Two more patients say they faced questions around citizenship at hospitals in Philly and Abington

Two more patients say they were asked questions concerning their citizenship at local hospitals, driving tensions at a time when the Trump administration is pressing its efforts to deport millions of immigrants.

A West Philadelphia woman said she was asked if she was a U.S. citizen when she sought medical care at the emergency room at the Hospital of the University of Pennsylvania in May. And an Abington woman said she was asked, “Were you born in the United States?” while registering for treatment at Abington Hospital this month.

Both said they wondered why that information was being sought. Both are U.S. citizens, but feared the potential impact on those already wary of seeking treatment because they may be undocumented or have uncertain immigration status.

At least five other people in the region responded to earlier Inquirer reporting on the issue by posting on social media that they too had been asked about their citizenship while seeking attention at area hospitals.

Groups like Physicians for Human Rights, the New-York-based advocacy organization, told doctors this year that they should not ask patients about immigration status unless required to do so.

The Pennsylvania Immigration Coalition and the National Immigration Law Center say queries around status are improper, and could cause those here without permission to avoid seeking needed medical care. Immigration advocates in Philadelphia say some migrants are skipping doctors’ visits, staying out of work, and avoiding public events amid heightened enforcement.

Maria Sciarrino said she didn’t expect questions about her status when she went to the HUP emergency room on May 18. The West Philadelphia digital strategist said that besides being asked about her citizenship, she was asked about her ancestry.

“It was a little unsettling,” said Sciarrino, 47, who was born in Edison, N.J., and raised in nearby Metuchen. “I was like, that’s a weird question. … I wasn’t feeling great, and now I have to have my ‘papers’?”

As a citizen, “I don’t have to think twice about answering,” she said, but she thought about the risk the question could bring to others.

In response to an Inquirer request for comment, health system spokesperson Holly Auer issued a statement that said: “Our registration process does not include a question about patients’ citizenship. … We regret any misunderstanding or distress that resulted from the registration discussion during this patient’s visit.”

Sciarrino filed a complaint with HUP, and in a June 2 letter Penn Medicine Assistant Vice President Lauren Steinfeld apologized for any distress.

“Please know that it is not our policy or practice to ask patients about their citizenship status, and there is no field in our medical record that collects this information,” she wrote.

Asking patients about country of origin, Steinfeld wrote, can be important to assess health risks and help providers tailor care.

Meanwhile, Alina Marone, 52, of Abington, said she became concerned on June 10, during a routine check-in at radiology at Abington Hospital. The question posed to her was not directly about her citizenship status, she said, but if she was born in the United States.

“My eyebrows probably scowled, and I said, ‘Yes,’” said Marone, who was born in Philadelphia. “I don’t know why anybody needs to be asked that question when they’re getting medical attention. This question makes people afraid to get medical care.”

She has phoned the hospital to try to get answers.

Asked for comment, Abington Hospital spokesperson Deana Gamble provided a statement that said the query was not part of the standard registration. “This question is not asked routinely but may be asked as part of a specific clinical risk assessment,” the statement said.

Earlier, on April 29, retired nurse Pamela Albright was questioned about her citizenship when she arrived at Temple University Hospital for presurgery testing. She stammered out a surprised, “Yes,” then thought for a moment and said, “Wait, I don’t want to answer that question.”

Albright, 72, of Melrose Park, said that flashing through her mind were ways that someone’s “no” answer could find its way to immigration authorities. She canceled her surgery at Temple and decided to seek care elsewhere.

A Temple spokesperson subsequently apologized and said the question had been asked in error.

Since taking office in January, President Donald Trump has aggressively pursued his mass-deportation plans, calling on federal agencies, state and local law enforcement, and everyday citizens to help identify those who could be removed.

The administration has made hospitals and health clinics potential targets for enforcement, revoking the “sensitive locations” policy that generally barred Immigration and Customs Enforcement agents from taking action in those and other designated areas.

Questions around who and who is not a citizen have become ever more sensitive, and elected leaders in two states have directed hospitals to probe for answers.

In 2023, Florida passed a law requiring all hospitals that accept Medicaid to ask admitted patients and emergency-room visitors to state their immigration status.

The Society of General Internal Medicine, the professional organization, spoke out in opposition, saying the law threatened not just undocumented people but the health of the nation.

“People stay home when they are afraid of seeking care — putting everyone at risk,” the group said in a statement. “Asking the question is itself enough to produce such a chilling effect.”

In Texas in 2024, Gov. Greg Abbott issued an executive order that directed hospitals to do the same as in Florida.

Officials in both states say the goal is to learn the cost of providing medical care to undocumented immigrants and to potentially shift some of that financial burden to them.

All hospitals nationwide are mandated to ask about citizenship and status for patients covered by Medicare, Medicaid, and Affordable Care Act marketplaces, for purposes of verifying insurance. Undocumented migrants are generally ineligible for those federal programs.

The illness that took Sciarrino to the HUP emergency room began on May 17, she said, when she experienced pain near her kidneys. She was concerned, having undergone kidney surgery as a child.

At about 6 a.m. the next day, after a restless night, she headed to the hospital at 34th and Spruce Streets.

On that Sunday morning the emergency room was quiet and mostly empty, she said. She checked in and was admitted, then was asked about the nature of her pain and sent to have blood drawn.

She saw a doctor and a physician assistant, who explained that the lab results were good. She was given a pain reliever and muscle relaxer and told to wait an hour to see if it helped — which it did. It turned out her kidneys were fine, and she prepared to leave.

An administrator came by to wrap up, and the initial questions were typical, such as her mailing address, Sciarrino said.

And then, she said, she was asked, “Are you a U.S. citizen?” followed by the question on her ancestral origins.

“I thought it was kind of weird,” Sciarrino said. “They didn’t say ‘for insurance purposes.’ … I responded ‘yes’ to the citizenship. And then I responded to the ethnicity as asked.”

Afterward, as she thought more about the interaction, she wondered what her ancestry had to do with her care, since the question was asked after her doctor’s visit had ended.

When Assistant Vice President Steinfeld responded by mail, she said it was not hospital policy to ask patients for their citizenship status. She described the question on country of origin as “solely for clinical purposes.”

Steinfeld, assistant vice president for audit compliance and privacy, and the chief privacy officer at Penn Medicine, wrote that “we are sorry that you felt uncomfortable during the registration process.”

After receiving Sciarrino’s complaint, the hospital checked with its registration leaders, who reached out to the relevant emergency-department personnel, “who confirmed that patients are not asked about citizenship as part of our registration process.”

Sciarrino’s partner, Sebastian Petsu, who accompanied her to the emergency room, said he was beside her and heard the exchange.

“They asked her what her ethnicity was, her country of origin, and if she was a citizen,” he said. “It struck me as weird.”

Steinfeld said the question on ancestry can help providers better tailor care, adding that patients are not required to respond.

“We apologize,” she wrote, “if this was not clearly communicated to you at the time of registration.”

Hospitals are expected to report data on ethnicity to the federal Centers for Medicare & Medicaid Services, the main administrator of those programs.

In Abington, Marone had been sick for a few days with a bad cough when she went to see her doctor, who sent her for an X-ray at the radiology department at Abington Hospital. At check-in she was asked a series of routine questions, including her name and date of birth, she said, before being asked if she had been born in the United States.

“When I got to the back and was ready for the X-ray, I was like, ‘Did they really just ask me if I was born in the United States?’” she said. “It hit me as, ‘That’s not normal.’”