In the latest outrageous move against non-citizens, the Trump Administration seems to be eliminating a long-standing program that allows people with serious medical conditions and their caregivers to remain in the United States beyond the normal period of stay. The change means that children and adults with cancer, leukemia, AIDS, and other serious health problems could be deported to their deaths.

The program on the chopping block is known as deferred action. It is basically a form of prosecutorial discretion. The government simply chooses not to initiate deportation proceedings against a person who is in the U.S. without status. In some cases, the person may receive permission to work. A person could receive deferred action for different reasons, but for the cases at issue here, the non-citizens were permitted to remain in the U.S. due to serious--and often life-threatening--health problems. Here is a statement from USCIS, as conveyed to the American Immigration Lawyers Association--
USCIS field offices will no longer consider non-military requests for deferred action, to instead focus agency resources on faithfully administering our nation's lawful immigration system. This redirection of agency resources does not affect DACA or other deferred action requests processed at USCIS service centers under other policies, regulations, or court orders (such as VAWA deferred action and deferred action related to the U nonimmigrant status waiting list). As deferred action is a type of prosecutorial discretion used to delay removal from the United States, USCIS will generally defer to the DHS component agency responsible for removing individuals from the United States - U.S. Immigration and Customs Enforcement (ICE) - to make most non-DACA, non-military deferred action determinations.

USCIS confirmed that this change became effective on August 7, 2019, and that no public notice about the change was issued. The public is being informed about the change on an individual, case by case basis.

This basically means that medial patients and their caregivers who applied for deferred action may now be denied. The denial letters that I have seen in the press indicate that applicants have 33 days to leave the United States or face removal proceedings. The letters do not indicate how these medical patients can apply to ICE for deferred action, and at this stage, it is unclear whether ICE is even accepting such applications.

You can imagine how these denials would affect sick people (many of whom are children) who suddenly learn that they have to leave the U.S. and quite possibly lose their medical treatment. Here is a statement from Jonathan Sanchez, who has cystic fibrosis and whose sister earlier died from the same disease:
"If they deny the program, then I need to go back to my country [Honduras], and I'll probably die because in my country, there's no treatment for CF [cystic fibrosis]," Sanchez said, crying and trying to catch his breath. "Doctors don't even know what's the disease. The only ones who can help me are here in the United States."

Even if he is ultimately allowed to remain here for treatment, the idea that this boy has been threatened with deportation at a time when he is fighting for his life is a true horror. From my point of view, the fact that we are even having this conversation is extraordinarily repulsive. That our country would mistreat people--especially children--in this manner is a black stain on our nation (one of many, unfortunately). All that said, the question I want to address here is, Can these medical patients (and their family members/caregivers) make a viable claim for asylum, so that they can try to remain in the country?

First, to receive asylum, you need to demonstrate that you filed for asylum within one year of arriving in the United States. There are exceptions to this rule, and if you have (or had) deferred action, you may meet such an exception (the "extraordinary circumstances" exception). However, once deferred action ends, you must file within a "reasonable" period of time; otherwise the asylum application will be considered untimely filed, and it will be denied. What is a reasonable period of time? There is no set definition, and I have seen cases indicating that two or three months is reasonable, but six months is not reasonable. So the bottom line is, if your deferred action ends and you want to request asylum, you should file your application as soon as possible.

Second, in some deferred action cases, more than one family member is in the United States (for example, a sick child and a caregiver parent). Certain family members can file for asylum together, and so it is worth considering which family member, if any, has a viable asylum case. An adult asylum applicant can include a spouse and any minor, unmarried children in her asylum case. A child who is over 21, or who is married, cannot be included in a parent's asylum application. An unmarried couple would each have to file their own application for asylum. A child with his own asylum case cannot include a parent in that case (though sometimes when a child faces persecution, the parent can articulate her own, independent claim - an example might be where the child faces FGM or female genital mutilation, and the parent faces harm for trying to protect the child). So you have to think about who in the family might have a claim for asylum, and whether all family members could be included in that application.

Third, if a person was persecuted in the past--even the distant past--based on race, religion, nationality, political opinion or particular social group, he may be eligible for "humanitarian" asylum or "other serious harm" asylum. Humanitarian asylum is available to people who have faced severe persecution in the past. Even if the country is now safe, we allow the person to remain in the United States rather than force him to go back to a place where he faced terrible harm. I once did such a case for a Rwandan woman whose family was massacred during the genocide, when she was only 11 years old. The Immigration Judge found that the harm she suffered qualified her for humanitarian asylum, even if it would be safe for her in Rwanda today. Other serious harm asylum is for people who suffered persecution in the past based on their race, religion, nationality, political opinion or particular social group. If such a person would face any other serious harm today, even if that harm is not on account of a protected ground, she can qualify for asylum. So for example, if a woman was subject to FGM as a child (FGM is persecution on account of a particular social group) and today, she faces harm due to a lack of medical treatment for cancer, she might qualify for "other serious harm" asylum.

Finally, what if there is no basis for asylum other than the medical condition itself? Such cases are often difficult, since there needs to be a "persecutor" - someone who wants to harm the asylum applicant. Poor hospital conditions or lack of medical care--without more--would not normally qualify for asylum protection. But sometimes, people with medical conditions face discrimination that rises to the level of persecution. For instance, we once obtained protection for a Mexican man who was HIV positive. We argued that discrimination in Mexico was so severe that his life would be at risk there. For people from countries where law and order has broken down, one argument might be that people with medical conditions will be targeted by criminals or member of society due to their particular vulnerabilities. Central American countries with rampant gang issues may be places where vulnerable people are specifically targeted by gang members, and maybe that could form the basis for an asylum claim. Other medical conditions, such as albinism, are so stigmatized in certain societies that people with those conditions face harm or death. The key to cases like these often involves obtaining country condition information that demonstrates the danger faced by people with medical conditions. Specific examples of people who were harmed can also help. For example, we did a case where a Turkish man faced imprisonment for political reasons. The man had leukemia, and so we argued that even a short imprisonment would be life threatening. We supported our claim with newspaper articles about people who died in prison due to health problems. These articles demonstrated that the harm faced, at least for this specific person, was severe enough to qualify him for asylum.

The status of deferred action cases is still unclear. Will ICE announce a procedure for people with serious medical conditions to apply for deferred removal? Will USCIS respond to the backlash and re-institute the program? It now appears that cases filed before August 7, 2019, which were denied, are now being reopened, but the fate of the program going forward seems uncertain (at best). For those affected, it is important to start thinking about alternatives. One such option may be asylum; other options may exist as well, depending on the case. Talk to a lawyer, and if you cannot afford a lawyer, remember that free or low-cost help is available. Unfortunately, this new change affects the most vulnerable, and it is easy to lose hope. But there are many people who want to help, and the sooner you take action, the more likely you are to find an alternative way to remain in the United States.

Originally posted on the Asylumist: