Gabrielle Lotito is a master’s student studying Community Health Science and Practice at the NYU School of Global Public Health.
It’s no secret that the Trump administration has ramped up immigration restrictions and detentions since the start of his second term, with U.S. Immigration and Customs Enforcement claiming over 65,000 detentions since October. Many migrants avoid health care every day, for fear that stepping into a health care center and disclosing their identity could expose them to the authorities. What starts as a border-security policy turns into a mass-scale campaign of terror, intimidating immigrants away from care for what should be easily treatable conditions, but often turns into expensive medical intervention.
This fear of being targeted while receiving medical care doesn’t just plague immigrants who’ve come to the United States without documentation, but also those who reside here completely legally. Nearly half of legal residents surveyed reported adverse medical and psychological effects thanks to these immigration related worries. Immigration enforcement policies have consistently led to suppression of health care access even before President Donald Trump’s crackdown — Latino immigrants reported lowering rates of good health and mental health scores all the way back in 2012 — but conditions since then have precipitously worsened, with that suppression extending to legally residing migrants. Among migrant communities in the United States, fear has become a social determinant of health.
ICE’s intimidation tactics that force migrants to avoid medical treatment violate a number of human rights frameworks that collectively guarantee the right to life, physical and mental health, and the care needed to support it. Health care has become neither accessible nor safe for this exceptionally vulnerable population — a slap in the face to the core principles of international human rights, many of which the United States itself championed. A society that forces people to choose between medical safety and legal survival is one that abandons both its public health obligations and its most basic commitments to human dignity and life.
In the 2024 fiscal year, the International Rescue Committee in New York City assisted more than 3,000 refugees and asylum seekers — serving people from countries experiencing war, political collapse and humanitarian disaster, including Ukraine, Venezuela, Guatemala and Afghanistan. Upon arrival, many are in urgent need of primary care, mental health services and health system navigation. But even without concern that they may be targeted at a medical center, many face delays in Medicaid enrollment, lack of transportation and language barriers.
This health crisis is a direct result of Trump’s repressive anti-immigrant agenda. ICE is known for taking preemptive and aggressive actions against migrants, even going so far as to ambush migrants at their routine immigration hearings. Congress has done little to enact policies that would guarantee public health among migrants, and state governments have failed to implement protections from immigration authorities at health care providers.
Politicians need to act as if they are serious about public health and human rights.
Firstly, policy makers need to ban data sharing between health care systems and immigration authorities. Data protection and the confidentiality of Medicaid enrollments, patient files and other sensitive health care information is of the utmost importance for establishing ethical practices. Next, policy makers that claim to advocate for migrants should implement guidelines that prohibit ICE and the Department of Homeland Security from entering community health centers, hospitals, private practices, mental health facilities and specialists’ offices. Lastly, they need to implement state-funded programs that guarantee access to primary and preventive care for all residents, regardless of immigration status, to promote health equity.
Fear should not be a barrier to medical care, yet for many migrants it has become one of the most overwhelming obstacles to wellbeing. Delays in chronic illness treatment and skipped preventative care appointments often escalate to life-threatening conditions and long-term public health costs. This fear and its consequences reflect more than individual patient outcomes: this administration’s priority for scapegoat-based immigration manhunts makes it clear that the collective health and well-being of the nation will remain secondary to exploitative identity politics.
Immigration enforcement practices do not exist in isolation from health care systems. Policy makers need to do more to ensure the confidentiality of medical records and declare medical buildings as immigration-enforcement-free zones. Until these changes are made, migrants will continue to make impossible choices between protecting their families from deportation and prioritizing their own medical needs. The United States cannot achieve equity within its public health infrastructure until migrants no longer fear going to the doctor.
WSN’s Opinion desk strives to publish ideas worth discussing. The views presented in the Opinion desk are solely the views of the writer.
Contact Gabrielle Lotito at [email protected].