The New York Times on Sunday examined how U.S. "hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance." The article is the second in a series, titled "Getting Tough," that examines efforts by government and other organizations to coerce undocumented immigrants to leave the U.S.

According to the Times, newly arriving documented and undocumented immigrants qualify for emergency medical care only under Medicaid, which "covers only a small fraction" of costs. In most states, the government does not provide funding for post-hospital care for undocumented immigrants, temporary immigrants and documented immigrants who have been in the U.S. for less than five years. Under federal law, hospitals receiving Medicare funds must transfer or refer patients to "appropriate" post-hospital care, the Times reports. According to the Times, the "hospitals are operating in a void, without governmental assistance of oversight, leaving ample room for legal and ethical transgressions on both sides of the border."

Some hospitals choose to turn these immigrants over to the care of their home country; however, some immigrant advocates "see these repatriations as a kind of international patient dumping, with ambulances taking patients in the wrong direction, away from first-world hospitals to less-adequate care, if any," the Times reports. Some hospitals say the only alternative to deportation is to keep these immigrants in acute-care hospitals indefinitely. According to the Times, "Hospital administrators view these cases as costly, burdensome patient transfers that force them to shoulder responsibility for the dysfunctional immigration and health care systems."

Lawsuit

The Times profiles Luis Alberto Jimenez, an undocumented immigrant who was injured in a car crash involving a drunk driver. Florida-based Martin Memorial saved Jimenez' life twice. Then, after being unable to find a rehabilitation center willing to accept an uninsured patient, Martin Memorial cared for him for years at a cost of $1.5 million. The hospital then sought to return him to Guatemala, his home nation. Circuit Court Judge John Fennelly granted the hospital's request to return Jimenez to Guatemala, which claimed it would provide care to him upon his return, the Times reports. Martin Memorial spent $30,000 for an air ambulance to transport Jimenez back to Guatemala.

The ruling later was overturned by the Fourth District Court of Appeals. The court said that there was no evidence to support that Guatemala would provide the appropriate care for Jimenez required under federal law and that Fennelly overstepped his bounds in a deportation issue that should have been handled by the federal government. According to the Times, "The decision has become what is known legally as a case of first impression on the issue of hospital repatriations." Later appeals court rulings in Jimenez' favor also ruled that the hospital can be sued for punitive damages and the cost of his medical care. The case is pending (Sontag, New York Times, 8/3).

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