Hostname: page-component-5db58dd55d-xnzfm Total loading time: 0 Render date: 2026-06-02T06:34:05.188Z Has data issue: false hasContentIssue false

No sanctuary? Public attitudes about healthcare providers and their role in immigration enforcement and policy

Published online by Cambridge University Press:  26 January 2026

Christine Crudo Blackburn
Affiliation:
Department of Health Policy & Management, School of Public Health, Texas A&M University, College Station, TX, USA
Simon F. Haeder*
Affiliation:
Division of Health Services Management & Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
*
Corresponding author: Simon F. Haeder; Email: haeder.1@osu.edu
Rights & Permissions [Opens in a new window]

Abstract

This study aims to understand if the American public supports five policies related to the involvement of healthcare providers in immigration enforcement efforts such as documenting legal status in medical charts to actively assisting immigration enforcement. We also seek to establish whether public attitudes are stable on this issue using an experiment highlighting the implications of these policies for immigrants, communities, and the broader public. To assess public attitudes, we fielded a survey (N = 6049) from 7 March to 26 March 2025. We randomly assigned respondents to one of six treatments highlighting various implications of these policies for immigrants and communities. We found a divided public on the topic, with a substantial number of Americans willing to blur the lines between immigration policy and the provision of healthcare. Respondents were most receptive to tracking the number of undocumented patients served and least supportive of assisting in detaining patients. We found substantial differences based on party affiliation and presidential vote choice but not personal connections or residence inside or outside of border states. Our findings suggest that a majority of Americans support some level of immigration enforcement in healthcare settings while public opinion on this issue is hard to move.

Information

Type
Article
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press
Figure 0

Figure 1. Distribution of support for five policies regarding healthcare providers and requirements related to individuals who lack legal status.Notes: Based on a national survey of 6049 US residents from 7 March to 26 March 2025. The control group contained 859 respondents. Respondents were asked whether they supported the following policies. Results only shown for control group. Additional results are displayed in the appendix. (1) Some have proposed for all hospitals and other healthcare providers to track how many undocumented patients that they provide care to (Track); (2) Some have proposed to requiring hospitals and other healthcare providers to ask for a patient’s immigration status before providing care (Ask Status); (3) Some have proposed to requiring hospitals and other healthcare providers to note a patient’s immigration status on medical charts and medical bills (Mark Status); (4) Some have proposed to requiring hospitals and other healthcare providers to report undocumented immigrants they treat to immigration enforcement (Report); (5) Some have proposed to requiring healthcare providers and staff to actively assist immigration enforcement in detaining undocumented immigrants (Assist). Respondents were provided with a 5-point scale for each question.

Figure 1

Figure 2. Predicted mean levels of support for five policies regarding healthcare providers and requirements related to individuals who lack legal status.Notes: Based on a national survey of 6049 US residents from 7 March to 26 March 2025. Respondents were asked whether they supported the following policies. (1) Some have proposed for all hospitals and other healthcare providers to track how many undocumented patients that they provide care to (Track); (2) Some have proposed to requiring hospitals and other healthcare providers to ask for a patient’s immigration status before providing care (Ask Status); (3) Some have proposed to requiring hospitals and other healthcare providers to note a patient’s immigration status on medical charts and medical bills (Mark Status); (4) Some have proposed to requiring hospitals and other healthcare providers to report undocumented immigrants they treat to immigration enforcement (Report); (5) Some have proposed to requiring healthcare providers and staff to actively assist immigration enforcement in detaining undocumented immigrants (Assist). Respondents were provided with a 5-point scale for each question.

Figure 2

Table 1. Predicted mean levels of support for five policies regarding healthcare providers and requirements related to individuals who lack legal status, control versus treatments

Figure 3

Table 2. Predicted mean levels of support for policies regarding healthcare providers and requirements related to individuals who lack legal status, comparing requirement to assist versus other policies

Figure 4

Figure 3. Predicted mean levels of support for five policies regarding healthcare providers and requirements related to individuals who lack legal status, by partisanship.Notes: Based on a national survey of 6049 US residents from 7 March to 26 March 2025. Respondents were asked whether they supported the following policies. (1) Some have proposed for all hospitals and other healthcare providers to track how many undocumented patients that they provide care to (Track); (2) Some have proposed to requiring hospitals and other healthcare providers to ask for a patient’s immigration status before providing care (Ask Status); (3) Some have proposed to requiring hospitals and other healthcare providers to note a patient’s immigration status on medical charts and medical bills (Mark Status); (4) Some have proposed to requiring hospitals and other healthcare providers to report undocumented immigrants they treat to immigration enforcement (Report); (5) Some have proposed to requiring healthcare providers and staff to actively assist immigration enforcement in detaining undocumented immigrants (Assist). Respondents were provided with a 5-point scale for each question.

Figure 5

Figure 4. Predicted mean levels of support for five policies regarding healthcare providers and requirements related to individuals who lack legal status, by residence.Notes: Based on a national survey of 6049 US residents from 7 March to 26 March 2025. Respondents were asked whether they supported the following policies. (1) Some have proposed for all hospitals and other healthcare providers to track how many undocumented patients that they provide care to (Track); (2) Some have proposed to requiring hospitals and other healthcare providers to ask for a patient’s immigration status before providing care (Ask Status); (3) Some have proposed to requiring hospitals and other healthcare providers to note a patient’s immigration status on medical charts and medical bills (Mark Status); (4) Some have proposed to requiring hospitals and other healthcare providers to report undocumented immigrants they treat to immigration enforcement (Report); (5) Some have proposed to requiring healthcare providers and staff to actively assist immigration enforcement in detaining undocumented immigrants (Assist). Respondents were provided with a 5-point scale for each question.

Supplementary material: File

Crudo Blackburn and Haeder supplementary material

Crudo Blackburn and Haeder supplementary material
Download Crudo Blackburn and Haeder supplementary material(File)
File 138.5 KB