Twenty-two states and D.C. sue DHS over public-benefits immigration shift
In a voice message left on WhatsApp earlier this year, a Maryland mother identified by NPR only as M described a medical emergency in Spanish. “My child woke up this morning feeling like he was suffocating. I am worried,” she said. The boy had a history of asthma.
M, who is undocumented along with her husband even though her son is a U.S. citizen, asked NPR to use only her first initial because of concerns about immigration enforcement. She told the reporter she had been debating whether to take her son to the local clinic, worried that she could be detained. “All the roads northbound have had ICE operations on them,” she said in another voice message. She decided to wait it out.
By the time she brought him in, his condition had worsened. “His lips were turning blue,” she recalled. They took the bus to the local clinic at night; the doctor told her the child was in serious condition and administered oxygen. He was then medevaced to Washington, D.C. In another voice message, she said, “Please. Let him be ok.”
There was no room for M on the helicopter, she said, and staff told her to meet them at the hospital. “And now I’m wondering whether I will be safe in an Uber. If my whole family drives, what happens if we get stopped. Do ICE agents board public transportation?” A nurse at the Maryland clinic paid for her Uber.
During the ride, M recorded another message. “I just passed by the Washington Monument,” she said, calling the obelisk “the needle.” “And the White House. This feels dangerous.” As she got closer to the hospital, another fear surfaced: that she might be asked for her immigration papers.
The morning after the hospitalization, M wrote again. Her son had a respiratory infection that had triggered a severe asthma attack, and the hospital told her she should have brought him in sooner.
M’s case illustrates a pattern the American Academy of Pediatrics documented in its national survey. Forty percent of pediatricians reported noticing families staying away from care due to immigration concerns, and thirty percent said they had seen families who were hesitant to apply for public health services and support, including Medicaid. The survey also found families avoiding sending their children to school, according to Dr. Lee Beers, the academy’s chief medical officer.
Beers described schools as a venue where health risks can be identified early. “They can receive health services within the school. They can receive mental health services,” she said. “It’s a place where caring and supportive adults can help identify if there’s an emerging health issue or mental health issue.”
The pattern M described sits against a shift in how immigration enforcement operates, according to NPR’s reporting. Earlier in 2026, ICE raids in Minneapolis drew heavy backlash; similar operations took place in Los Angeles and Chicago in 2025. The network reported that the current strategy has become quieter, though detentions — which the network said skyrocketed this summer — continue. Increasingly, according to NPR, enforcement also means cutting off access to services and benefits to push people to self-deport.
As of this week, immigration officials deciding whether people can enter the U.S. or obtain legal residency began considering a wider range of public benefits a person receives, including benefits received by family members, NPR reported. The expanded scope could include Medicare and food assistance such as SNAP. Previous administrations had specifically excluded certain benefits from being considered in immigration applications, according to NPR.
Twenty-two states and the District of Columbia are jointly suing the Department of Homeland Security over the change, arguing it could keep people away from basic health services. “Hardworking families should not be forced to go without the support they need because they fear asking for assistance will get them deported,” New York Attorney General Letitia James, a Democrat, said in a news release.
DHS responded to NPR by email: “This is the ideological contortion required by left-wing leaders to justify their defrauding of the American taxpayer at the hands of illegal criminals.”
The legal backdrop for medical visits remains mixed. Hospitals can ask patients about immigration status; in Florida and Texas, they are required to in order to report on healthcare costs for undocumented patients. In both states, patients have the right to refuse to answer. Hospitals nationwide cannot deny emergency care on the basis of immigration status, though there have been reports of ICE agents appearing at medical facilities.
A doctor at one Maryland clinic asked NPR not to use her name, citing concerns that her largely immigrant patient population could be targeted. She said the health effects of delayed care are likely to become more visible. “We’re seeing patients who aren’t coming in not just for routine screening, but their diabetes checkup, their blood work done,” she said. “Maybe in a year we’ll see a bump in heart attacks and strokes in this population. We know that people are afraid. We know right now the immediate effect is worsening mental health.”
The doctor said the consequences extend beyond immigrant families. “If we have patients who are afraid to go get vaccines, that affects everybody,” she said, citing recent U.S. measles outbreaks. “And that’s just one example. We’ve already seen what’s happened with measles in this country in the last few years. It hurts the whole community.”
Beers framed pediatric visits as the front line for catching problems before they escalate. “A visit with your pediatrician is an opportunity to catch acute issues before they get worse,” she said. “If those concerns are not identified early and addressed promptly, they can have really long term and serious health impacts on children and ultimately, you know, place a greater burden, not just on the family and the child, but also on the health system as a whole.”