While these concerns have resurfaced under the second Trump administration, the message from advocates, lawyers, and health centers is clear and unequivocal: health care is always a priority and treatment should not be stopped.

Among the immediate local impacts of returning president Donald Trump has been a chilling effect on immigrant and undocumented communities in New York.

According to local advocates, attorneys, and health centers, some immigrants have expressed fear of continuing medical treatment or are reluctant to enroll in health care and benefits for fear that it will negatively affect their immigration cases or risk exposing them as undocumented.

“In the past couple of weeks,” said Rebecca Telzak, deputy director at Make the Road New York, “we’ve seen an uptick of undocumented community members expressing reservations when it comes to accessing health programs and services that they are eligible for, such as Medicaid, Child Health Plus, NYC Care, and doctors visits out of fear that their information may be shared with [U.S. Immigration and Customs Enforcement] ICE.”

Concerns have been raised both by immigrants who are already insured and want to drop coverage—even when they have U.S.-born kids—and those who are not yet insured and are now reluctant to enroll.

“There are parents who have children with chronic, pre-existing conditions, and the parents are undocumented, but the children [are] citizens of the United States, but they are also worried,” said Rehan Mehmood, director of health services at the South Asian Council for Social Services.

Mehmood cited the example of one client enrolled in emergency Medicaid who didn’t want to go to the hospital to get care because they feared that it could jeopardize their information.

The person had Type 2 diabetes and a heart condition, and needed urgent care. “We had to work with the client and convince them that nothing is going to happen, you should go and get the care that you need,” Mehmood said, adding that the person ended up going to the emergency room.

Advocates and attorneys insist that federal and state privacy laws restrict the sharing of patient information with law enforcement, including information related to immigration status.

Even so, Trump’s re-election—following a campaign in which he repeatedly pledged to crack down on immigration and carry out mass deportations—has stirred up familiar fears in immigrant communities. 

In 2019, during the first Trump administration, the U.S. Department of Homeland Security changed the grounds of inadmissibility under the “public charge” rule that could deny someone a green card, visa, or admission to the country. The use of certain housing, nutrition, and health programs were among the public services weighed by the rule, creating a “chilling effect” in immigrant communities that lingered even after the Biden administration dismantled Trump’s public charge criteria in 2022.

Robert Hayes is president and CEO of Community Healthcare Network, which serves more than 65,000 people—20 percent of whom are uninsured, and most of whom are undocumented. He said that “there are no data at this point,” in terms of a concise number of people who have unenrolled or stopped treatment, “although there is deja vu.”

While these concerns have resurfaced, the message from advocates, lawyers, and health centers is clear and unequivocal: health is always a priority and treatment should not be stopped.

“We have heard of people who are no longer seeking health care, and so they are avoiding their well-child visits. They are not going to the doctor when they are ill,” said Lara Kassel, coalition coordinator at Medicaid Matters NY. “And we have also heard of people calling their managed care company, their insurance company, to say, ‘I’d like to drop my coverage.’”

For weeks, advocates and attorneys have been educating and reassuring people, encouraging them to continue getting health care when they need it.

New York Legal Assistance Group (NYLAG) and its LegalHealth partnership program—which provides free legal services on public benefits, immigration, and housing inside hospitals and community health centers—has been receiving referrals from healthcare professionals. 

“Since December, we have heard reports of patients not wanting to enroll in health insurance, and this week, we have heard from a client who refused to go to the emergency room, notwithstanding severe pain and advice from her primary care physician to go to the emergency room,” said Norma Tinubu, interim associate director of NYLAG’s LegalHealth.

In addition to the fears of those they’re fielding calls from, advocates and also attorneys worry about those who remain silent and don’t seek answers or assistance.

“The people who expressed the concern,” Hayes said, “we could talk to and allay the concern, the people who don’t show up are the people who worry me the most … we generally are able to educate the patient to make healthcare the priority and put fear in the backseat.”

“But the people who don’t talk are the people who are worried the most,” Hayes added, “because they may never come in. It’s a killing impact. It will be across all human services, and kills people. I mean, sadly it does.”

When seeking immigration-related advice, NYLAG attorneys warn people to avoid getting it from a “notario” (the Spanish word for “notary”) who is not a legal expert; and to be on alert for misinformation propagating baseless fears.

They also recommend patients speak with healthcare providers or social workers for referrals to legal services, which are available at major healthcare systems in New York City.

“With Trump’s administration injecting fear into our communities, many are losing their trust in facilities as sanctuary spaces,” Telzak of Make the Road New York said. “That’s why our staff have been dedicating more and more time educating New Yorkers about their rights and reaffirming their ability to apply for benefits so that they do not shy away from receiving the medical attention they may need.”

Recently, the city has seen an explosion of “know your rights” sessions, many prompted by concerns over potential interactions between immigrants and ICE agents; others are focused on how to go about daily life in schools, subways, and workplaces.

And there may be further waves of distress to come. On Jan. 20, Department of Homeland Security issued a directive rescinding the Biden Administration’s guidelines for ICE and Customs and Border Protection (CBP) which restricted enforcement actions in or near “sensitive” areas such as schools, social services establishments, places of worship, and medical facilities. The next day, the Justice Department ordered federal prosecutors to investigate state or local officials who they think are obstructing the Trump administration’s immigration crackdown.

DHS’s directive states that officers “apply enforcement discretion to balance a variety of interests, including the degree to which any law enforcement action occurs in [a] sensitive location. Going forward, law enforcement officers should continue to use that discretion along with a healthy dose of common sense. It’s not necessary, however, for the head of the agency to create bright line rules regarding where our immigration laws are permitted to be enforced.”

Crains reports that the Greater New York Hospital Association, a trade association representing hundreds of New York-area medical facilities, has circulated guidelines to its members informing them of the changes and suggesting protocols for dealing with ICE agents.

New York City Health + Hospitals, which runs the city’s public hospitals network, did not respond to City Limits’ requests for comment on what guidelines it’s providing to workers on dealing with ICE agents. Documented previously reported on a memo H+H issued to its staff instructing them to document and communicate such incidents to managers, while also reminding them that it is illegal to “intentionally protect a person who is in the United States unlawfully.”

When Trump came out on top in the 2016 election, H+H was quick to distribute a letter reassuring immigrant New Yorkers that they could seek care in any setting without fear. In that earlier letter, H+H promised that “the city of new york has a policy to protect immigration status and other confidential information. NYC Health + Hospitals will honor your right to privacy.”

Though ICE agents haven’t shown up at their network facility in the 10 years he’s been running it, Hayes said it’s still better to be prepared.

“I’m doing staff education at our 14 health centers to make sure that we know what federal officials can do and can’t do as they show up. I’m not expecting them to show up, but if they do it, we’ll be ready for it,” he said.

To reach the reporter behind this story, contact Daniel@citylimits.org. To reach the editor, contact Jeanmarie@citylimits.org

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