So, you don’t think the repeal of the so-called Dream Act is going to affect you?
You might change your mind if your doctor’s office closes.
Or you can’t find someone to take care of your elderly parents.
Or research on some of the country’s most serious diseases seems to be going slower than you think it should.
Leaders in the medical community say the revocation of the Deferred Action for Childhood Arrivals (DACA) last week by the Trump administration will have far-reaching effects on the nation.
For starters, they say it will harm the healthcare of the 800,000 children of illegal immigrants now protected by the DACA program.
In addition, they say the repeal will also force the thousands of Dreamers who are healthcare professionals or medical students to leave the profession just as the nation is facing a serious physician shortage.
“It changes the whole face of healthcare,” Shalini Pammal, MPH, a public health expert who is on the board of directors for Doctors for America, told Healthline. “You’re going to see a huge impact on all Americans.”
Ending the program
A week ago today, the White House announced it was rescinding the DACA program.
The administration left the program in place for six months to give Congress a chance to enact a new set of laws.
President Trump said he has “great compassion” for the Dreamers, but he said the nation must enforce and reform its immigration laws.
“Long term, it’s going to be the right solution,” the president told reporters.
Leaders of some of the nation’s largest health-related organizations vehemently disagree.
These organizations criticized the decision as highly unfair to the Dreamers.
“[The DACA repeal] is the latest cruel setback for immigrant children, youth, and families across the country,” the AAP statement said.
“Today’s decision does little to reform our nation’s immigration system,” added the CMA statement. “It simply punishes young people who are American in all ways but on paper.”
Young people’s health
Supporters of the DACA program say one of the initial effects of the repeal will be Dreamers not seeking healthcare because of the fear of being deported when they show up at a medical facility.
“Federal policies have significant impacts on individuals,” said Pammal. “I see a lot of young people who will not seek healthcare.”
This shunning of health services will also affect the children of some of the older Dreamers.
“I worry that families won’t feel safe,” Dr. Julie Linton, FAAP, a pediatrician who is co-chair of the AAP’s Immigrant Health Special Interest Group, told Healthline.
Dr. Ruth Haskins, a private physician who is president of the CMA, said this fear will extend beyond the Dreamers.
She said even legal immigrants may be wary of going in for preventative care.
“I think there is a sense of fear to be in a country that is so anti-immigrant,” Haskins told Healthline.
The implications also go beyond physical health.
Linton said the stress over possible deportation can lead to mental health problems.
“As a physician, I can’t emphasize enough the effect fear and uncertainty has on children,” she said.
Haskins said she sees this effect every day in her office.
“I can feel how unwelcome they feel,” she said.
Medical professionals say Dreamers who are working in or studying to be in the medical field may feel threatened enough to leave the profession.
And that is not a healthy thing for the nation.
The impact on the medical industry
Right now, projections estimate the United States will have 95,000 fewer physicians than it needs by 2025.
A lot of those positions were expected to be filled by immigrants.
The CMA states that the healthcare profession has the highest percentage of foreign-born and foreign-trained workers than any other industry in the country.
They add that the number of Dreamers being accepted into medical school is on the rise. That number jumped from 26 in 2014 to 112 in 2016.
In addition, the organizations states, 94 percent of 800 Dreamers heading into the healthcare field want to practice in underserved or rural areas.
“The vacuum of them leaving would be enormous,” said Haskins. “We cannot afford to lose any more doctors.”
Pammal added the impact goes beyond physicians.
She said there would be Dreamers leaving nursing, home care, research, and other medical fields.
“This stops so many young people who want to thrive and contribute to our society,” she said.
The medical leaders also note the departure will be depriving the healthcare industry of some of its most promising candidates.
They say the children of immigrants are some of the most motivated people they know.
That’s largely because of the risk and effort of their parents to get to the United States. Those parents demand that their children succeed.
“DACA recipients have big and bold dreams,” said Linton. “America will be so much better if we can harness that resilience.”
Pammal knows the feeling all too well.
Her parents emigrated legally from India before she was born.
A lot was expected of her and she didn’t disappoint. She graduated from Harvard before going into the health field.
“There is a hunger to succeed,” she said of immigrant children. “Their parents are going to push them to greater heights.”
Two personal examples
Jirayut New Latthivongskorn came to the United States from Thailand in 1999 at the age of 9.
His parents were here on business-related visas. However, when the visas expired, they stayed.
Latthivongskorn went to high school in San Francisco and has been attending the University of California, San Francisco (UCSF) to obtain a medical degree. He is actually taking a year off from that endeavor to obtain a master’s degree in public health from Harvard University.
After his studies, he plans to be a family doctor or an internal medicine specialist. He would prefer to work in an underserved region in an urban area.
Those plans, however, may get derailed with the DACA repeal.
Latthivongskorn told Healthline the situation is frustrating because he’s been working hard on the assumption he would be protected by DACA.
“Without DACA, we have a really tough brick wall,” he said.
Latthivongskorn expects to have $50,000 in student loans when he’s finished with school. He’ll have to pay those off whether he stays in the United States or not.
He feels the country will be deprived of some talented, hard-working medical professionals if the DACA repeal goes through.
He agrees with Linton that immigrants are a highly motivated group encouraged by their parents.
“I watched them sacrifice with my own two eyes,” Latthivongskorn said. “The least I could do was to go to school and be successful.”
Rosangela Cruz knows this feeling all too well.
She came to the United States illegally 14 years ago at the age of 7 with her mother and two brothers.
Cruz became motivated when she saw her mother “struggling at a number of jobs.”
So, she got good grades throughout school and went to college to become a medical assistant.
“I decided I needed to do something to help my family,” Cruz told Healthline.
After a one-month internship, Cruz was hired at Haskins’ Sacramento County office.
The CMA president said Cruz is “the best medical assistant I’ve ever had.”
“I hate the thought of her leaving,” said Haskins.
Cruz became a U.S. citizen in 2015, so she’s not officially under the “Dreamers Act.”
But she worries what might happen next in a country she now sees as hostile to immigrants.
“I’m scared,” she said. “This is the only country I know.
If Cruz leaves, she will be taking her $8,000 in college loans with her. The lender isn’t likely to let her off the hook either.
She agrees that the children of immigrants are highly motivated.
“They’re all hard workers,” she said.
In addition, Cruz said, they’ve also overcome a lot of obstacles.
“I’ve had to fight through more adversity to get to where I am,” she said.