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Providers and advocates: ICE raids and federal data sharing are deterring care and straining health systems
Summary
Community advocates, county health officials and safety‑net providers reported measurable declines in clinic and emergency visits after immigration enforcement actions and expressed concern that federal data sharing and public‑charge changes are chilling enrollment and care‑seeking among immigrant families.
Speakers at the hearing said immigration enforcement operations and federal administrative moves on data sharing and public charge are producing a chilling effect that deters immigrant families from seeking routine and urgent health care.
Monica Madrid, a state policy advocate with the Coalition for Humane Immigrant Rights (CHIRLA), opened the second panel with a family story: after an ICE raid her organization helped, a man who had been the "anchor of his family" returned in a markedly different mental state, and she described the "anxiety, depression, fear, isolation, and lasting trauma" that follow enforcement actions.
Los Angeles County Department of Health Services officials described measurable declines in visits following enforcement actions. Dr. Patel (Los Angeles County Department of Health Services) said the system cares for more than 750,000 people a year and reported month‑to‑month declines in June compared with May: a roughly 14% decline in emergency department visits and about a 15% decline in urgent care visits (June vs May), with partial rebound in July. The department also reported staff and community feedback that people were avoiding public spaces, delaying preventive and in‑person care, and expressing fear about sharing health information.
Community health center response and outreach
- Mobile and in‑home care: St. John's Community Health described a "Health Care Without Fear" outreach that included home visits, medicine delivery and food support. Jim Monja, president and CEO of St. John’s, said teams visited roughly 600 patients in the first weeks of the program and that no‑show rates at the health center had risen from about 9% to over 31% at the peak, then declining as immediate enforcement activity eased.
- Street medicine and mobile clinics: Providers said some mobile units have been approached by enforcement, which in at least one instance temporarily shut down street medicine outreach at a MacArthur Park site; clinicians reported being threatened and ordered to leave during enforcement activity.
Public‑charge and data sharing concerns
Carlos Alarcn, a health policy analyst with the California Immigrant Policy Center, said the reported sharing of Medi‑Cal records with DHS has multiplied public fear. He said people are calling enrollers and telling them they want to disenroll or delay enrollment because they fear ICE will use health records to find family members.
Children and schools: Lisa Davis of The Children's Partnership said enforcement disrupts early childhood education and school attendance; she cited a Stanford study finding a 22% jump in school absences in some Central Valley districts after deportation sweeps.
Why it matters: Declines in preventive and primary care can raise costs and health risks for individuals and communities. County and provider witnesses warned that delays in care raise the likelihood of more severe illness later and strain emergency services and the health workforce.
Suggested mitigations and next steps
Panelists urged rapid expansion of outreach, legal services funding, clear state guidance on privacy and enforcement boundaries for health settings, and investments in community‑based navigators and promotores to counter misinformation. Officials asked for more granular data from counties and providers about visit declines so legislators can tailor mitigation and budget responses.
Quotes
- "Raids destabilize families, inflict trauma, and undermine mental and physical health of our entire communities," Monica Madrid said.
- "We provide comprehensive primary specialty and emergency care... In the month of June, we saw a decline in overall ED visits about 14% in comparison to May," said Dr. Patel of Los Angeles County Department of Health Services.
- "We developed a program called Health Care Without Fear... we've seen close to 600 patients so far in the last 3 weeks in this program," Jim Monja said, describing home visits, medication delivery and grocery support for patients avoiding clinics.
Ending: Providers and advocates asked legislators for immediate funding for outreach and legal services, state protections for health‑care settings and expedited data to quantify declines and target mitigation efforts.
