Protecting Patient Access to Care Amid Immigration Enforcement Activity

California physicians are increasingly concerned that immigration enforcement actions are creating fear that deters patients from seeking medically necessary care. Reports from physicians across the country describe patients—both undocumented immigrants and U.S. citizens—missing routine appointments, delaying emergency care, and avoiding pharmacies or hospitals altogether because they fear interaction with Immigration and Customs Enforcement (ICE). Recent violent incidents in Minnesota connected to immigration enforcement activity have only intensified fear among patients and families.

“A physician’s duty is to care for anyone who needs us, without fear or hesitation,” said René Bravo, M.D., president of the California Medical Association (CMA). “Patients must feel safe seeking medical care. Hospitals, clinics and doctors’ offices should be neutral spaces where health comes first. When fear keeps people from seeing a doctor or going to the hospital, the consequences can be devastating for patients and communities alike.”

Physicians warn that delayed or foregone care increases the risk of medical emergencies, worsens chronic disease outcomes and strains emergency departments. When patients avoid care, trust in the health care system erodes—often undoing years of progress addressing health disparities.

Legal Protections for Patients and Health Care Settings

California law provides important protections designed to ensure health care facilities remain safe spaces for patients.

In September 2025, Governor Gavin Newsom signed SB 81 (Care Over Fear Act) into law. The statute strengthens safeguards for immigrant patients and clarifies how health care facilities and provider organizations may respond to immigration enforcement activity.

Guidance and Resources for Health Care Providers

Physicians and health care organizations may wish to review existing guidance and tools that address immigration-related issues in clinical settings, including:

• Guidance from the California Attorney General outlining legal considerations and policy recommendations for responding to immigration enforcement activity.

• Information from the California Hospital Association addressing how immigration actions may affect hospital operations and patient care.

• Resources from the California Primary Care Association tailored to clinics and community-based practices.

Physician practices should consider developing protocols (or reviewing and updating existing policies and procedures) for collection and retention of patient data, including patient immigration status, and for responding to immigration enforcement visits and requests for access, as well as training staff on any new protocols in advance. Practices should consult with an attorney on developing or updating these protocols, as well as when faced with a request by an immigration enforcement officer for physical access to a practice site or patient, or access to data on patients or their families, to ensure compliance with HIPAA, CMIA, and other applicable state and federal laws. Physicians practicing in facility settings should also familiarize themselves with the facility’s policies and procedures on immigration law enforcement actions and notify the designated health care facility administrator of any request by an immigration enforcement officer.

CMA will continue to monitor developments, advocate for policies that protect patient access to care, and share additional guidance and resources with members as they become available.