California physician says ICE threat is deterring patients from receiving care | Opinion

In July, 20 states sued the Trump administration for releasing Medicaid enrollees’ personal information, including immigration status, to the Department of Homeland Security, which oversees U.S. Immigration and Customs Enforcement (ICE).

As a physician, I’m apprehensive about how news of this data transfer could deter people from seeking vital medical care. More broadly, I worry about how the encroachment of immigration enforcement into the realm of health care can jeopardize patients’ well-being. I am already seeing the harmful effects, including for lawful immigrants and even U.S. citizens.

In light of the recent increase in ICE operations, multiple patients have told me they are afraid to leave home to obtain medical care. One woman constantly checks an app on her phone that tracks the presence of ICE agents (if any have recently been detected near her health care providers’ offices, she skips her appointments). Although she is lawfully present in the United States, she remains concerned about being detained.

Such fears are even more acute for unauthorized immigrants: One undocumented patient told me that she was advised three months ago to get a mammogram to follow up on a breast mass. However, she has still not scheduled the test because of worries about being caught en route and deported.

Moreover, concerns about undocumented relatives can negatively impact the medical care of the approximately 11 million U.S. citizens and lawful immigrants living in households of mixed legal status. For example, one of my patients is delaying shoulder surgery because of his wife’s immigration status. He has a rotator cuff tear, and I told him that, without the operation, he is unlikely to recover full shoulder function or be able to return to his job. Nevertheless, he seemed hesitant.

When I asked why, his answer surprised me. “It’s not that I don’t want the surgery,” he said. “My wife … she doesn’t have papers. Our future is so uncertain. We might have to leave the country at any time. So I can’t spend months recovering from a procedure right now.”

For the 4.4 million U.S. citizen children living with an unauthorized immigrant parent, disrupted medical care can present even more problems. Adults who distrust the health care system may not enroll their kids in programs like the Children’s Health Insurance Program. And since many minors rely on their parents for transportation, they may miss vaccinations and screenings, or experience delays in urgent care.

It’s apparent that immigration enforcement activities can interfere with the effective provision of health care. States should consider passing legislation to help mitigate the resulting negative consequences.

Californians can ask their Assembly member to support Senate Bill 81, authored by Sen. Jesse Arreguín, D-Oakland, which would require that health care entities and providers deny immigration authorities access to nonpublic areas of facilities, such as patient care areas, unless specific conditions are met. Keeping ICE agents out of these spaces would help patients feel more comfortable going to the doctor. It would also allow medical professionals to focus on our job without interference.

In addition, SB 81 would specify that immigration status and place of birth are protected medical information that health care providers may not disclose to outside parties without patients’ authorization, except under limited circumstances. An OB/GYN colleague told me that pregnant women who require hospital admission have often asked her whether their immigration status would be reported to authorities; if reassured that it won’t be, they can typically be convinced to stay and receive treatment.

By strengthening privacy protections, SB 81 would improve patient care.

Medical professionals are motivated by a desire to heal the sick, but it’s hard to do so when those we treat are afraid. We work hard to provide high-quality health care, so it’s infuriating when political factors prevent patients from achieving optimal health outcomes.

Mimi Zheng is a physician in Los Angeles.