Making Healthcare “Illegal:” A comparison of legal barriers to accessing health services for immigrants in Germany and the US

Unauthorized immigration remains a contentious topic worldwide, and measures to constrain unauthorized immigrants' access to health care have emerged through various legislative processes. This presentation discusses the legal constraints in accessing health services for unauthorized immigrants in Berlin, Germany, and Atlanta, Georgia, USA. In Germany, assisting unauthorized individuals, including for medical treatment, can result in imprisonment and fines, and legal debates have focused on whether or not physicians should be held liable for treating undocumented patients. In Georgia, USA, one of the state's many immigration-focused laws, H.B. 87, potentially implicates health service professionals providing non-emergency care with “harboring an illegal alien.” Both examples of Germany and the United States present considerable questions about immigrants' health seeking behaviors, as well as providers' obligations to uphold professional ethics while also abiding federal and local laws. The topic is especially important given the spread of statewide immigration laws and the growing number of jurisdictions that participate in the federal Secure Communities program, all of which may impact immigrants' health seeking behaviors. Through a comparative approach, this presentation offers theoretical insights informing research and action steps for immigrant health researchers and medical professionals who serve immigrant populations.