Health Providers Gird for Immigration Crackdown

In his return to the White House this week, President Donald Trump issued a flurry of executive orders on immigration, including declaring an emergency at the U.S.-Mexico border, suspending refugee admissions, and calling to roll back birthright citizenship.

His administration rescinded a long-standing policy not to arrest people without legal status at or near sensitive locations, including hospitals. That has left different states offering starkly different guidelines to hospitals, community clinics, and other health facilities for interacting with immigrant patients.

• California is advising health care providers to avoid including patients’ immigration status in bills and medical records and telling them that, while they should not physically obstruct immigration agents, they are under no obligation to assist with an arrest. The guidance from Democratic Attorney General Rob Bonta also encourages facilities to post information about patients’ right to remain silent and provide patients with contact information for legal-aid groups “in the event that a parent is taken into immigration custody.”
• Meanwhile, Florida and Texas are requiring health care facilities to ask the immigration status of patients and tally the cost to taxpayers of providing care to immigrants living in the U.S. without authorization. Still, patients can refuse to answer questions about their immigration status without losing access to care.

Some health care providers fear immigration authorities will disrupt their work at health facilities and cause patients, particularly children, to skip medical care. They point to examples from Trump’s first term, when agents arrested a child during an ambulance transfer, a young man leaving the hospital, and a woman waiting for emergency surgery.

“You are instilling fear into folks who may defer care, who may go without care, whose children may not get the vaccines they need,” said Minal Giri, a pediatrician and the chair of the Refugee/Immigrant Child Health Initiative at the Illinois chapter of the American Academy of Pediatrics.

On Tuesday, Trump directed the U.S. Department of Justice to investigate state and local officials who don’t cooperate with immigration enforcement.

But no matter the guidelines that states issue, hospitals around the U.S. stress one thing: Patients won’t be turned away for care because of their immigration status.

“None of this changes the care patients receive,” said Carrie Williams, a spokesperson for the Texas Hospital Association, which represents hospitals and health care systems in the state. “We don’t want people to avoid care and worsen because they are concerned about immigration questions.”