By Kristine de Leon, Gosia Wozniacka
oregonlive.com
PORTLAND, Ore. — A patient diagnosed with cancer delayed treatment. A diabetic rationed insulin to dodge a trip to the pharmacy. Parents avoided a specialist for their child suffering seizures. An expecting mother arrived to give birth having received no prenatal care.
These are no longer isolated cases but part of a growing pattern of people delaying or forgoing medical care, driven by fear, as armed federal agents cluster in cities throughout the state in President Donald Trump’s immigration dragnet, say doctors and community health workers serving Oregon immigrants and their families.
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Federal officers have detained people mostly in public spaces, on streets, in parking lots and roadways – but increasingly, near hospitals and clinics that have been off-limits in the past.
The fear escalated after federal agents shot a man and a woman outside a medical office in Portland in early January and two weeks later detained a family seeking emergency care for their child in the parking lot of the same medical campus.
“Patients are not coming in, they’re just avoiding or delaying medical care,” said Eva Galvez, a doctor who works in Washington County. “We’re seeing a massive disruption of chronic disease management, people rationing medications, patients avoiding preventative visits, tests and vaccines.”
It’s not just patients who lack legal status who are staying away, Galvez said. Deep anxiety is rippling through the Latino communities at large, she said, because many families have mixed immigration status, including undocumented parents who aren’t bringing their U.S. citizen children for care.
Few immigrants facing health care problems talked directly to The Oregonian /OregonLive over weeks of reporting this story, concerned they would expose themselves to arrest. Several doctors who spoke to the newspaper asked not to name their clinics to protect their staff and patients from potential ICE incursions.
That wariness shows up in waning enrollment in public benefits. Healthier Oregon — the state-funded, Medicaid-like program open to income-eligible residents regardless of immigration status — saw enrollment drop by about 10,000 people, or 9%, between June and this January, according to state health officials. They attributed the drop to mounting data privacy concerns and stepped-up immigration enforcement.
The pattern extends far beyond Oregon. Health care providers in communities targeted by immigration enforcement nationwide report fewer patients seeking care and rising distress, particularly among children, with some doctors accusing federal agents of interfering with medical decisions.
A November survey by Physicians for Human Rights and Migrant Clinicians Network found that 84% of more than 690 health care workers in 30 states reported significant or moderate declines in patient visits after January 2025. Parents, the survey found, are making the same calculation doctors in Oregon describe — weighing medical needs against the risk of detention or deportation.
The consequences, doctors say, are far-reaching: Delayed care turns manageable illnesses into medical emergencies — and, in some cases, preventable suffering and death. Treatment then shifts to costly emergency rooms, where care is far more expensive and frequently goes unpaid. Those costs don’t disappear — hospitals absorb them and pass them on to patients and taxpayers.
And though clinics, hospitals and legislators are working on interim solutions, it’s unclear whether those efforts can quell the desperation now shaping the way many immigrants navigate their lives, including even the most basic medical decisions.
“This is a looming health care crisis,” said Galvez, who asked The Oregonian /OregonLive not to identify her clinic’s location due to staff and client safety.
A growing care gap
Dr. Antonio Germann, who oversees two Woodburn-based nonprofit community clinics that serve low-income and predominantly Latino communities, said no-shows and canceled appointments among Spanish-speaking patients have climbed over the past several months, reaching 20% in some weeks.
Patients with dangerously high blood sugar or uncontrolled blood pressure are simply not coming in, he said. Others with diabetes, Germann added, have seen their disease spiral out of control after skipping prescriptions because they’re afraid to go to the pharmacy.
“If people aren’t accessing preventive care, they’re potentially setting themselves up for more serious health problems that could have been avoided,” Germann said. “Then it leads to more emergency department visits … when we could have intervened with some prevention.”
That shift places added strain on emergency departments, he said, which are required by federal law to treat all patients, regardless of immigration status or ability to pay.
Germann said he’s now seeing patients with more advanced disease because they’ve waited too long. But many, he said, are refusing to go to a specialist or to the hospital for necessary care.
For example, Germann said his team recently cared for an undocumented patient diagnosed with pancreatic cancer who was afraid to go to a Portland hospital to begin treatment.
“We really had to support them with a number of follow-up phone calls to help them understand that they really needed to go to a hospital,” he said.
After weeks of outreach, Germann said, the patient eventually sought care.
For Dr. Genoveva Ollervides O’Neill, a family physician and vice president of Free Clinic of Southwest Washington in Vancouver, the fear often surfaces in quieter moments.
She recalled treating a 4-month-old baby whose parents were worried about their daughter’s “shaking” episodes. After reviewing videos that the mother showed, O’Neill said she feared the baby might be having seizures and recommended an urgent referral to a pediatric neurologist.
But the mother hesitated, according to O’Neill, explaining that she and her family were undocumented. Despite O’Neill’s concerns, the family ultimately declined the referral.
“They were very afraid of what may happen if they went to the hospitals in Portland,” O’Neill said. “I tried to explain to her the severity of my concern, but it was clear that her fear of being separated from the life she had built was big enough to drown her anxiety about her baby’s potential diagnosis.”
O’Neill said she’s seeing the same fear take a toll on teenagers. A 16-year-old patient came in struggling with insomnia and anxiety, she said, overwhelmed with daily worry that her undocumented parents might not come home from work. Her parents were too afraid to travel to the appointment, O’Neill said, leaving the teen to navigate medical decisions on her own.
“It is incredibly disheartening to struggle to provide the basic care that should be available to everyone,” O’Neill said. “A person’s immigration status holds no bearing on how their body functions, but has now become a real factor in their medical treatment.”
Dr. Toren Davis, a family medicine doctor who treats patients both in clinic and hospital settings in Vancouver, said it has become increasingly common for pregnant patients to arrive at the hospital to give birth having received little or no prenatal care.
“One reason we’re seeing limited prenatal care is fear of leaving the home,” Davis said. “People are afraid of being detained while pregnant and what that could mean for their child.”
Missing prenatal visits can mean missing screenings for conditions like gestational diabetes or infections, increasing the risk of preventable complications — and even death — for both mother and baby, Davis said.
“This is a complex health crisis,” he said. “The weight of our current reality harms health in multiple ways.”
Detentions, data sharing fears
Hospitals and medical clinics were once considered off-limits to immigration enforcement. But that sense of safety eroded last year when Trump rescinded a long-standing policy that had restricted enforcement actions at health care facilities and other “sensitive locations,” including schools and churches.
The effects were swift. In Hillsboro, a Virginia Garcia Memorial Health Center clinic went into lockdown in October as a precaution for patient and staff safety because ICE agents were near the facility. The health center is one of the region’s most important safety nets, especially for immigrants in the region. Immigration detentions were also reported near several other area clinics.
In Portland earlier this month, three unmarked cars with immigration agents surrounded the car of a Gresham family, including a 7-year-old child, in the Adventist Health ER parking lot as the girl’s parents sought emergency care for her. The child never saw a doctor. The family — immigrants from Venezuela with a pending asylum case — was detained and flown to a detention center in Texas, where they remain.
Two weeks earlier at the same medical campus, a Border Patrol agent cornered, shot and wounded a man and woman from Venezuela. According to court records, the man was there to take his partner to a medical appointment when six agents in four unmarked cars tried to box in their pickup truck. The two, who both entered the country without authorization, fled after ramming an unoccupied Border Patrol rental car with their truck and called 911. They’re now facing federal charges.
Cases of arrests at hospitals have also been reported in other states – including most recently in Minnesota, where ICE agents followed a seriously ill patient to a hospital room without a judicial warrant, shackling the patient to a bed for 24 hours before hospital staff forced them to leave.
In mid-December, Oregon’s largest nurses union accused Legacy Health of allowing ICE officers to roam the halls and units at Legacy Emanuel Medical Center in Portland, one of the state’s busiest trauma centers, to shackle patients to their beds and make medical decisions for the detainees. Hospital system officials said they treat immigration agents as they would any other law enforcement officers. Earlier this month, the hospital sent a cease-and-desist letter to the nurses union, accusing it of making ‘false and misleading statements’ about its policies and asking it to stop.
Health care providers said worries have also deepened amid concerns that personal health information could be used for deportation purposes. In late December, a federal judge in California cleared the way for immigration authorities to access some Medicaid data, including names, addresses and dates of birth. The patients affected are those who have sought emergency care, which is paid for by federal dollars.
The Oregon Health Authority warned the decision could have a chilling effect on people seeking crucial medical treatment. Health policy researchers at KFF, a nonprofit health policy research organization, also cautioned that federal health databases aren’t designed to reliably separate people by immigration status, raising the risk that legal immigrants and U.S. citizens could be swept into enforcement efforts.
At the same time, immigration detentions have become increasingly data-driven. Palantir, a technology firm that has long worked with ICE, has developed a tool known as ELITE that consolidates government data – including health care data – and maps potential deportation targets. The Oregonian /OregonLive reported on court testimony that showed ICE officers used the tool during enforcement actions in Woodburn.
Seeking solutions on the front lines
At Woodburn Pediatric Clinic, manager Deb Bartel said staff members have posted signs stating immigration agents aren’t permitted in exam rooms and now escort patients directly into private areas rather than having them wait in the lobby.
“We try really hard to make our clinic feel like a safe space for them,” she said. “I don’t think it’s going to get much better for a while.”
The clinic has expanded telehealth visits and spends hours calling families who are too afraid to come in — service time that Bartel said the clinic doesn’t bill to insurers or patients. Staff members are also helping families set up legal agreements allowing trusted friends and distant relatives to bring children to appointments.
The clinic also has a team of people working to help patients stay on Medicaid benefits, even as many worry about their data being shared.
Other clinics have taken similar steps. Germann, the doctor in Woodburn, said his staff has been increasingly accommodating virtual visits.
“We’re doing everything in our capacity to create a safe environment for our families and patients,” he said. “We’re trying to be creative in solutions for telemedicine and alternative ways to reach out to patients and connect them to the care they need.”
A coalition of doctors, nurses and community health care activists in Oregon created Scrubs for Sanctuary, which is circulating a petition urging Gov. Tina Kotek and Oregon’s state and federal elected officials to better protect patients and providers from immigration enforcement in medical settings and help vulnerable families stay connected to health care. The petition also seeks to prevent medical neglect in immigration detention centers.
“Our safe spaces like clinics and hospitals are no longer safe,” said Galvez, the Washington County doctor. “So we really felt that we needed to coalesce with other clinicians to share resources about how to protect ourselves and our patients.”
Lucas Bezerra, a spokesperson for Kotek, said the governor recognizes the “fear and chaos” created by what her office described as the Trump administration’s “aggressive unlawful actions” that have scared people away from seeking medical care and have left some providers questioning their own safety on the job.
“The Governor and her staff will review the petition and look to partners across Oregon’s health care delivery system to do what is best for people seeking care in Oregon,” he said.
Sen. Wlnsvey Campos, D- Aloha, also plans to introduce a bill that would set clear policies for when and how federal immigration agents can access health care settings, including barring agents from entering or questioning patients in non-public care areas of hospitals and federally qualified health care centers if they don’t have a signed judicial warrant.
It also would treat immigration status and place of birth as protected health information. And it seeks to protect health care workers from retaliation from their management for trying to protect patient privacy or follow their ethical obligations during interactions with ICE.
“Hospitals and clinics are places where folks go when they’re vulnerable, when they’re sick, when they’re scared, when they’re caring for a child. And ultimately, when fear enters those spaces, it undermines trust and public health,” Campos said. “We want to make sure that healthcare settings are places of care and not places of fear.”
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