An Environment of Fear: How a Florida Law is Hurting Immigrant Health Care Access

Introduction

Since arriving in the United States four years ago, Alex has worked at a primary care office. He has witnessed firsthand how difficult it is for immigrants to access preventive care.

When he heard of the implementation of Florida’s Senate Bill 1718, Alex feared it would have dire consequences for the patients he served.

Alex is a pseudonym for one of our research subjects.

Florida Senate Bill 1718

SB 1718, signed into law by Gov. Ron DeSantis in May 2023, imposed sweeping restrictions aimed at discouraging unauthorized immigration. Among its provisions, it requires hospitals that accept Medicaid funds to question patients about their immigration status and share data about how many immigrants they are serving within the state.

The law had several more provisions. It mandated E-Verify, a system to check employment eligibility, be used for new hires in businesses employing more than 25 employees. It also criminalized driving into Florida with an unauthorized immigrant, and restricted community organizations from issuing IDs.

An Environment of Fear

After the law passed, Alex told his patients that they could refuse to divulge their legal status when asked on hospital forms. But he says his reassurances didn’t work. He watched as many immigrant patients hesitated to access necessary medical care for themselves and their children – or even left the state.

Alex had legal documentation to be in the country, but as his immigrant community shrunk, he wondered if he, too, should leave Florida.

Consequences for Public Health

Our survey of 466 immigrants to Florida and adult U.S.-born children of immigrants between May and July of 2024 found that nearly two-thirds of non-U.S. citizens and one-third of U.S. citizens who responded said they hesitated to seek medical care in the year after SB 1718 passed.

“I was very sick recently and needed medical care, but I was scared,” one survey participant told us.

While hospitals cannot deny care based on a patient’s immigration status, our data shows that anticipating they would be asked deterred not only immigrants lacking permanent legal status but also those with legal status, including U.S. citizens, from seeking care.

We believe U.S. citizens are affected by spillover effects because they are members of mixed-status families.

Conclusion

The results of our survey in Florida may be a warning sign for the rest of the country. Health care hesitancy like we documented could increase the likelihood of delayed treatment, undiagnosed conditions, and worsening health disparities among entire communities.

These legal restrictions are likely to increase the spread of communicable diseases and strain health care systems, increasing costs and placing a greater burden on emergency services and public health infrastructure.

FAQs

Q: What is Florida Senate Bill 1718?
A: SB 1718 is a law that requires hospitals that accept Medicaid funds to question patients about their immigration status and share data about how many immigrants they are serving within the state.

Q: What are the consequences of this law for immigrant health care access?
A: Our survey found that nearly two-thirds of non-U.S. citizens and one-third of U.S. citizens who responded said they hesitated to seek medical care in the year after SB 1718 passed.

Q: How does this law affect U.S. citizens?
A: U.S. citizens are affected by spillover effects because they are members of mixed-status families. The law also restricts access to essential services and exacerbates economic and social vulnerabilities.

Q: What are the broader implications of this law for public health?
A: The law is likely to increase the spread of communicable diseases and strain health care systems, increasing costs and placing a greater burden on emergency services and public health infrastructure.