Immigration Backlogs Jeopardize Child’s Organ Transplants

While debates on immigration policy often tend towards philosophical ideas, in practice the immigration system in the United States can lead to serious and even life-threatening situations. Eleven-year-old Julia Espinosa was born in Miami while her parents were attending college on student visas. Julia was born with a congenital malformation to her small intestine, which prevents her from eating normally. As a lifesaving measure, doctors removed most of her small intestine. Julia survives by getting daily infusions of nutrients through an intravenous post in her chest.

Due to Julia’s critical condition, which requires specialized care not available in their home country, her parents’ plans to return to Ecuador upon their college graduation had to be discarded. Instead, the family moved to Seattle a decade ago to be near Seattle Children’s Hospital, where she is treated by specialists who understand her condition. Julia’s internal organs are damaged due to her nutritional infusions, and so she is now on transplant lists for her small intestine, as well as her deteriorating liver and pancreas.

Because intestinal transplants aren’t available in Ecuador, the Espinosa family applied for Medical Deferred Action to remain in the United States. Once revoked under the Trump Administration and later reinstated, Deferred Action gives foreign nationals the opportunity to request that United States Citizenship and Immigration Services (“USCIS”) defer removal or deportation for humanitarian reasons. If granted, individuals are eligible to apply for employment authorization. While Julia is a US citizen, her parents are citizens of Ecuador, and so must apply for Deferred Action every two years to remain in legal status.

Because their most recent Deferred Action and work authorization are set to expire in July 2022, Mr. Espinosa filed his application to renew the Deferred Action in a timely manner in November 2021.  The family’s Deferred Action was just recently approved by USCIS after appeals from members of Congress and the press. However, due to the case processing backlogs that have been consuming USCIS, Mr. Espinosa still awaits approval of his work authorization, which not only secures his employment but also the health insurance for his family. If the family loses health insurance because USCIS does not process their work authorization in a timely manner, Julia will be removed from the transplant list. Unfortunately, work authorizations stemming from Deferred Action applications are not covered under the temporary increase of automatic extension period for certain renewal applicants’ employment authorizations recently implemented by USCIS.

Julia’s story is heartbreaking, but she is not alone. Many people face uncertainty due to the backlogs that plague our immigration system. Mahsa Khanbabai, a board member for the American Immigration Lawyers Association, said “this is a very good example of a broken system… there’s just a lot of heartbreak that could easily be fixed with immigration reform.” For now we look forward to the Espinosa family receiving their work authorization in a timely manner and Julia continuing her dedicated care in Seattle.