Since arriving in the USA 4 years in the past, Alex has labored at a main care workplace. He has witnessed firsthand how tough it was for immigrants to entry preventive care.
When he heard of the implementation of Florida’s Senate Invoice 1718, Alex feared it will have dire penalties for the sufferers he served.
Alex is a pseudonym for considered one of our analysis topics.
SB 1718, signed into regulation by Gov. Ron DeSantis in Could 2023, imposed sweeping restrictions aimed toward discouraging unauthorized immigration. Amongst its provisions, it requires hospitals that settle for Medicaid funds to query sufferers about their immigration standing and share knowledge about what number of immigrants they’re serving inside the state.
The regulation had a number of extra provisions. It mandated E-Confirm, a system to verify employment eligibility, be used for brand spanking new hires in companies using greater than 25 workers. It additionally criminalized driving into Florida with an unauthorized immigrant, and restricted group organizations from issuing IDs.
After the regulation handed, Alex advised his sufferers that they might refuse to expose their authorized standing when requested on hospital kinds. However he says his reassurances didn’t work. He watched as many immigrant sufferers hesitated to entry vital medical look after themselves and their youngsters – and even left the state.
Alex had authorized documentation to be within the nation, however as his immigrant group shrank, he puzzled if he, too, ought to depart Florida.
We’re a bunch of social science professors and graduate college students finding out immigrant communities in Florida. We consider SB 1718 has vital implications for immigrants, for Floridians and all Individuals – notably because the nation faces surges in outbreaks of communicable illnesses like measles and the flu.
An surroundings of worry
These considerations are based mostly on our survey of 466 immigrants to Florida and grownup U.S.-born youngsters of immigrants between Could and July of 2024.
Practically two-thirds of non-U.S. residents and one-third of U.S. residents who responded to our survey mentioned they hesitated to hunt medical care within the yr after SB 1718 handed.
“I was very sick recently and needed medical care, but I was scared,” one survey participant advised us.
Whereas hospitals can not deny care based mostly on a affected person’s immigration standing, our knowledge reveals that anticipating they’d be requested deterred not solely immigrants missing everlasting authorized standing but additionally these with authorized standing, together with U.S. residents, from in search of care.
We consider U.S. residents are affected by spillover results as a result of they’re members of mixed-status households.
Our survey occurred in the course of the intense 2024 presidential election season when anti-immigrant rhetoric was prevalent. The immigrants we surveyed additionally reported experiencing discrimination of their on a regular basis lives, and these experiences have been additionally related to a reluctance to entry well being care.
Legal guidelines like SB 1718 amplify preexisting racial and structural inequities. Structural inequities are systemic obstacles inside establishments — equivalent to well being care and employment — that limit entry to important sources based mostly on one’s race, authorized or financial standing.
These sorts of legal guidelines discourage immigrants from using well being sources. They foster an exclusionary coverage surroundings that heightens fears of enforcement, restricts entry to important companies and exacerbates financial and social vulnerabilities. Furthermore, restrictive immigration insurance policies exclude folks from accessing companies based mostly on their race. Immigrants who’ve been discriminated in opposition to in on a regular basis settings could internalize the expectation that in search of care will lead to additional hostility – and even hazard.
Penalties for public well being
U.S. historical past holds quite a few examples of racial and ethnic obstacles to well being care. Examples embrace segregation-era hospitals turning away Black sufferers . It additionally entails systemic restrictions on well being care entry for non-English audio system, together with insufficient language help companies, reliance on untrained interpreters and lack of culturally competent care.
President Donald Trump’s new government orders signed in January 2025 threaten to additional ostracize sure communities. For instance, the order terminating federal range, fairness and inclusion applications dismantles efforts to deal with racial disparities in public establishments. New restrictions on federally funded analysis on race and fairness might hinder efforts to review and tackle these disparities.
Civil rights advocates consider these measures characterize a systemic rollback of rights and variety practices that generations fought to safe and will speed up a nationwide shift towards exclusion based mostly on race underneath the guise of immigration enforcement.
Supporters of immigrants’ rights protest in opposition to U.S. President Donald Trump’s immigration insurance policies on Feb. 7, 2025 in Homestead, Florida.
Joe Raedle through Getty Photographs
The outcomes of our survey in Florida could also be a warning signal for the remainder of the nation. Well being care hesitancy like we documented might enhance the chance of delayed remedy, undiagnosed circumstances and worsening well being disparities amongst complete communities.
These authorized restrictions are prone to enhance the unfold of communicable illnesses and pressure well being care methods, growing prices and inserting a better burden on emergency companies and public well being infrastructure.