Florida is budgeting nearly $558,000 to surveil patients who are still navigating the immigration system when they visit the doctor. Republican lawmakers and Gov. Ron DeSantis are allocating the funding to enforce a harsh new anti-immigrant law that is spreading fear and confusion and pushing people to forgo medical treatment — including an alarming number of pregnant women.
The controversial policy has patients avoiding mammograms and critical prenatal care because they fear being punished for disclosing their immigration status, according to health care providers and immigrant rights groups in Florida.
Thelisha Thomas, executive director of the Healthy Start Coalition in Orange County, told Politico last month that fewer pregnant migrant women are seeking treatment even in emergency situations. Thomas’s nonprofit clinic has seen a 10 percent overall decrease in the number of pregnant patients who show up for care.
Championed by DeSantis and passed just weeks before he launched a doomed presidential campaign last summer, Florida’s anti-immigrant law cracks down on businesses that hire undocumented workers and establishes criminal penalties for anyone who brings an undocumented person into the state.
The law reportedly has had significant unintended economic consequences and has angered Florida’s business community. A Florida roofer was recently charged with human smuggling under the law after driving a work crew back from a job in Georgia in a van.
But the law also requires public hospitals and clinics that receive Medicaid funding to ask patients about their citizenship or immigration status along with the other background questions typically asked of patients when they arrive for treatment. Migrant rights advocates are encouraging immigrants — and anyone concerned about their privacy — to decline answering the question.
While many Florida doctors and hospitals are required to ask patients about their immigration status, declining to answer is totally legal. Florida lawmakers almost certainly knew that forcing all patients seeking care from public providers to disclose their citizenship or immigration status would violate the Constitution and be struck down by the courts.
However, migrant rights advocates say confusion over the law has immigrants forgoing medical treatment out of fear of arrest and deportation, and now Florida taxpayers are on the hook for the more than half a million dollars to hire a team of bureaucrats who will set up a system to surveil a vulnerable population at doctors’ offices.
There are roughly 1.8 million noncitizen residents of Florida, including both lawfully present immigrants and undocumented people. A recent analysis by the Kaiser Family Foundation found that the anti-immigrant law could have “stark” health impacts beyond the undocumented people it targets. A large number of Floridians come from immigrant families with a mix of legal statuses, including children born as citizens in the United States, and the law’s chilling effect could prevent parents from seeking care both for themselves and their children.
The first official state report on the impacts of the law found that people who self-reported their undocumented immigration status made up less than 1 percent of all hospital admissions and emergency room visits. As advocates for immigrants point out, the report contradicts rhetoric from Republicans who accused undocumented people of straining the health system.
Undocumented people in Florida and most other states are not eligible for Medicaid, the public insurance program for lower-income people, which creates another barrier to health care for millions of people nationwide.
Adriana Rivera, communications director for the Florida Immigrant Coalition, remembers being asked about her immigration status at the emergency room last year. Rivera knew about the anti-immigrant law and said the hospital staff were “clearly ashamed and apologetic,” but she still froze as the question sent “shockwaves” through her body.
Rivera said she regained her bearings and declined to answer, but for many others, the question will “will send them out of the door and into harm’s way.”
“When a disease or health emergency strikes, it doesn’t stop to ask someone’s immigration status,” Rivera said in a statement. “And scaring people into not seeking care puts us all in danger of communicable diseases, like the measles, respiratory viruses, and even STIs.”
Some Florida Democrats balked at the price tag, but they are the minority in a legislature where Republicans work in lockstep with DeSantis.
“When we were going through this, it talked about having minimal to almost no cost … now, we’re looking at something with a price tag of $557,000,” said State Sen. Tracie Davis of Jacksonville when the DeSantis released the state budget to lawmakers in December. “My question to you is, is that minimal?”
Florida’s effort to surveil the immigration status of medical patients is part of a broader backlash fueled by Republican demagogues, racist conspiracy theories and sensationalist media coverage of migrants arriving at the southern border. DeSantis and Texas Gov. Greg Abbott in particular appear to be almost competing over who can be crueler, with both Republicans thrusting themselves into the national spotlight by busing large numbers of migrants to sanctuary cities in blue states.
Not to be outdone by Florida, Abbott recently signed SB 4, which allows Texas law enforcement to arrest and jail undocumented people who cross the border unless they agree to leave the country. Federal law already makes crossing the border illegally a crime, but Republicans baselessly blame the Biden administration for the number of people fleeing poverty and violence and seeking asylum.
However, the White House backed a harsh immigration reform package in Congress that would have curtailed rights for asylum seekers. The legislation was full of GOP policy priorities but was tanked by opposition from former President Donald Trump, who is once again fearmongering about migrants as he seeks reelection.
The Biden administration challenged the Texas law in court, arguing that the only federal government can enforce immigration laws at the border, not individual states. The Supreme Court put the law on hold while it considers the administration’s challenge.
Back in Florida, lawmakers are poised to approve the budget containing the controversial funding for tracking immigration status at the doctor with a vote on Friday.
“The half-million dollars designated for collecting data on patients’ immigration status could be far better utilized to directly improve access to life-saving care for all residents of Florida,” Rivera said.
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Mike Ludwig is a staff reporter at Truthout based in New Orleans. He is also the writer and host of “Climate Front Lines,” a podcast about the people, places and ecosystems on the front lines of the climate crisis. Follow him on Twitter: @ludwig_mike.
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