Communications Director, Connecticut Hospital Association
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rall@chime.org, 203-265-7611
Modern Healthcare – Friday, January 24, 2025
By Caroline Hudson
Providers and industry watchers are concerned by a new directive from the Department of Homeland Security that allows law enforcement personnel to go into hospitals when looking for people without legal immigration status.
On Monday, Acting Department of Homeland Security Secretary Benjamine Huffman issued a directive that gives law enforcement permission to pursue people without legal status in or near sensitive areas, such as hospitals and medical clinics. That tactic had been prohibited under the Biden Administration.
President Donald Trump turned a critical eye on immigration policies in the run-up to his reelection, and industry observers were already worried stricter policies could exacerbate an already-dire healthcare workforce shortage. Monday’s directive raised more concerns.
Here’s a look at the new Trump administration’s latest directive to law enforcement agents and how it could impact providers.
What is the directive?
The directive lifted the Biden Administration’s restrictions on Immigration and Customs Enforcement and Customs and Border Protection agents that kept them from arresting immigrants without legal status in sensitive areas such as hospitals, churches and schools.
Why did the Department of Homeland Security change policy?
A Department of Homeland Security spokesperson said in a statement that reversing Biden-era restrictions will allow agents to enforce immigration laws and capture criminals hiding in sensitive areas.
“The Trump Administration will not tie the hands of our brave law enforcement, and instead trusts them to use common sense,” the spokesperson said.
How could the change affect hospitals and clinics?
Some hospitals and medical clinics, especially in border states, may see an influx of agents requesting information about patients’ legal status.
However, agents would not be allowed to enter private patient care areas without a valid judicial warrant, according to the National Immigration Law Center. The Fourth Amendment protects all individuals from unreasonable searches and safeguards areas where people have a reasonable expectation of privacy.
Healthcare providers, already bound by the Health Insurance Portability and Accountability Act, generally have no legal obligation to share information about patients’ legal status. The Emergency Medical Treatment and Labor Act also requires hospitals to provide emergency medical treatment, regardless of a patient’s immigration status.
NILC is encouraging healthcare providers to avoid asking patients for their immigration status and scrutinize the scope of warrants law enforcement provides.
Why are providers and others concerned?
Some providers and industry watchers say Trump’s directive could dissuade patients from seeking necessary care due to the fear of being arrested. In some cases, delayed care could lead to worsening, even life-threatening, patient conditions.
How are providers reacting?
Clinicians must be able to provide care without the fear of law enforcement, Beth Feldpush, senior vice president of policy and advocacy at America’s Essential Hospitals, said in a statement.
“Patients deserve to feel safe in healthcare settings at a time when they are already more vulnerable because they are sick or injured. Our hospitals’ highest goal is to always provide the best care to every patient who comes through their doors,” Feldpush said.
A spokesperson for Renton, Washington-based Providence said the nonprofit health system serves patients regardless of legal or socioeconomic status.
“At Providence, we see healthcare as a fundamental human right, not a privilege,” the spokesperson said. “We will continue to follow state and federal laws. Enforcement agents do not have access to patient care areas and may not conduct enforcement activity on our campuses. We do not report our patients’ personal information, including legal status, to enforcement authorities.”
The American Hospital Association said it is reviewing the directive.
Scottsdale, Arizona-based HonorHealth declined to comment.
Other large systems, including Kaiser Permanente, Mayo Clinic, Tenet Healthcare and Memorial Hermann Health System, did not respond to requests for comment.