By Ana B. Ibarra, California Fellow
Editor’s note: This article covers a session at AHCJ’s annual conference, HJ25, before President Trump sent troops into L.A.
President Donald Trump’s immigration policies and rhetoric are deterring people from seeking care, which is likely to have long-term personal and public health implications, said Arturo Vargas Bustamante, professor of health policy at UCLA, and Sandy Reding, president of the California Nurses Association at Health Journalism 2025 in Los Angeles.
The panel, moderated by Politico’s Alice Miranda Ollstein, highlighted the current federal administration’s policies and their impact on health care nationwide.
Allowing ICE agents into health care settings and the potential of penalizing immigrants for using Medicaid via a public charge rule, are top of mind for many immigrants. Those concerns make them think twice before seeking care at a clinic or hospital.
Reding, who works in Bakersfield, Ca., said her hospital sees a large number of immigrants — both undocumented and lawfully present — who work in the region’s agricultural and oil fields.
Delaying care, Reding said, means someone who skips doctor visits and doesn’t get their blood pressure checked could end up in the emergency room with a stroke.
In recent months, Reding has observed an uptick in ruptured appendixes in the emergency department. While there is no data tracking whether the ruptured appendices are directly linked to delays in care over immigration concerns, the trend and timing align, she said.
“They’re afraid to go unless it’s absolutely necessary,” Reding said.
And it’s not just patients who are being affected by the administration’s’ immigration policies. Workers are, too.
About 16% of the country’s nurses and 38% of home health aides are immigrants. As immigration enforcement and fears spill over to lawfully present immigrants, such as green card holders, some nurses are making contingency plans in case they’re detained and deported, Reding said.
The state of California has long positioned itself as a leader in protecting immigrants and their health. Over a phased-in 10-year process, California opened its Medicaid roll to all low-income people, regardless of legal status.
This expansion is credited with improving health outcomes. For example, the proportion of undocumented children who reported “excellent health” increased by 10 percentage points after the expansion, according to the California Budget and Policy Center.
But as California faces a $12 billion budget deficit, the state is rolling back some of these benefits. Gov. Gavin Newsom recently proposed freezing enrollment for adults who lack legal status and charging them $100 a month to keep their Medicaid.
Bustamante said while this may save the state money in the short term, it will likely cost more in the long run.
“This is ultimately going to increase utilization of the ER, uncompensated care, and perhaps increase the cost for people who wait until the last minute to get care for complex conditions,” Bustamante said.
“And at the end, everyone is going to pay for it. That’s the most inefficient way of paying for health care.”
Ana B. Ibarra is a health policy reporter for CalMatters. She is based in Los Angeles.
