Immigrant patients in the United States encounter exceedingly intimidating hurdles that block their access to medical care. This is particularly the case for pregnant women who fall within ICE’s detention oversight authority. Today, ICE and its contractor BI Inc. monitor about 200,000 people under its Alternative to Detention (ATD) program. This new alternative to detention pilot program is intended to provide community-based alternatives to detention. Yet, healthcare providers are rightfully alarmed by the impact it’s having on the health and safety of our most vulnerable pregnant women.
That monitoring system works with a wide range of technologies, including the new VeriWatch smartwatch, which was released two years ago by BI Inc. This device was pitched as a more subtle alternative to ankle monitors, but it’s just as controlling. Healthcare providers at the hospital have said that many physical mothers refuse to remove their smartwatch. They’re afraid that taking the devices off could set off alarms to ICE or BI Inc. This fear is only exacerbated by ICE’s refusal to make any exceptions for the removal of smartwatches. This policy applies even to those with true medical reasons.
The Fear of Medical Care
Healthcare providers like Dr. Kelli Swensen have seen a concerning pattern with their pregnant patients who use these location-tracking devices. Many are hesitant to seek necessary medical attention due to their fears of being reported for non-compliance with ICE regulations. According to hospital staff across the U.S., this situation has resulted in a marked decline in immigrant patients attending medical appointments. Data indicates a 30% drop in patients showing up for appointments and a 40% decrease in those picking up medication since the Trump administration took office.
In recent months, hospital personnel have identified a new aggressive pattern. We heard from a lot of pregnant patients with smartwatches who’ve expressed their worry about accessing care. One example was a patient who required a C-section. Later, she was diagnosed with preeclampsia, a potentially severe condition that can result in major complications if left untreated. Hospital workers have been warning about the repercussions of unremovable smartwatches. Public health advocates fear that these devices will have negative health outcomes for the most vulnerable women.
“Waiting and trying to figure these things out even when things are not super emergent can cause something emergent to happen,” – a healthcare worker.
The hesitance among immigrant patients is palpable. As a result, often they are afraid even to report unsafe conditions or seek assistance. This silence can have dire consequences for mothers and babies alike.
The Consequences of Overreach
Scott Shuchart, a former assistant director for regulatory affairs and police at ICE under the Biden administration, criticized the structure of the ATD program. He argued that the design served only to enrich BI Inc. More importantly, it didn’t put the needs of the non-citizens it was tracking first.
“The program is really structured for the benefit of BI and not for the benefit of the non-citizens who were going to be managed through it,” – Scott Shuchart.
Shuchart raised issues that she has seen in ICE’s enforcement and removal division. In addition, they fight to have wiser policies developed which would protect these populations and meet the unique needs of vulnerable populations, including pregnant women. This resistance raises fundamental ethical concerns. Where is the line between legitimate immigration enforcement and civil liberties violations in healthcare settings?
“Therefore ERO was extremely resistant to bring rationalization and consistent policy into it,” – Scott Shuchart.
This kind of overreach can set catastrophic precedent. People can even end up being locked up at regular monitoring appointments with immigration agents, regardless of their enrollment in the ATD program. Advocates describe allegations of people being detained despite following all monitoring guidelines. This new reality is only exacerbating fears about losing access to care.
George Zoley, the founder and executive chairman of the GEO Group, expressed his chagrin. He fears that progress is moving too slow in expanding monitoring to encompass all 7.5 million people on the federal government’s non-detained docket. His comments betray a vision that prioritizes expansion over grappling with ethical questions posed by this kind of surveillance.
“Now the count has been fairly stable, which is a little disappointing, obviously,” – George Zoley.
Our Nation’s healthcare workers have long been concerned about the impacts illegal immigration enforcement actions have on their ability to provide critical medical care. One Colorado hospital staff member highlighted the vulnerability of their patients, stating, “They’re looking at people who literally can’t speak up, who have no legal resources, who are not American citizens, and are pregnant.” This pervasive sentiment reveals a deeply ingrained systemic issue that places marginalized populations under increased scrutiny and threat even when they’re just trying to receive necessary medical care.
“That’s the true pilot program: How far can they overreach?” – a Colorado hospital staff member.
These monitoring systems have consequences that extend beyond isolated cases. By doing so, they raise fundamental concerns regarding civil liberties and further healthcare access for immigrant populations in the U.S. Pregnant women are afraid to seek medical care because they know immigration enforcement will come for them. This pervasive reality underscores the compelling need for policy reform and a new approach that considers the impact of immigration enforcement on healthcare access.