California is advising health care providers not to write down patients’ immigration status on bills and medical records and telling them they don’t have to assist federal agents in arrests. Some Massachusetts hospitals and clinics are posting privacy rights in emergency and waiting rooms in Spanish and other languages.

 

Meanwhile, Florida and Texas are requiring health care facilities to ask the immigration status of patients and tally the cost to taxpayers of providing care to immigrants in the United States without authorization.

 

President Trump returned to the White House declaring a national emergency at the U.S.-Mexico border, suspending refugee admissions and challenging birthright citizenship, or the policy of giving U.S. citizenship to anyone born in the United States. As he carries out the “largest deportation operation” in the nation’s history, states have offered starkly different guidelines to hospitals, community clinics and other health facilities for immigrant patients.

 

Trump has also rescinded a long-standing policy not to arrest people without legal status at or near sensitive locations, including schools, churches and hospitals. A proposal to formalize such protections died in Congress in 2023.

 

But no matter the guidelines that states issue, hospitals around the country say patients won’t be turned away for care because of their immigration status. “None of this changes the care patients receive,” says Carrie Williams, a spokesperson for the Texas Hospital Association, which represents hospitals and health care systems in the state. “We don’t want people to avoid care and worsen because they are concerned about immigration questions.”

 

An estimated 11 million immigrants live in the United States without authorization, with the largest numbers in California, Texas, Florida, New York, New Jersey and Illinois, according to
the Pew Research Center.

 

Half of immigrant adults likely without authorization are uninsured, compared with fewer than 1 in 10 citizens, according to the 2023 KFF–Los Angeles Times Survey of Immigrants, the largest nongovernmental survey of immigrants in the United States to date.