Lawmakers on the Senate Armed Services Committee for five years have sought to include a small provision in an annual defense authorization bill that would allow Guantanamo Bay detainees to be transferred to the United States for emergency medical care.
Now, for the first time, it might happen.
The panel approved a small carve-out in the ban on transferring Guantanamo Bay’s 40 remaining detainees to the United States for medical treatments the Defense Department cannot provide on-site.
“I would not call it an exception to the transfer ban, I would call it a very very small narrow carve-out for emergency medical [care],” a senior committee aide said. “Those detainees are getting older and older and there’s not a robust medical facility down there.
“There are certain emergency conditions that cannot be treated at Guantanamo.”
The legislation still has a few hurdles to clear: it must pass the full Senate, be married up with the House version of the bill, and win President Trump’s signature. In previous years, medical exemption language for Guantanamo prisoners did not survive to the final version of the bill. But Democrats, most of whom have advocated for closing the detention facilities at Guantanamo Bay, control the House for the first time since 2010, likely giving the provision a better chance than it had under the GOP-controlled chamber.
Meanwhile, senior officers at the base have been petitioning policymakers to give them guidance on how they are expected to care for their aging detainee population, who must be given the same level of care as U.S. service members under the Geneva Conventions.
And several recent high-profile medical emergencies at the facility have highlighted the challenges for U.S. military personnel to provide complex care at the remote outpost, perched on the southeast tip of Cuba. In January, the judge in the 9/11 case canceled a pre-trial hearing and then waited 16 hours to be flown to Miami for emergency surgery for a detaching retina.
The Senate’s markup of the National Defense Authorization Act, or NDAA, also calls for the establishment of a chief medical officer who would operate outside of the chain of command of the Joint Task Force leadership that manages the prison. “We had a concern that medical officers at Guantanamo under JTF command might not be able to make as independent of decisions with regard to medical care as we would like,” a committee aide said, adding that the committee wanted to give the officer the ability to “appeal to the assistant secretary of defense for health affairs where there might be a conflict.”
The new chief medical officer would be able to recommend the emergency transfer of a prisoner to the United States for medical treatment, but would not have the authority to unilaterally make the determination, the aide said. Committee aides did not specify who would have that power.
The Senate panel’s version of the bill would continue the ban on using U.S. funds to transfer Guantanamo detainees to the United States.
The 40 remaining prisoners at Guantanamo Bay Naval Base have the same physical ailments of any aging population, the senior medical officer at the facility told reporters visiting last month. Many are in their 50s. The oldest is 71 years old. They need hip replacements, eye surgeries, treatment for sleep apnea, mental health disorders and, one day, probably cancer and dementia. The secure medical facilities built to treat the detainees can’t cope with every kind of surgery geriatric patients typically need, and weren’t built to last indefinitely.
Specialists and equipment are flown in as needed, including a handicapped-accessible cell sent to the war court facility so that a 57-year-old inmate recovering from emergency spinal surgeries could stay overnight at the medical complex rather than endure transport back and forth from the detention facility.
Experts on detention medical care question how detainees will be treated for some complex conditions if they are not able to leave the base.
The provision may also face challenges in the White House. Trump on the campaign trail vowed to keep the detention facility open and fill it up with “bad dudes,” formally announcing that the facility would remain operational in last year’s State of the Union address.
A Pentagon memo one month later said that U.S. Southern Command, which oversees the Cuba base, will provide the detainees with the same level of care as the U.S. armed forces only “when it is possible” and “to the extent practicable.” If the appropriate care can’t be provided on the island, according to the memo, “a panel will be formed to provide direction…on medical courses of action.”
The full Senate is expected to take up the legislation in June.