The chilling effect of ICE in hospitals

William Lopez (0:01)

N-P-R.

Adrian Ma (0:06)

This is The Indicator from Planet Money. I'm Adrian Ma.

Wailin Wong (0:09)

And I'm Waylon Wang. Adrian, do you watch the show The Pit, you know, the medical drama it's on HBO Max about an emergency room?

Adrian Ma (0:16)

I love The Pit. You really? I love to be stressed out.

Wailin Wong (0:20)

It's very compelling. Well, you probably remember then this episode from March, where a couple of ICE agents come into the ER with a woman they've detained in a raid.

And their presence at the hospital spooks the patients and the staff. And then the attending physician, played by Noah Wiley, gets really upset about the disruption.

SPEAKER_5 (0:39)

I'm already short staffed, and I just lost five nurses and half my environmental services team because you walked in. You know, patients come in here for help, right? Because they're either sick or they're injured and documented or undocumented. They have a right to emergency care.

Adrian Ma (0:52)

Dr. Robbie.

Wailin Wong (0:53)

I know. Always.

Adrian Ma (0:54)

I care so much.

Wailin Wong (0:55)

He's under so much pressure all the time.

And this episode, it was a real, you know, ripped from the headlines moment. Because under the second Trump administration, immigration agents can more easily access so-called sensitive areas, including hospitals. And heightened enforcement has chilled communities across the US. A lot of people are missing school, work and doctor's appointments.

Adrian Ma (1:18)

So today on the show, we'll look at how both patients and health care workers are bearing the physical and economic costs of the administration's deportation campaigns.

Wailin Wong (1:33)

Members of the National Nurses United Organization have been protesting ICE and the administration's immigration policies across the country. The most recent demonstration was in San Francisco. Around 1,000 nurses marched to an ICE field office. What do we do?

SPEAKER_6 (1:47)

As immigrants are under attack, what do we do?

Adrian Ma (1:53)

One of the protesters of the demonstration in San Francisco was Kelly Brennan. She traveled from Portland, Maine, where she works as a neuroscience nurse at Maine Medical Center.

Kelly Brennan (2:02)

Having that many nurses and, you know, sitting down in the street and front of the detention facility and really making our voices heard, that's amazing to be a part of, and it fills my cup.

Adrian Ma (2:15)

Kelly is the co-president of the Nurses Union in Maine. It's an affiliate of National Nurses United. In January, ICE launched an operation in Maine called Catch of the Day.

ICE said it was targeting people in the state illegally who had been charged and convicted with, quote, horrific crimes. Although later analysis by local news outlets showed that the vast majority of those targeted had no criminal convictions or pending charges.

Wailin Wong (2:40)

Kelly said the operation had a chilling effect at her hospital. Staffers in departments like housekeeping and transport services called out of work because they were afraid to come in.

Kelly Brennan (2:50)

The void they were leaving directly impacted all of patient care. ORs couldn't be prepped or sterilized timely. Patients were getting delayed being transported to procedures like x-rays and MRIs.

You know, there was a day where I had to teach an office person how to push a stretcher.

Adrian Ma (3:08)

That was on the staffing side. Patients also stayed home.

Kelly said there was an uptick in missed appointments. Some mothers with high-risk pregnancies avoided prenatal care.

Kelly Brennan (3:19)

And when people delay coming to the hospital, right, that doesn't stop the diseases from continuing to happen. So they're delaying coming in. And by the time they got there, they were sicker than they needed to be.

Wailin Wong (3:31)

One recent study in the Journal of the American Medical Association shows that in Los Angeles County, ER visits by foreign-born patients dropped by more than 20 percent in the weeks after enforcement ramped up in June 2025

Adrian Ma (3:44)

At the same time, there was an increase in admitting the foreign-born patients that did show up. According to the study, these numbers likely signal that patients delayed care until their conditions were more severe.

Wailin Wong (3:56)

And it's more costly to treat these patients in the emergency room than if they had seen a doctor earlier. William Lopez is a professor at the University of Michigan School of Public Health.

William Lopez (4:06)

We know in public health and we know in economics that the emergency room is the least efficient way to treat any kind of illness. Because by that point, it's usually escalated to something fairly catastrophic.

Adrian Ma (4:18)

William studies how deportation impacts the health of both immigrant communities and the ones where people have different legal statuses, like a household where the parents are not citizens, but their children are. He says both undocumented and documented people use less health care when there's a fear of immigration enforcement.