Here’s why immigrants in Florida are unlikely to seek health care

Since arriving in the US four years ago, Alex has been working in the primary care office. He witnessed firsthand how difficult it is for immigrants to access preventive care.

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

Alex is one of our graduate school pseudonyms.

SB 1718 was signed into law in May 2023 by Governor Ron Desantis, imposing drastic restrictions aimed at blocking fraudulent immigration. Within that provision, hospitals accepting Medicaid funds must ask patients about the status of their immigration and share data on how many immigrants are working in the state.

The law provided several more provisions. It was mandated by E-Verify, a system that checks employment eligibility, and was used to recruit new companies employing more than 25 employees. It also criminalized driving to Florida with fraudulent immigration, and community organizations restricted the issuance of IDs.

After the law was passed, Alex told patients she could refuse to leak legal status when asked on hospital forms. However, he says his sense of security has not worked. He saw many immigrant patients hesitate to access the medical care they need for themselves and their children.

Alex had legal documents saying he was in the country, but as his immigrant community reduced, he wondered if he should leave Florida too.

We are a group of social science professors and graduate students studying the Florida immigrant community. We believe SB 1718 has important immigrants, Floridians and all Americans. This is especially true because we are facing a surge in the outbreak of infectious diseases such as measles and influenza.

A fearful environment

These concerns are based on a survey of 466 immigrants to Florida and children of adult immigrants between May and July 2024.

Almost two-thirds of non-Americans and one-third of US citizens who responded to our survey were hesitant to seek medical care the year after SB 1718 passed.

“I’ve been very ill recently and needed medical care, but it was scary,” one survey participant told us.

Although hospitals cannot deny care based on the patient’s immigration situation, our data demonstrate that we expect immigrants with legal status, not only those who lack permanent legal status, but also those with legal status, including US citizens, from seeking care.

We believe that American citizens are members of the mixed status family and are affected by ripple effects.

Our survey was conducted during the 2024 presidential election season, when anti-immigrant rhetoric was prevalent. The immigrants we investigated reported experiencing discrimination in their daily lives, and these experiences were also associated with involuntary access to health care.

Laws like SB 1718 amplify existing racial and structural inequality. Structural inequality is a systematic barrier within institutions such as healthcare and employment, limiting access to critical resources based on race, legal or economic status.

These types of laws discourage immigrants from using health resources. They foster an exclusive policy environment that raises fear of enforcement, limits access to critical services, and exacerbates economic and social vulnerability. Furthermore, restrictive immigration policies exclude people from accessing services based on their race. Immigrants who are discriminated against in their everyday environments may internalize their expectations that seeking care will bring more hostility, or even risk.

Public Health Results

American history has many examples of racial and ethnic barriers to health care. Examples include hospitals in the era of quarantine driving away black patients. It also includes systematic restrictions on non-English speakers’ access to health care, including inadequate language support services, reliance on untrained interpreters, and lack of culturally competent care.

President Donald Trump’s new executive order, signed in January 2025, could further expel certain communities. For example, an order ending federal diversity, equity and inclusion programs dismantles efforts to address racial disparities in public agencies. New restrictions on federally funded research on race and equity could hamper efforts to study and address these disparities.

Civil rights advocates believe these measures represent a systematic rollback of rights and diversity practices that generations fought to secure, and can accelerate national change to exclusion based on races pose as immigration enforcement.

The results of the Florida survey may be a warning sign for other parts of the country. As we have documented, medical hesitations can increase the likelihood of delayed treatment, undiagnosed conditions and worsening health disparities across the community.

These legal restrictions could increase the spread of epidemics and health care systems tensions, increase costs, and place a significant strain on emergency services and public health infrastructure.

Elizabeth Aranda is a professor of sociology at the University of South Florida. Deborah Montes is a PhD. A sociology student at the University of South Florida. Elizabeth Vakela is an associate professor of sociology, public policy and administration at George Washington University. Emely Matos Pichardo is a PhD. Student, Sociology at the University of South Florida. Lizventura is a sociology researcher at the University of South Florida.