Rising immigration enforcement is shifting how immigrants access healthcare, at times putting their health and lives at risk, local community leaders say.
Faisa Farole, the executive director of Global Perinatal Services, runs a nonprofit based in Federal Way that operates a clinic and birthing center where people can access pregnancy care. She said there is an increase in the number of clients who are trying to avoid hospitals due to the potential presence of Immigration and Customs Enforcement (ICE) agents, even when those clients experience complications that arise during labor.
"People shouldn't have to do that," Farole said.
She described a situation where she helped a client give birth, and the client showed signs of high blood pressure, which can signal preeclampsia, a disorder that can occur during pregnancy or postpartum and lead to strokes, seizures, or even death. Despite repetitive support and warnings about the consequences, she refused to go to the hospital.
"We're seeing people who choose to have a child are not able to do that in a healthy, safe, and sustainable environment," said Jackie Vaughn, executive director of Surge, a reproductive justice organization based in South Seattle.
Across the country, in places such as New York and California, there have been reports of ICE raids in hospitals, following the Trump administration's reversal of a policy that protected against enforcement in "sensitive locations" such as healthcare facilities, places of worship, and schools.
These fears are showing up locally. In February, KUOW reported that nurses said there is a growing presence of ICE at St. Joseph Medical Center in Tacoma. There was also an incident where an ICE officer left a gun unattended in the hospital bathroom.
These worries may increase after the recent fatal shootings by ICE officers of Lorenzo Salgado Araujo in Houston on July 7 and Joan Sebastián Durán Guerrero in Biddeford, Maine, on July 13. The shootings occurred as immigration enforcement was ramping up to a nationwide standard of 2,000 arrests per day set by the Trump administration, according to The New York Times.
"People are scared because of the political environment," Farole said.
In 2025, a survey by KFF and The New York Times found that nearly half of likely undocumented immigrant adults said they had avoided seeking medical care since January 2025 due to immigration-related concerns.
When people delay care, it can cause lower health outcomes for individuals and costly consequences for the community, said Justin Gill, an urgent care nurse practitioner and president of the Washington State Nurses Association. In addition to rising immigration enforcement concerns, Gill said that costs are also a reason why many immigrants delay care.
Federal law requires emergency rooms to treat people regardless of immigration status. When people wait until their health concerns worsen, they likely end up in the ER, which can contribute to ERs becoming strained and overwhelmed.
As a nurse practitioner, Gill has noticed more people don't follow up on appointments to address long-term diseases, such as diabetes or high blood pressure, and instead seek immediate fixes in urgent care or the ER.
Organizations like the one Farole runs, which help immigrants, have also seen a decrease in the number of people without legal status who utilize the services for fear of being exposed.
Some of Farole's clients have even tried to minimize their stay at a hospital and have chosen to wait until they're on the verge of giving birth to seek medical care. She described a client who tore through her rectum because she refused to go to the hospital for a C-section.
"We are seeing a lot of people who are being affected like this. They could have sought help, they could have gotten help, but they didn't. They delayed it, not because they wanted to delay," Farole said.
When pregnant people don't receive prenatal care, it prevents doctors from being able to monitor, identify, and manage risks during a baby's development, Vaughn said. High levels of stress during a pregnancy can also lead to unnecessary C-sections and interventions during labor and delivery, she added.
Despite the fear among some immigrants, the need for services grows while the capacity shrinks. Farole's organization recently had to cut their staff in half due to budget constraints.
There is also a growing lack of trust among immigrants about institutions.
Medicaid is only available to citizens and certain lawfully present immigrants. Noncitizens are prohibited by federal law from accessing benefits, but states like Washington have utilized state dollars to create programs, such as Apple Health Expansion, for those in the U.S. without legal authorization.
The enrollment is capped based on available funding and currently covers around 13,000 individuals in the state. Apple Health is also extended to noncitizens who are pregnant and those with cancer and dialysis treatments.
Last year, Washington's Medicaid data was shared with the U.S. Department of Homeland Security. This included information such as names, citizenship and immigration status, addresses, phone numbers, and Medicaid ID numbers of individuals who lack legal status.
"There were patients I saw that I let them know about this program, and it made me kind of think twice: Was I really helping them at that time, or did I actually hurt them by exposing their information to ICE?" Gill said.
Generally, most hospitals and clinics have now developed protocols if ICE agents are present. Medical centers typically do not disclose any personal information to law enforcement, including ICE, unless there is a signed warrant by a judge.
"We understand laws around confidentiality and privacy," Gill added, "but we never ever trained for the moment where we would expect immigration enforcement officers coming to a clinic when we're trying to provide care to a patient that's in need of help."
Gill said that it's important that at the local level organizations reach out to the community and communicate the safety and rights of patients that medical professionals will uphold, but that it's ultimately up to leaders and policies at the federal level that create these situations.
"These are individuals, these are human beings, these are community members," Gill said. "For those of us as healthcare workers, our main goal is to care for people and treat people without any judgment or bias, but it's becoming difficult when the social issues around caring for that patient are directly affecting that person's ability to access care."
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