Since arriving in america 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 Bill 1718, Alex feared it might have dire penalties for the sufferers he served.
Alex is a pseudonym for one in every of our analysis topics.
SB 1718, signed into legislation by Gov. Ron DeSantis in Could 2023, imposed sweeping restrictions geared 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 legislation had a number of extra provisions. It mandated E-Confirm, a system to check employment eligibility, be used for brand new hires in businesses employing more than 25 employees. It additionally criminalized driving into Florida with an unauthorized immigrant, and restricted group organizations from issuing IDs.
After the legislation handed, Alex instructed his sufferers that they may refuse to disclose their authorized standing when requested on hospital types. However he says his reassurances didn’t work. He watched as many immigrant sufferers hesitated to entry obligatory medical take care of 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 gaggle of social science professors and graduate college students studying immigrant communities in Florida. We imagine SB 1718 has essential implications for immigrants, for Floridians and all People – notably because the nation faces surges in outbreaks of communicable diseases like measles and the flu.
An atmosphere 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.
Nearly two-thirds of non-U.S. citizens and one-third of U.S. citizens who responded to our survey stated they hesitated to hunt medical care within the yr after SB 1718 handed.
“I used to be very sick not too long ago and wanted medical care, however I used to be scared,” one survey participant instructed us.
Whereas hospitals can’t deny care based mostly on a affected person’s immigration standing, our knowledge exhibits that anticipating they would be asked deterred not solely immigrants missing everlasting authorized standing but in addition these with authorized standing, together with U.S. residents, from in search of care.
We imagine U.S. residents are affected by spillover results as a result of they’re members of mixed-status households.
Our survey came about 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 had 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 — comparable 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 utilizing health resources. They foster an exclusionary coverage atmosphere that heightens fears of enforcement, restricts entry to important companies and exacerbates financial and social vulnerabilities. Furthermore, restrictive immigration insurance policies exclude people from accessing services based on their race. Immigrants who’ve been discriminated towards in on a regular basis settings could internalize the expectation that in search of care will lead to additional hostility – or even danger.
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 patients . It additionally entails systemic restrictions on health care access for non-English speakers, together with insufficient language help companies, reliance on untrained interpreters and lack of culturally competent care.
President Donald Trump’s new executive orders signed in January 2025 threaten to additional ostracize sure communities. For instance, the order terminating federal diversity, equity and inclusion applications dismantles efforts to handle racial disparities in public establishments. New restrictions on federally funded research on race and equity might hinder efforts to review and tackle these disparities.
Civil rights advocates imagine these measures symbolize a systemic rollback of rights and diversity practices that generations fought to safe and will speed up a national shift toward exclusion based mostly on race beneath the guise of immigration enforcement.
Joe Raedle via Getty Images
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 treatment, undiagnosed conditions and worsening health disparities amongst whole communities.
These authorized restrictions are prone to enhance the spread of communicable diseases and strain health care systems, rising prices and putting a better burden on emergency companies and public well being infrastructure.
