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Fear of Immigration Enforcement Drives Patients to Telehealth
Southern California clinics are seeing a dramatic shift toward telehealth as immigration enforcement ramps up. Pediatrician Jacob Sweidan, who serves low-income and immigrant families in Los Angeles and Orange counties, reports unprecedented drops in patient visits.
“They are scared to come to the offices. They’re getting sicker and sicker,” Sweidan said, noting that children are increasingly ending up in emergency rooms due to delayed care.
Emergency Room Visits Rising Among Vulnerable Patients
Over the past two months, Sweidan has sent several children to the ER after their parents delayed care for days of high fever. In one case, a 14-year-old boy nearly suffered a diabetic coma because his family was too fearful to refill his insulin.
Clinics across Southern California report similar trends, with immigrant families avoiding routine appointments for fear of ICE activity, even for U.S. citizen children.
Telehealth Revival as a Response to Enforcement
After pausing telehealth services post-COVID, many clinics have revived virtual visits to maintain care access. St. John’s Community Health clinics report telehealth appointments increasing from 8% to 25%, while in-home visits are being offered to further support patients who avoid public spaces.
Staff at these clinics have been trained to navigate ICE encounters, ensuring patient safety while continuing essential care.
Impact on Immigrant Communities
Patients without legal status face heightened fear, often skipping medications, lab tests, and specialist visits. One 71-year-old patient from Huntington Park shared that fear of deportation kept her from attending necessary appointments, putting her prediabetic condition and mobility at risk.
Healthcare advocates describe the situation as a “fear pandemic,” drawing parallels to the isolation and caution experienced during COVID-19.
Policy and Legal Context
Recent federal policy changes have removed protections for “sensitive” locations, allowing ICE operations in schools, hospitals, and churches. Southern California clinics report encounters with federal agents during mobile clinic operations, heightening patient anxiety. Local governments and state lawmakers are exploring ways to restrict ICE access to healthcare settings, while some courts maintain temporary restraining orders.
Limitations of Telehealth for Vulnerable Populations
While telehealth provides a temporary solution, it cannot fully replace in-person care. Challenges include the inability to conduct lab work, limited internet access, technical difficulties, and translation needs.
Clinics like Venice Family Clinic have implemented proactive calls to patients, offering telehealth for those who are hesitant or miss appointments. In the Salinas Valley, Spanish-language radio campaigns educate farmworker communities about virtual care options.
Strain on Healthcare System and Safety Net
Delayed care among immigrant populations is expected to increase reliance on emergency rooms. Cuts to Medicaid and rising healthcare demand put additional pressure on safety-net clinics. Experts warn that without interventions, preventable conditions may worsen, leaving vulnerable patients at risk of serious health crises.
Community Response and Adaptation
Healthcare providers are adapting rapidly: virtual visits, home-based care, and outreach campaigns aim to reduce barriers. Patients continue to weigh fear of enforcement against medical necessity, highlighting the urgent need for policies that protect access to care for all communities.
“This fear is real,” said a patient at Venice Family Clinic. “Somebody has to wake up, or people are going to start falling apart outside on the streets.”
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