ALLENTOWN, PA. — Junior Clase’s cluttered kitchen table paints a picture of his life in the United States. Scattered across it are bottles of deodorant and conditioner that he sends back to the Dominican Republic, a Spanish-language Bible and a plastic medical brace for his wife, Solibel Olaverria.
Olaverria began having intense headaches and vomiting five months after she joined her husband in the U.S. In the emergency room, she was diagnosed with a brain aneurysm; during surgery to stop it from rupturing, she suffered a stroke and was induced into a coma.
She left the couple’s Allentown row house in December 2022 and has yet to return. Clase worries she never will.
In February 2023, Clase said, hospital administrators suggested transporting his still-comatose wife to a facility back in the Dominican Republic – an option he refused.
“They told me that they could send her back to my country,” he said – even without his consent. “At that moment, she was missing a piece of her skull. … If they put her in an airplane or a helicopter, it was possible that she would die.”
Though the federal government is the only entity with the jurisdiction to remove people from the U.S., hospitals across the nation sometimes return uninsured noncitizen patients in need of long-term care to their countries of origin.
Advocates call this “medical deportation.” Hospitals and medical transport companies refer to it as “medical repatriation.” By either name, the practice exists in ethical and legal gray areas – without specific federal regulations, widespread public knowledge or a national tracking system.
Facing limited options for care, some immigrant patients and family members may voluntarily decide to continue treatment outside of the U.S. Other times, experts say, the process occurs without full consent.
Lori Nessel, a professor at Seton Hall University who supervised a 2012 report about medical repatriation, said the practice amounts to “private deportation.”
“They were essentially being deported,” she said, “but outside of the legal process for deportation, because there was no immigration court involved.”
While some foreign governments track these repatriations, data is inconsistent and doesn’t reflect whether patients wanted to return, felt they had no other option or were forced to leave.
Since 2020, the Philadelphia-based Free Migration Project has tracked 19 cases of patients facing medical deportation, through referrals and a telephone hotline it runs. Six of those came in the first six months of 2025, from cities in Pennsylvania but also Florida, New Jersey and New York, according to Adrianna Torres-García, deputy director of the organization.
Experts believe medical deportation happens more than tracking efforts account for, and some worry cases could now increase, given that the practice sits at the intersection of health care and immigration.
Early on, Olaverria was able to get treatment under a federal law that requires hospitals to provide stabilizing care to anyone with an emergency condition, regardless of insurance, ability to pay or immigration status. But recent changes threaten to leave even more immigrants uninsured and provide less funding for emergency care if they need it.
Patients “get sent bills that they often can’t pay, that often are going to go to collections,” said health policy researcher Benjamin Sommers. “Sometimes we see hospitals diverting patients. … I think there’ll be more of that.”
U.S. citizens might be discharged to other hospitals, long-term care facilities or their families. Noncitizens, with limited access to health insurance, might instead get sent to a facility in their country of origin.
Local advocates connected Clase with the Free Migration Project, which organized protests against Olaverria’s transfer. After media coverage of her case, hospital administrators agreed to hold off on the transfer if they could work together to find another long-term care option.
Media coverage helped bolster interest in a bill before the Philadelphia City Council to stop nonconsensual medical repatriations. In December 2023, it became the nation’s first law banning the practice.
Claudia Martínez participated in the campaign to pass the law after her uncle faced medical repatriation. “I don’t want anyone to go through what I went through,” she said.
In May 2024, Olaverria woke up from the coma after being transferred to a long-term care facility. Later that year, Clase and his wife obtained medical deferred action, allowing them to remain in the country temporarily.
Despite uncertainties, Clase now focuses on his daily visits to his wife, keeping hope alive through his love and dedication. “The majority of my time,” he said, “I dedicate it to my wife.”
