are not required to disclose when medical repatriation—also known as medical deportation—occurs.
Why does this happen?
Medical treatment is expensive. The law requires emergency rooms to treat anyone in an “emergent state”, regardless of the patient’s ability to pay for such treatment. However, once the patient is stabilized, if they are uninsured or underinsured, the hospital will push to get them discharged—even if they need long-term care—because hospitals can’t afford to absorb the cost of such care themselves.
What are the consequences?
This practice can be especially damaging to vulnerable patients. If you’re a foreign national with insufficient insurance, the hospital may try to transfer you back to your home country to handle your medical care—even if the medical facilities in that country are inadequate to give you the treatment you need.
From an immigration perspective, the ramifications are severe. If you’re an undocumented immigrant, medical repatriation can amount to deportation. You could be barred from re-entering the country and separated from your family. If you’re a green card holder applying for naturalization, you’re required to stay continuously in the U.S. for a certain amount of time. Being involuntarily removed could mean you abandon your status in the U.S.
What can you do?
If you’re a foreign national, it’s important have a designated power of attorney (POA) to make decisions on your behalf, in case you’re ever incapacitated. You POA should give a notarized letter to the hospital case manager—making your wishes to remain in the country clear. You—or your POA—should also consult with an immigration attorney. Hospitals that operate without getting informed consent are violating a basic precept of medical ethics, and an experienced lawyer can effectively advocate for you.