Civil rights advocates and health care workers warned Tuesday that growing fears of immigration enforcement are keeping patients from seeking medical care in Michigan.
In response, the American Civil Liberties Union of Michigan and its partners released new guidance for hospitals handling encounters with law enforcement.
At a news conference Tuesday, speakers said the problem is not just the possibility of immigration agents showing up at hospitals, but the chilling effect it’s already having on patients across Michigan.
“For many years, federal immigration enforcement agencies had internal guidance that limited enforcement at locations considered sensitive,” ACLU staff attorney Ramis J. Wadood. “But last year, the second Trump administration ended the sensitive locations policy, allowing immigration [agents] to now do enforcement at schools, places of worship, hospitals, and medical clinics.”
That policy change has led to confusion among health care providers and fear among patients, even though the law itself hasn’t changed, Wadood said.
“Regardless of immigration status, patients remain entitled to necessary medical care under federal and state law,” he said. “Health care facilities retain the legal authority to protect patient privacy and control access to nonpublic areas.”
The guidance letter, sent Monday to providers statewide, lays out the protections in detail, emphasizing that hospitals are not required to help enforce immigration law and must continue to follow longstanding privacy rules.
It also makes clear that patient information generally cannot be shared with law enforcement without a judge-signed warrant, and that immigration agents cannot enter private areas of a hospital without judicial authorization or consent.
Still, doctors say the broader climate is already affecting care.
“Trust is not earned lightly,” Dr. Lauren Snyder, a family medicine physician, said. “People come to us in their most vulnerable states.”
But that trust is eroding.
“No one should feel afraid to get the medical care that they need,” Snyder said. “And people in vulnerable communities are not comfortable seeking out care that has typically been routine.”
She described patients skipping medications and delaying cancer screenings because family members are afraid to leave their homes.
“I have seen a patient of mine experiencing high blood pressure … and it turns out they haven’t been able to get their medications,” Snyder said. “Because their family member … doesn’t feel safe going out.”
Dr. Elliot Brannon, a family medicine resident who has lived in Southeast Michigan for the past decade, said the impact extends beyond undocumented immigrants.
“The most insidious impact is for the patients that we don’t see,” Brannon said, pointing to research showing immigration enforcement reduces routine care and preventive visits.
A 2025 survey found 84% of clinicians reported declines in patient visits, largely driven by fear of deportation or family separation, he said.
“People are silently suffering within the confines of their own homes,” Brannon said.
Health care workers and advocates repeatedly stressed that the guidance is meant to reassure providers and standardize responses if law enforcement shows up.
Under the recommendations, hospitals should route all law enforcement requests to designated administrators, avoid confirming whether a patient is present, and require proper legal documentation before granting access to private areas.
Yousef Rabhi, legislative director for the Michigan Nurses Association union, called the issue a growing public health crisis.
“In hospitals, what should be happening is healing,” Rabhi said. “If there is a constant fear of immigration showing up and disturbing that process, that has had an impact on health care outcomes.”
Rabhi cited an incident near an Ann Arbor hospital where someone was detained, saying it “instilled fear in our whole state.” He added that “there is no safe space in America anymore.”
Elinor Jordan of the Michigan Poverty Law Program said additional federal policy changes are adding to the problem, including potential data-sharing concerns and new limits on Medicaid eligibility for some noncitizens.
“True health and safety comes from people having the resources that they need,” Jordan said. “It doesn’t come from uprooting our neighbors from their communities.”
Advocates said the goal of the guidance is to ensure hospitals remain places where patients feel safe seeking care.
“Health care providers are not responsible for enforcing immigration law,” the letter states, emphasizing that facilities should avoid collecting immigration information and prioritize patient care above all else.
Wadood said that message is especially important as enforcement policies shift.
“This policy change does not alter patients’ legal rights or health care providers’ legal obligations,” he said.