Life, Death, and Dialysis: Medical Repatriation and Liminal Life among Undocumented Kidney Failure Patients in the United States

Anthropological research on policy and health underscores how policy reflects cultural ideologies and results in marginalizing specific populations. Ethnographic inquiry can further reveal the broader, unexpected effects of policy change. In this article, I describe how state legislators in Georgia revised an existing entitlement program to specifically exclude undocumented immigrants with kidney failure from receiving life-sustaining care. This health policy change converged with broader efforts to financialize the US health system and resulted in undocumented immigrant patients dying; being medically repatriated to their countries of birth; placed in private, for-profit dialysis centers; or obtaining care through a burdensome process involving a public hospital's emergency room. Drawing from Mbembe's concept of necropolitics, I show how policy changes left undocumented kidney failure patients in a state between life and death, revealing the hidden outcomes of policies targeting immigrants. As anti-immigrant policies continue to be proposed in the United States, findings from this article provide a cautionary tale about the sweeping consequences of legislation that targets immigrants.