Health Care and U.S. Immigration Enforcement: What Providers Need to Know

Recent changes in regarding U.S. immigration enforcement have created new challenges for health care providers who are committed to ensuring care for all patients. This guide does not constitute legal advice but offers essential information to navigate the evolving enforcement landscape while upholding your duties as a health care professional. As a health care provider, your primary responsibilities are to: • Maintain trust with all patients, regardless of immigration status • Understand your legal rights and obligations • Know how to respond if immigration enforcement occurs in your facility • Advocate for institutional policies that protect patient access to care.

Introduction and Policy Context

On January 20, 2025, President Donald Trump issued an executive order titled “Protecting the American People Against Invasion,” which broadly directed the Department of Homeland Security (DHS) to rescind the concept of enforcement “priorities” to expand the number of people who could be subject to enforcement actions.

In response to this order, on January 21, 2025, DHS posted a statement regarding the “protected areas” policy (PAP). The PAP was issued through guidance by the Biden administration but originated in a 2011 memo, had provided safeguards that limited U.S. immigration enforcement in hospitals, clinics, and other sensitive locations like schools and places of worship. The new DHS statement means that Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP), or other law enforcement agencies acting on their behalf, are no longer guided to avoid conducting enforcement actions – including arrests, detentions, and interrogations – in or near spaces where people seek medical care. The original 2011 memo provided guidance that discouraged such actions, but was never an enforceable prohibition.

Impact on Health Care Access

By removing this “protected areas” policy, the federal government has reignited fear within communities, which has been known to result in many immigrants or their families avoiding seeking necessary medical attention out of concern that they or their loved ones may be detained or deported while trying to access care.

Health care facilities provide services essential for the health, wellness, and safety of not only patients but also for the whole community, which depends on the wellness of all residents. When community members avoid care due to fear of immigration enforcement, public and personal health suffers, including worsening outcomes from delayed treatment leading to more serious conditions.

This fear also extends beyond patients to the people providing care. Nearly 20 percent of the health care workforce in the United States is composed of immigrants, many of whom work on the front lines in hospitals and clinics.9 Immigration policies that create fear and uncertainty not only harm patients but also have potential to threaten the stability of the health care workforce. Institutions that fail to adopt supportive policies risk losing valued employees, further exacerbating workforce shortages and undermining the ability of health care systems to provide consistent, quality care.

Recognizing and addressing these challenges is critical to ensuring both the well-being of patients and the professionals who serve them.

*For footnotes and bibliography, please reference the PDF version of this resource below.