Update: UofL Hospital officials told the man's family on Monday afternoon that his transfer to Guatemala is on hold indefinitely out of concern for his health, according to the man's daughter, Virginia. The original report from KyCIR, published Monday morning, is below.
A 23-year old woman named Virginia C. said she’s been wrestling with an impossible decision since last Thursday: Give doctors at the University of Louisville Hospital permission to take her father off life support or see him put on a plane and sent to Guatemala, the country where her father was born.
Her father, Marvin, is an undocumented immigrant who left the Central American country three decades ago for the promise of prosperity in the United States. Virginia said he suffered a seizure earlier this month, falling down a set of stairs in his home and hitting his head. Marvin, 49, has been in a coma at the hospital ever since.
Hospital officials are threatening to remove the man from the U.S. because he doesn’t have insurance and is unlikely able to pay the steep costs that will come with the care needed for his recovery, according to Virginia and attorneys with the Free Migration Project, a Philadelphia-based nonprofit that advocates for the abolition of deportation. The nonprofit is working to help Virginia keep her father in the U.S. — the place she said he’s made his home.
Virginia asked KyCIR to withhold publishing her full name or her father’s out of fear of retribution.
Hospitals that remove an undocumented patient from the U.S. because they cannot afford the cost of care is a process known as “medical deportation,” said David Bennion, an immigration attorney and executive director of the Free Migration Project. The practice is not uncommon, but one that Bennion said is deeply problematic for its cruelty and lack of safeguards provided to patients facing critical injury or illness and in need of sophisticated medical treatment. He said the practice is better referred to as “involuntary medical repatriation” or, simply, “kidnapping.”
“It's kind of shocking that hospitals and medical transportation companies do this routinely.”
A UofL Hospital spokesman said privacy laws prevent officials from discussing an individual patient’s medical care. David McArthur, the spokesman, said UofL Health routinely works with families to help place patients that no longer require hospital care at other appropriate facilities.
“Finding a facility that can provide care and is located close to family are both priorities,” McArthur said in an emailed statement to KyCIR. “In the case of international patients, sometimes the best fit is with family in their country of origin. We always work to ensure a smooth transition of care and financially support the transportation when necessary.”
An unknown practice
The extent of medical deportations nationwide is not widely known — in part because there is no systemic reporting mechanism to track how often hospitals remove undocumented patients from the country, Bennion said. The removals often happen without court or law enforcement intervention.
The Free Migration Project spearheaded an effort in Philadelphia last year to ban medical deportations. City officials passed a law to do just that and require hospitals to look for other solutions.
A 2021 report from the Free Migration Project found one medical transport company that flies patients out of the country has transported thousands of people to more than 100 countries. According to the report, the company, MedEscort, touts its service as a tool to help hospitals avoid the financial losses that could come with treating an undocumented patient who doesn’t have health insurance.
The University of Louisville Hospital reported $1.1 billion in revenue in its 2022 filings with the Internal Revenue Service.
An American dream, turned ‘death sentence’
Virginia said she broke down in tears when hospital staff entered her father’s room a week after doctors asked for permission to perform a tracheostomy and presented her with the possibility that he could be sent back to Guatemala.
“They just want to really get rid of my father, since he doesn't have insurance,” Virginia said in a telephone interview with KyCIR. “I’m his best support over here. I’ll do anything it takes for my father. It’s just not fair.”
Her father, Marvin, moved to the United States in the 1990s as a young man wanting a better future than he could find in his home country. He built a family with a woman also from Guatemala and together they raised two daughters and have one young grandson. Marvin worked in Kentucky’s storied horse racing industry. But he was thrown from horse about 15 years ago, Virginia said. He suffered a head injury that caused him to have intermittent seizures ever since.
“My father, ever since he got to the U.S., he's been working,” Virginia said. “He's never broken a law, never murdered anybody. He just went from work to home and from home to work and spent time with me, my sister, my mom and my son.”
Earlier this month, Marvin was walking down the stairs to the basement of his home when a seizure began and he fell to the floor, hitting his head.
Virginia has spent the days since either at work or at his bedside. Her father responds to his family’s voice by fixing his posture or wiggling his toes, she said.
“I just never imagined seeing my father go away like this,” Virginia said.
She said she always imagined her father growing old, beaming with pride as his daughters accomplished their goals and filled his home with grandchildren.
“It feels like I'm in a dream and then the hospital is just putting more pressure on me every single day,” she said.
The hospital staff say they will send her father Guatemala on Wednesday, Virginia said.
The move would amount to “a death sentence,” said Duffy Trager, an immigration attorney in Louisville.
Hospitals in Guatemala do not have the same resources or obligations to provide care for uninsured patients, Trager said.
“If we, the supposedly richest country in the world can’t do it, then they sure as hell can’t do it [in Guatemala],” Trager said.
Chloe Atwater, an attorney with the Kentucky Equal Justice Center, said she had never heard of medical deportations until Virginia reached out to her last week, seeking help.
Atwater said she was shocked to hear it happening in Louisville and said her office is exploring legal options to keep the family together.
“This is not ICE [Immigration and Customs Enforcement] deporting somebody,” Atwater said. “This is a completely extra-judicial process that, if you substitute in a U.S. Citizen for an undocumented person, I don’t think that anyone would bat an eye to call it kidnapping.”
The story has been updated.
