(UNITED STATES) Immigration clinics and hospital staff across the United States 🇺🇸 say fear of deportation is driving parents to delay or avoid medical care for their children in 2025, even when the children are U.S. citizens. The result is showing up in emergency rooms as preventable crises.
A new survey by Physicians for Human Rights and the Migrant Clinicians Network, based on responses from 691 health care workers in 30 states, found that 84% saw “major” or “moderate” drops in patient visits since January 2025. Many respondents linked the fall to worries about Immigration and Customs Enforcement (ICE) detentions.
Examples from clinicians: delayed care with serious consequences
One clinician in Illinois told the survey teams that parents sometimes will not bring a sick child to the hospital at all, or will send the child alone, because they fear being stopped, questioned, or arrested. That clinician described a case where “the baby was completely gray” after an illness went untreated for too long.
Other providers reported:
– Children arriving at emergency departments without a parent, or with an older sibling attempting to explain symptoms and sign forms they could not legally complete.
– Parents skipping routine visits until conditions become emergencies.
Survey timing and key findings
The survey period, March–August 2025, captured a pattern clinicians said had hardened into routine since President Trump returned to office and pushed for tougher enforcement.
Major reported impacts:
– 43% of workers said preventive services were being disrupted.
– 36% cited problems with chronic disease care (e.g., asthma, diabetes).
– 28% pointed to reduced access to mental health care.
Clinicians also noted a rise in panic and sleep problems among young children who did make it to appointments.
How fear affects decisions before reaching clinics
In interviews and written comments, many workers said the fear often starts before a family ever gets to a clinic door. Parents weigh several risks, for example:
– Whether a hospital visit could expose them to immigration checks.
– Whether an address on a form could later be used to find them.
Survey highlights on barriers:
– 49% listed deportation fears as a top barrier to care.
– 39% cited fear of family separation.
Providers reported children as young as six asking where they should go if a parent “disappears” on the way home.
“Families are scared to renew their Medicaid.” — Oregon health worker
“We are increasingly alarmed that the children of immigrants may soon lose access to vital programs like SNAP and Medicaid, not because they are ineligible, but because their parents are being targeted and surveilled…” — North Carolina health worker
Hesitation to apply for benefits
The fear is not limited to hospitals. Respondents reported:
– 27% said families were hesitating to apply for or renew nutrition and health benefits, including SNAP and Medicaid, even when their children are eligible.
This hesitancy can cause gaps in nutrition, preventive care, and medication access for children.
Policy changes and broader context
The source material describes several policy moves since January 2025 that advocates and clinicians say have increased risk for mixed-status families:
– An executive order that suspended the U.S. Refugee Admissions Program.
– Restoration of the “Remain in Mexico” policy for many asylum seekers.
– Expansion of expedited removal, a fast-track deportation process, for people who cannot prove at least two years of residence in the United States 🇺🇸.
Physicians for Human Rights warned that such policies can deepen long-term stress, including symptoms of post-traumatic stress disorder (PTSD), especially in children.
Prenatal care and birthright citizenship concerns
Clinicians pointed to efforts to redefine birthright citizenship as another pressure point—affecting pregnant patients who have lived in the country for years.
- Research links high prenatal stress to higher risks of preterm birth and low birth weight.
- For families worried about deportation, routine prenatal visits can feel like a paper trail, and some patients may skip care until labor, increasing medical risks and costs.
Conditions in detention and their ripple effects
Although the survey focused on community care avoidance, respondents said stories about detention shape families’ choices. The source material cites:
– Reports by the Government Accountability Office and the Department of Homeland Security about inadequate screenings and allegations of forced sterilizations in detention settings.
– Accounts of crowded facilities, lack of medication, and difficulty reaching lawyers or family.
These reports contribute to fear that any contact with government systems could be dangerous.
Workforce impacts and system strain
The source material reports significant workforce effects:
– About 1 million immigrants have left health jobs.
– 1.1 million foreign-born non-citizen health workers are at risk as enforcement tightens.
– Immigrants make up about 30% of the direct care workforce.
Potential impacts:
– The sector could lose 394,000 jobs, pushing more care responsibilities back onto families.
– Many families already face barriers such as lack of childcare, paid leave, or transportation to clinics.
Regional examples and service shifts
Local stories show variation by region but similar patterns:
– New Orleans and parts of Mississippi: immigrants skipping care because of detention threats.
– New York: direct care workforce could shrink by 45%, raising concerns about elder care and disability support amid existing staff shortages.
Families that do seek help may:
– Choose urgent care centers farther from home.
– Wait until symptoms are severe enough to justify the perceived risk.
Related national data and projections
Other national data cited:
– KFF data from March 2025 found 32% of immigrants reporting negative health effects linked to the climate of enforcement.
– The National Immigration Law Center estimated 900,000 people could lose health coverage from status changes and another 300,000 from green card bans.
Clinicians warned these losses would likely spill over to citizen children when parents avoid clinics, pharmacies, and benefit offices.
How families respond to perceived enforcement risk
Several respondents said the message in their communities is that any official contact could trigger faster removals, especially after the expansion of expedited removal for people who cannot show two years in the country.
Reported behaviors during March–August 2025:
1. Some parents canceled follow-up visits after hearing about neighbors detained at routine check-ins or traffic stops.
2. Parents asked staff whether their names could be shared with ICE.
3. Families switched phones, changed addresses, and stopped answering reminder calls from clinics.
Providers tried to reassure families that care is care, but trust remains fragile.
Legal protections and resources
Hospitals and community health centers say they still treat patients regardless of immigration status, and health groups emphasize:
– Emergency departments must provide stabilizing care under federal law.
– States have different rules on who can get Medicaid coverage, especially for children.
Official information on Medicaid and the Children’s Health Insurance Program is available from the federal Centers for Medicare & Medicaid Services at Medicaid.gov.
According to analysis by VisaVerge.com, the sharpest risk is that fear will keep minor problems from being treated early, turning simple infections into emergencies.
Key takeaway: Fear of enforcement can transform routine care avoidance into acute medical crises—often affecting U.S. citizen children.
Emotional toll on children and clinicians
Many clinicians said the hardest part is watching citizen children carry adult fears:
– Toddlers cling to parents in exam rooms.
– Older children translate at appointments while trying to hide their own anxiety.
Some workers now spend time explaining that clinics are not immigration offices and that medical records are private. Yet these assurances often collide with news of raids, removals, and shifting rules.
For the families they serve, clinicians say, the choice is often framed starkly:
– A doctor visit today, or the chance of deportation tomorrow.
A national survey of 691 clinicians (March–August 2025) found 84% saw declines in pediatric visits as fear of ICE detentions grew. Nearly half cited deportation fears as a primary barrier; 43% reported disruptions to preventive care, 36% to chronic disease management, and 28% to mental health services. Clinicians described children arriving alone or critically ill. Policy shifts—expanded expedited removal and refugee program suspensions—appear to deepen stress and reduce benefit enrollment.
