Immigration raids are driving patients back to telehealth and ERs

Editor's Note

Providers are reviving pandemic-era telehealth strategies as stepped-up federal immigration raids deter some patients from visiting clinics, KFF Health News reports via HealthLeaders August 14. With families fearful of arrest following the Trump administration’s rollback of protections for “sensitive” areas such as hospitals and schools, physicians report sharp declines in in-person visits. A pediatrician quoted in the article who runs five clinics in Southern California said he is seeing children arrive at emergency rooms (ERs) only when conditions become critical, citing examples of high fevers and a teenager nearly in diabetic coma after running out of insulin.

Many providers had scaled back virtual care after COVID-19 but are rapidly reinstating it. At St. John’s Community Health, telehealth visits jumped from 8% to 25% of appointments within weeks, while some patients now receive in-home visits funded by donors. CEO Jim Mangia described recent confrontations with federal agents at clinics, adding that patients are delaying or skipping care altogether. Similar trends are emerging nationwide, with Sara Rosenbaum of George Washington University noting no community health center has been untouched by the drop in immigrant patient visits.

Per the outlet, insurers and public health agencies are also deploying outreach tactics. CalOptima Health sent over 250,000 text messages promoting telehealth and medication delivery, while Los Angeles County officials directed agencies to expand virtual appointment options. Venice Family Clinic staff now proactively offer telehealth if patients hesitate to attend in person, and clinics in Salinas Valley have promoted virtual care via Spanish-language radio. Still, leaders such as Isabel Becerra of the Coalition of Orange County Community Health Centers caution telehealth cannot replace services like lab work or dental exams and is limited by technology access and translation barriers.

Patient fear reportedly extends beyond those lacking legal status. Some naturalized citizens are also avoiding care, carrying passports to routine appointments or depending on others to pick up prescriptions. Advocates warn the resulting delays will shift care to more costly emergency departments, just as new Medicaid cuts strain hospital capacity. Nicole Lamoureux of the National Association of Free & Charitable Clinics said the safety net faces mounting pressure as patients retreat from preventive services and conditions worsen before treatment.