In January, doctors and nurses in Minnesota began documenting unprecedented fear and disruption in healthcare delivery following the Trump administration’s extension of immigration enforcement into hospitals. The shift ended a 14-year sanctuary policy that had protected hospitals from immigration raids since 2011, allowing federal agents to conduct enforcement operations in facilities previously off-limits to immigration authorities. ‘I have been a practicing physician for more than 19 years here in Minnesota, and I have never seen this level of chaos and fear,’ said Dr. Roli Dwivedi, past president of the Minnesota Academy of Family Physicians, speaking Tuesday at a St. Paul news conference.
The crackdown, known as Operation Metro Surge, deployed 2,000 federal agents to the Minneapolis area and resulted in more than 3,000 arrests according to a government court filing. Healthcare workers across multiple states report similar patterns of fear disrupting medical care, with hospitals documenting declining patient numbers and staff maintaining encrypted communications to share information about Immigration and Customs Enforcement encounters.
Medical Care Disrupted as Immigration Enforcement Reaches Minnesota Hospitals
At Hennepin County Medical Center, the state’s busiest emergency room and a critical safety net for uninsured patients including those in the country without authorization, plainclothes federal agents have become a regular presence. A nurse at the hospital, speaking on condition of anonymity, described a landscape where staff monitor for ICE officers focusing on people of color and asking patients and employees for documentation as they leave. “I can’t believe we’re having to resort to this,” the nurse said of the encrypted group chats where medical staff now share information about Immigration and Customs Enforcement encounters, including a recent incident in which an officer was accused of unnecessarily shackling a patient.
The scene reflects a sharp reversal in immigration enforcement policy. For more than a decade, hospitals, schools and churches were designated as off-limits to federal immigration operations under a sanctuary policy established in 2011. The Trump administration announced one year ago that federal immigration agencies could now make arrests in those facilities. By January, the consequences were unfolding across the healthcare system.
Patient Fear Disrupts Care
A pregnant woman missed her prenatal checkup, afraid to visit a clinic. A patient with kidney cancer was detained without access to his medications. A diabetic delayed picking up insulin. Another patient’s treatable wound festered untreated before requiring intensive care. These cases were documented by physicians at a St. Paul news conference Tuesday, where doctor after doctor described patients suffering amid the crackdown.
“I have been a practicing physician for more than 19 years here in Minnesota, and I have never seen this level of chaos and fear,” said Dr. Roli Dwivedi, past president of the Minnesota Academy of Family Physicians, speaking at the state Capitol. His statement reflected a broader consensus among medical professionals across the country that immigration enforcement activities are disrupting healthcare delivery at a scale not seen even during the COVID-19 pandemic.
The crackdown, known as Operation Metro Surge, deployed 2,000 federal agents to the Minneapolis area. According to a government court filing, the operation has resulted in more than 3,000 arrests of people in the country without authorization.
Pattern Spreads Across the Country
The scale of the disruption extends beyond Minnesota. Sandy Reding, a vice president of the National Nurses United union and president of the California Nurses Association, said immigrants are “absolutely” avoiding medical care due to fear of being targeted. Hospitals in Southern California have reported declining patient numbers since the crackdown intensified.
In Portland, Oregon, nurses have raised concerns about federal officers bringing detainees to hospitals and pressuring medical staff for faster discharge. The Oregon Nurses Association wrote to Legacy Emanuel Medical Center expressing alarm that ICE officers have pressured nurses and doctors to skip assessments, tests or monitoring to facilitate discharge more quickly. “Nurses have reported instances where physicians have recommended continued hospitalization, but ICE insisted on removing the patient, effectively forcing discharge over clinical advice,” the union stated. “In some cases, nurses report that detainee patients have had little or no opportunity to participate meaningfully in these decisions; the officers simply announce, ‘We’re going,’ and Legacy staff are left to accommodate.”
Dr. Erin Stevens, legislative chair for the Minnesota section of the American College of Obstetricians and Gynecologists, said the crackdown has disrupted pregnancy care at a concerning scale. “Our patients are missing,” she said, noting that requests for home births have increased significantly “even among patients who have never previously considered this or for whom it is not a safe option.” Home births carry higher risks than hospital births for complications in pregnancy and childbirth.
A Department of Homeland Security spokeswoman, Tricia McLaughlin, denied that federal officers are interfering with medical care. ICE “does not conduct enforcement at hospitals—period,” she said in a statement, adding that officers would only enter hospitals if there were “an active danger to public safety” or to accompany detainees already in custody.
Incidents Deepen Tensions
The crackdown has also involved additional incidents that have heightened tensions between state and local officials and the Trump administration. A mother of three was shot and killed by an ICE officer in what federal officials characterized as an act of self-defense, but that local authorities described as reckless and unnecessary.
On Sunday, protesters disrupted a service at a St. Paul church after discovering that one of its pastors leads the local ICE field office. Some protesters walked to the pulpit, with others chanting “ICE out.” The U.S. Department of Justice announced it has opened a civil rights investigation into the church protest.
Medical professionals said the crackdown reflects a fundamental shift in the relationship between federal enforcement and healthcare access. What was once a protected space for medical treatment has become, in their view, a contested environment where fear shapes decisions about seeking care.