The Chilling Effect of ICE Raids on Emergency Medicine

When I walk into the chaos of the emergency department (ED), I expect traumas, cardiac arrests, and acute strokes. What I don’t expect is the eerie sense that some patients walked in the door more afraid of being deported than of their own medical emergency. Recent data has shown an alarming increase in [federal] Immigration and Customs Enforcement (ICE) detentions and arrests under the Trump administration, driven by racial/ethnic profiling and $45 billion in funding courtesy of the reconciliation bill signed into law by President Trump in summer 2025, resulting in a nearly 40 percent increase in detainments.^1,2

Although news of raids in cities such as Chicago, New York City, Los Angeles, Charlotte, North Carolina, and elsewhere around the country is publicized, the injuries to patients are not always reported. Data regarding the surge in injuries related to ICE raids have been poorly tracked. From a strictly data-driven standpoint, there lies a dangerous gap in information. Currently there is no trackable national database showing a clear increase in ED visits for injuries sustained during ICE agent enforcement. Some regional reporting hints at increases in trauma: A Chicago alderwoman said agents brought injured people to the hospital from a raid; one man “broke his leg running from the agents.”³ Another report from California described doctors seeing detained patients with injuries after raids and agents embedded in hospital rooms. Some reports stated that “hospital administrators are allowing federal immigration agents to interfere in medical decisions and block doctors from properly treating detainees who need emergency care.”⁴ But no robust epidemiologic study has yet quantified the rise in injuries and ED visits as a consequence of ICE actions.

Emergency physicians are aware of the risk . An article intended for ED staff warns that when ICE enforcement moves into once-protected “sensitive locations,” such as hospitals, the consequences include disruptions of care, increased stress for staff and patients, and secondary injuries from delayed care.⁵ So while we can’t definitively say that ED visits for ICE enforcement-related injuries increased by a certain percentage, we can say the risk is real, and the institutional impact is apparent.

Here’s where the data get clearer, and scarier for us as emergency physicians. Research consistently shows that enforcement activity by ICE and the surrounding deportation rhetoric creates a chilling effect on health-seeking behavior in immigrant populations. For example, a study found that after raids or legislation targeting immigrants, visits to county public-health clinics dropped about 25 percent among Latino adults.⁶ A recent article reported that many patients have said that they’ve “hesitated or waited too long to come in for health care” because of fear of ICE [agents] in hospitals.⁷ In New York, a federally qualified health-center doctor said that one shelter stopped receiving patients altogether because “almost no one was showing up for care” after rumors that ICE was operating nearby.⁸ In another story, a woman reportedly avoided prenatal care because she feared her partner’s deportation. Her baby suffered complications as a result.⁹ So, no, we may not have a neat ICD-10 code for this yet, but we have real stories of delay, avoidance, and the medical sequelae that follows. It likely leads to more advanced presentations, more preventable complications, more cost, and worse outcomes.

As an emergency physician with a public health lens, I want you to imagine this scenario: a man showing up at 3 a.m., shirt still stained from drywall dust. He’s been hiding a deep cut from a power tool for several days because he heard ICE raided the job site next door. By the time he comes in, the wound is swollen, streaked with infection, and his hand barely moves. He’s now septic with an untreated open fracture. He tells you — through an interpreter — that he’d rather lose a limb than be deported. But now, he requires emergent surgery.

That’s the avoidable burden that I have seen.

In the emergency department, we are trained that time equals tissue. Whether that tissue is myocardium or bacteremic bone — delay costs. And when avoidance is driven not just by lack of resources but also by fear of deportation, we’re facing a social determinant of health in real-time. Moreover, when ICE agents show up in health care spaces (or are perceived to), trust evaporates. One hospital reported agents entering patient care areas without warrants, refusing to identify themselves, restraining detainees in cuffs while medical decisions were being made, and preventing doctors from contacting families.⁴ That undermines confidentiality, trust, and physician-patient autonomy — everything we rely on for safe, high-quality care.

This is no longer just an immigration issue. It is a public health issue. The rippling effects impact all of us. A study in New York reported that patients who feared ICE were three times more likely to delay care for tuberculosis (TB), even though untreated TB threatens the broader public.¹⁰ When fear prevents community members from seeking care, communicable diseases spread, ED volumes grow, hospitals’ resources become strained, and patient outcomes worsen.

We should call for hospital-level data surveillance linking enforcement events with care avoidance and injury trends, including use of force by law enforcement. We need hospital staff training and policies to handle these interactions ethically, in a way that protects all patients regardless of immigration status. And we must demand that agents should not be allowed to undermine physician treatment or patients’ access to care. Because, as much as I love the drama of a trauma bay, the quiet ones scare me more — the person who avoided coming in until it was too late, the parent who skipped their child’s follow-up appointment because ICE might show up at the clinic, the hospital corridor where patients glance over their shoulder and wonder if someone in uniform will step through the door.

If we believe in emergency medicine as a universal safety net, we must reckon with the fact that enforcement-driven fear is ripping holes in that net. And, yes, if you are a physician, a nurse, a hospital administrator, or a public-health advocate, you are part of the solution. Because when we lose trust, we don’t just lose access for undocumented patients, we lose access for everyone.

Without reform, this will only be the tip of the ICE-berg.

DR. ANYANWU is an emergency medicine physician in Houston with an MPH in epidemiology and fellowship training in leadership and advocacy. She serves on the ACEP Now Editorial Advisory Board.

U.S. Immigration and Customs Enforcement. ICE: First 100 Days. U.S. Department of Homeland Security. Published 2025. Accessed October 28, 2025. https://www.ice.gov/features/100-days
American Immigration Council. ICE Detention at 59,000: Record Levels, Horrible Overcrowding, Dwindling Due Process. Published 2025. Accessed October 28, 2025. https://www.americanimmigrationcouncil.org/event/ice-detention-59000-record-levels-horrible-overcrowding-dwindling-due-process/
ABC 7 Chicago. Chicago Alderperson Says Federal Agents Handcuffed Her at Humboldt Park Medical Facility. Published August 2025. Accessed October 28, 2025. https://abc7chicago.com/post/chicago-immigration-news-aldermen-speak-militarized-enforcement-humboldt-park-area/17931599/
LAist. At a Boyle Heights Hospital, ICE Agents Call the Shots, Doctors Say. Published October 2025. Accessed October 28, 2025. https://laist.com/news/politics/boyle-heights-hospital-ice-agents-patient-care-privacy-rights
Emergency Medicine Residents’ Association (EMRA). Responding to ICE in Emergency Departments: Protecting Patients & Navigating Legal Obligations. Published February 2025. Accessed October 28, 2025. https://www.emra.org/emresident/article/ice-in-the-ed
School of Public Health, University of Michigan. Increased Immigration Enforcement and Anti-Immigrant Rhetoric Has Potential ‘Chilling Effect’ on Health Care Access. Published June 2018. Accessed October 28, 2025. https://sph.umich.edu/pursuit/2018posts/increased-immigration-enforcement-and-anti-Immigrant-rhetoric-has-potential-chilling-effect-on-health-care-access.html
CBS News. Doctors Fear ICE Agents in Health Care Facilities Are Deterring People From Seeking Care. Published July 9, 2025. Accessed October 28, 2025. https://www.cbsnews.com/news/doctors-fear-ice-agents-health-care-facilities-deterring-people/
Health Beat New York. Ripple effects of ICE raids create health challenges for New York City. Published August 14, 2025. Accessed October 28, 2025. https://www.healthbeat.org/newyork/2025/01/29/your-local-epidemiologist-ice-raids-effects-on-health/
The 19th. ICE Fears Put Pregnant Immigrants and Their Babies at Risk. Published October 7, 2025. Accessed October 28, 2025. https://19thnews.org/2025/10/pregnant-immigrants-ice-fears-deportation/
Health Beat New York. Your Local Epidemiologist: ICE Raids and Their Effects on Community Health. Published January 29, 2025. Accessed October 28, 2025. https://www.healthbeat.org/newyork/2025/01/29/your-local-epidemiologist-ice-raids-effects-on-health/