On Monday September 2^nd, the Trump Administration announced a change to a policy that allowed immigrants to receive a temporary reprieve from deportation while receiving life-savings medical care in the US. In a joint statement from the American Society of Nephrology (ASN) and the American Society of Pediatric Nephrology (ASPN), the societies raised concerns about this the decision due to the harmful effect it will have on immigrants—children, their families, and adults—currently on dialysis treatment in the US.

US Citizenship and Immigration Services (USCIS)mailed letters to an unspecified number of people in mid-August informing them of the ending of the “medical deferred action” policy, meaning that in 33 days all those who had previously received a decision by Immigration and Customs Enforcement (ICA) or a judge to temporarily not be deported because they met medical or financial hardship criteria, must leave the country.

Kidney News Online spoke with Dr. Scott Bieber, who is a nephrologist at a Seattle, Washington hospital, and the chair of the ASN Quality Committee. He currently treats around 20 undocumented immigrants with kidney failure with life-sustaining dialysis treatments and he expressed that if these patients were deported, it would almost certainly be a death sentence. “They would be returning to countries where either dialysis care is not available or they do not have the financial resources to afford dialysis. Many of them would not even qualify for social/medical programs in their birth countries because they have lived in the US for so long. None of these patients are immigrants that developed kidney failure and then immigrated to the US. In fact, they are all young, working age adults who often have been working and raising families in the US for decades and some do not even know or remember their birth country,” said Dr. Bieber.

CBS News reported that “USCIS has said it has received about 1,000 deferred action requests a year, but that the "majority" have been denied. Going forward, USCIS said it will defer to Immigration and Customs Enforcement (ICE) so that agency can determine whether to grant non-military deferred action.”

Immigrant advocates as well as more than 100 Congressional Democrats have issued criticism regarding the change in policy.

 “Pediatric nephrologists are unique in that they provide care to children covered by both Medicare and Medicaid, and limiting access to end-stage renal disease (ESRD) care will be catastrophic for these children. Similarly, more than 40 percent of the adults receiving ESRD care in the Medicare program, treated by adult nephrologists are dual-eligible for Medicaid. We are concerned that the final public charge rule will cause patients and families to disenroll from or avoid critical health programs and services that they are otherwise eligible to receive. Furthermore, ending the Medical Deferral Program will harm children who need lifesaving care such as dialysis for kidney failure, many of whom face certain death if forced to return to areas of the world without the resources for such treatment. This arbitrary policy change jeopardizes the patient-provider relationship, prohibiting nephrologists treating both children and adults from providing medically-necessary and life sustaining care.

The statement continues, “we urge the Administration to reverse the public charge final rule and the changes to the Medical Deferral program, which will both carry serious consequences for the health of the children and adults we treat as well as their families”.

The House Oversight Committee is conducting a hearing on this issue on Wednesday, September 11. Stay tuned to Kidney News Online for further coverage.

Please see the full text of the joint ASPN/ASN statemen t.

Resources:

https://www.cbsnews.com/news/medical-deferred-action-trump-administration-will-process-some-deferred-deportation-requests-from-sick-immigrants/