Immigration Crackdown Raises Fears of Seeking Health Care

Many people get nervous any time they need to go to the doctor. But in the past year, some U.S. residents became more concerned than usual.

Immigrants around the country who are on edge about broader enforcement under the Trump administration have been skipping appointments, questioning whether enrolling in government-funded health care coverage could undermine their immigration applications and showing anxiety about visiting unfamiliar physicians, according to nearly two dozen medical providers and lawyers interviewed recently.

Isaura, an undocumented mother of two children living in the Washington, D.C., metro area, described the deep apprehensions some immigrants feel about venturing out in the current political climate.

“Now I feel scared to even go to a new doctor because you don’t know what can happen. You have to give all the information — give your address and personal information — and if I don’t know somebody, I don’t go,” Isaura said. Her older son is asthmatic and has allergies.

“I’m very nervous to go to a new doctor or new place because I’m scared to drive, and everyone else feels the same. Everyone feels threatened because the police can stop you,” said Isaura, who asked that her last name not be used.

So far, her family hasn’t had to visit a new physician. She feels comfortable taking her children to familiar clinicians that serve a large number of immigrants, but would be concerned about getting care elsewhere.

With fears of arrest causing undocumented residents to recalibrate their everyday lives — including fewer trips for medical care — the consequences could cascade beyond the immigrant population. Skipped vaccinations or treatments could hasten the spread of infectious diseases.

Avoiding treatment for chronic ailments invites a cascade of potential trouble, including more expensive and invasive care later. And when the patient is uninsured, those costs often are absorbed either by government health programs or by hospitals, which may cover the expense by hiking prices for insured patients.

“Immigrants are no more dangerous than anyone else, but when we craft policies that drive any population underground, it puts all of the rest of our health at risk, particularly for contagious diseases,” said Georges Benjamin, the executive director of the American Public Health Association.

Karen Mountain, the chief executive officer for the Migrant Clinicians Network, a nonprofit medical network, said thousands of clinicians are reporting higher no-show rates and a reluctance by immigrants, both those here legally and illegally, to get needed care.

“I’m in the business of trying to help people when they are ill, and I am unable to do that effectively when people are too afraid to seek care,” Mountain said. When patients are “scared to death” to seek even routine care, she adds, that “should be a concern to all taxpayers.”

Among those affected are children, including many born in America: 88 percent of children living with an immigrant parent are U.S. citizens.

Sensitive issues

The concerns are emerging against a backdrop of abruptly changing policies for the approximately 23 million legal and undocumented immigrants that account for about 7 percent of the U.S. population.

The Trump administration in its first year ended protections for about 330,000 people who were legally allowed to live in the United States under temporary protected status because of natural disasters, wars or other problems in their home countries. Many have lived here for decades.

President Donald Trump also overturned protections for about 690,000 young people, often called Dreamers, who came to the country as children and were allowed to work in the U.S. through the Deferred Action for Childhood Arrivals program. Democrats and Republicans are now debating whether to enshrine the DACA protections into law, roll back Trump’s decisions for several groups and boost border security as part of a deal.

Trump’s policies followed a stronger enforcement effort and more deportations under President Barack Obama. But Obama prioritized felons, those tied to gangs or terrorists, and people crossing the border, while Trump’s priorities are far broader. He is giving immigration officials discretion to pursue any violators they find.

Hospitals or medical treatment facilities, schools, churches, and public demonstrations have been considered safe havens — “sensitive locations,” in the parlance of a 2011 U.S. Immigration and Customs Enforcement memo under the Obama administration. But over the past year, reports surfaced of agents targeting immigrants near these locations. The Trump administration says on the ICE website that agents may capture someone at a sensitive location “if there are exigent circumstances, if other law enforcement actions have led officers to a sensitive location, or with prior approval” from a supervisor.

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Rebecca Adams