The Trump administration’s militant anti-immigrant agenda has wreaked havoc in the United States immigration system, exacerbating challenges that immigrants have faced for decades by imposing and escalating a set of policies designed to intimidate and persecute them. These policies have disrupted and endangered people’s lives and the consequences have been deadly. They have also had profound negative impacts on the health of immigrants and their families, including on their sexual and reproductive health and well-being. Particularly harmful policies and practices include targeting immigrants at hospitals and other health care facilities, detaining and mistreating pregnant and postpartum people in ICE custody, and accessing personal health data for the purpose of immigration enforcement, as well as new restrictions on access to publicly funded health insurance coverage and care, including abortion and contraception.

The punitive and broken immigration system in the United States has ruined many lives and forced many to live in fear and in the shadows for decades. It is administered by a complex and often unaccountable web of agencies housed within the Department of Homeland Security (DHS), including Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP). Rather than try to reform the system, the Trump administration has displayed open hostility to immigrant communities, aggressively profiling, detaining and deporting people without due process, often blatantly ignoring the rule of law and court orders, while holding immigrants in substandard facilities (including some outside the United States), where many have reported evidence of physical abuse, overcrowding and medical neglect. More than fifty people have died in immigration detention in the last 18 months. At the same time, the administration has, despite court challenges, terminated Temporary Protected Status protections for hundreds of thousands of people who fled to the United States from dangerous situations in Haiti, Venezuela, Syria, South Sudan and other countries.

As of June 2025, there were an estimated 51.9 million immigrants residing in the United States. These include naturalized citizens, lawful permanent residents and temporary lawful residents, as well as those who are “unauthorized” or “undocumented,” terms which can cover people living in the United States with a range of “impermanent, precarious statuses.” An analysis of 2023 Census data estimated that there were 14 million such unauthorized immigrants in the United States.^* Millions of households contain people with various citizenship and immigration statuses, with one in four children in the United States having at least one immigrant parent. 

While US immigration policies have long had negative effects on the health and well-being of immigrants and their families, the scale and intensity of the administration’s anti-immigrant campaign has imposed new restrictions on immigrants’ bodily autonomy and access to health care. These policies have overlapping and compounding effects in immigrants’ lives, reducing their access to a wide range of public services and spaces while often prompting them to delay or avoid visits to health care facilities. Everyone, regardless of immigration status or income, deserves access to comprehensive health care, including sexual and reproductive health services, and the ability to make decisions about their bodies and families. 

This fact sheet details some of the Trump administration’s policies and attacks on immigrants and the impact that has on their reproductive health and well-being.

ICE Enforcement at Hospitals and Health Care Facilities

• The threat of immigration enforcement at hospitals and other health care facilities has been shown to have a “chilling effect” on immigrants and their families accessing health care services out of fear for themselves or their family members being arrested and deported.
• In January 2025, the Trump administration rescinded guidance that had limited immigration enforcement at “sensitive locations” such as hospitals, at or near schools, places of worship, and courthouses. Agents are now permitted to enter public spaces, such as waiting rooms and lobbies, with a judicial warrant. 
• Since then, there have been increased reports of ICE agents showing up to engage in enforcement activities and detain immigrants at or near hospitals and clinics across the country.
• Nearly half (48%) of likely undocumented immigrant adults and 14% of immigrant adults overall say they or a family member have avoided seeking medical care since January 2025 due to immigration-related concerns. 
• Additionally, one in five pregnant women in an online survey reported that ICE activity has prevented them from seeking prenatal care. 

Mistreatment of Pregnant, Postpartum and Nursing Immigrants in ICE Detention

• Pregnant, postpartum and nursing immigrant women have suffered severe mistreatment and medical neglect while in detention facilities in violation of longstanding ICE guidelines. These conditions seriously jeopardize the health of parents and their children.
• While medical mistreatment in detention facilities is not unique to pregnant people and has been a problem for decades, reporting has shown that the problem has intensified under the second Trump administration. Investigations reveal that since January 2025, pregnant women have experienced substandard care and medical neglect in detention, including being shackled while experiencing a miscarriage, being placed in solitary confinement, being denied prenatal care, being denied medical care while bleeding, and experiencing serious life-threatening pregnancy complications while in detention.
• According to information from DHS in response to a Senate inquiry, 363 pregnant, postpartum and nursing immigrants were deported in the period between January 1, 2025 and February 16, 2026. DHS also reported that 16 miscarriages had occurred in its detention facilities in the first nine months of 2025, but have no information on miscarriages since October of that year.
• Young pregnant immigrants are especially at risk. Since July 2025, ICE has been detaining all pregnant unaccompanied minors in a facility in South Texas, a shift from previous longstanding practice where they were placed in Office of Refugee Resettlement (ORR) shelters or specifically designated foster homes. The Texas facility is several hours away from specialized obstetric care, aggravating health risks for these detainees, some of whom are as young as 13 and half of whom became pregnant as a result of rape. The Texas detentions also run counter to ORR rules, which say that priority placement for all pregnant youth should be in states without abortion bans and which prohibit federal officials from impeding pregnant unaccompanied minors’ access to abortion care.

Exacerbating Immigrants’ Barriers to Medicaid Coverage

• Medicaid is one of the largest sources of health insurance coverage for people with low incomes and is provided via federal‒state partnerships. Medicaid has been critical for people’s, including many immigrants’, access to contraceptive care and other reproductive health services.
• Medicaid eligibility rules are complicated for immigrants and often depend on policies in their state. While many immigrants do receive Medicaid coverage, certain groups of immigrants—including those who are undocumented—are ineligible for federal Medicaid coverage. Even those with qualified immigration status, such as individuals with green cards, are barred from accessing Medicaid for the first five years after their entry or status change. (This policy is known as the “five year bar.”) At the same time, some states have used their state funds to provide health care coverage for some or all undocumented immigrant residents.
• HR 1, the so-called “One Big Beautiful Bill Act” signed into law in July 2025, enacted severe cuts to Medicaid and other federal health programs, many of which impacted immigrants. For example, the law now includes refugees and asylum seekers in the categories of immigrants denied Medicaid coverage, adding to the high numbers of non-citizens already excluded from coverage.
• At the same time, the law is expected to limit many non-citizens’ access to marketplace plans under the Affordable Care Act (ACA). New, stricter eligibility limits on the subsidies that make coverage affordable will likely prevent as many as one million lawfully present immigrants from enrolling in marketplace plans, denying many low-income immigrants any pathway to affordable health coverage.
• Additionally, HR 1 instituted strict work requirements for adults aged 19‒64 who are enrolled in Medicaid. Guttmacher Institute analysis projects that this policy could cause over 2 million women of reproductive age to lose Medicaid coverage, including many who are immigrants.
• Losing insurance has been associated with decreases in the likely use of SRH care and access to person-centered care—evidenced by an increase in the likelihood of experiencing barriers to obtaining one's preferred method of contraception.

Barriers to Accessing Abortion

• At least 1.9 million undocumented immigrant women live in states with total abortion bans or bans before 18 weeks gestation. There are 13 states with total abortion bans and seven additional states ban abortion at or before 18 weeks.
• Millions more immigrants live in states with other medically unnecessary policies, including mandatory waiting periods and multiple required visits, all of which make abortion hard to access. 
• For noncitizens, the myriad of state laws restricting abortion are particularly challenging to navigate, especially alongside restrictive immigration policies. In states with abortion bans, many people seeking an abortion must travel to receive care, forcing them to cross state lines and potentially go through immigration checkpoints or airports. For those who are able to overcome the financial and logistical burdens of travel, these options place immigrants at increased risk of surveillance and detention. Yet others who choose to access abortion care via telehealth, online websites or community networks also face risks. The current context of abortion stigma and criminalization of pregnancy outcomes is compounded for immigrants who may have additional concerns about being tracked or surveilled in their online activity or in potential interactions with the health care or criminal justice systems.
• Affordability is also a challenge that abortion patients, including immigrants, must overcome. Due to the Hyde Amendment and related coverage restrictions, individuals who are insured through federally funded health care programs, like Medicaid, Medicare and CHIP, and those in federal detention—including immigration detention—are restricted from accessing abortion except in cases of life endangerment, rape or incest. While 21 states use state funds to cover abortion care through Medicaid, the Hyde Amendment disproportionately impacts people already facing systemic barriers to health care, including Black and Brown, indigenous and immigrant communities, and people with low incomes.

Medicaid Sharing Data with ICE

• Serious data privacy concerns have emerged for many individuals enrolled in Medicaid, who did so believing that their information would not be shared for immigration enforcement purposes.
• In 2025, it was reported that the Trump administration had started sharing with ICE the personal and health data of noncitizen Medicaid enrollees in several states. Subsequently, the Centers for Medicare and Medicaid Services (CMS) and ICE established an “information exchange agreement,” reversing earlier policies in which CMS had committed to not sharing health coverage eligibility information for the purposes of immigration enforcement. Despite several states securing a preliminary injunction that blocked such data sharing in those states, CMS proceeded to share their residents’ health data with ICE. 
• ICE’s new ability to access Medicaid records has created a further chilling effect on health care access for immigrant families, including those who may be citizens or have protected status but live in mixed status households. 
• In California, for example, where state funds help provide health coverage for immigrants of any status, many immigrants have disenrolled from the state’s Medicaid program due to fears that their personal information is being shared with ICE. 

Public Charge Rule Chilling Access to Care

• Public charge is a concept that has been in US law for decades and which asserts that some people can be denied admission into the country through a visa or denied legal permanent resident status, also known as a green card, if they will likely depend primarily on government support now or in the future.
• In September 2026, a new public charge rule went into effect that expands and distorts the definition of public charge. It gives DHS more discretion to deny status based on any use of income-based public services by an immigrant or their family members. While this expansion now allows programs such as Medicaid and Title X family planning services to be considered federal benefits, the new rule also makes the policy more ambiguous and gives more power to the US Citizenship and Immigration Service, leaving the interpretation of public charge to the discretion of individual officers in each case.
• The ambiguity of this new rule—especially when considered alongside immigration enforcement at hospitals and the sharing of insurance information with ICE—will likely have additional chilling effects on health care access by immigrants. For example, some families with US citizen children may fear using the Children's Health Insurance Program (CHIP) if other family members are still seeking authorized status, and studies suggest some citizens with undocumented family members are already forgoing health screenings and checkups for fear of retaliation.
• In addition to reducing health care access, the new rule could also aggravate patterns of immigrants forgoing other social services such as childcare, housing, and food support, losses which can impact the long-term health and well-being of families and communities.

Attacks on Title X and Defunding Family Planning Programs and Clinics

• Publicly supported family planning clinics serve as the primary entry point to the health care system for many people, including immigrants, and are sometimes one of the only ways that people can access sexual and reproductive health care.
• Title X is the nation’s only federal program dedicated to providing people with low incomes, particularly those who are under- or uninsured, with access to comprehensive family planning and contraceptive services, as well as to preventative health care such as screenings for sexually transmitted infections and cancer. This program serves many immigrants, including those with undocumented status. (Federal law does not disqualify such immigrants, although eligibility may vary by state and clinic.)
• In July 2025, the Department of Health and Human Services issued a notice that dramatically expanded the number of federal programs, including Title X, that are deemed inaccessible to certain segments of the immigrant population. While under litigation and not yet in effect, this new policy threatens to push reproductive health services and other supports even further out of reach for immigrants and others who need them most.
• For several months in 2025, the Trump administration froze millions of dollars designated for some Title X program providers. These funds had still not been released by July, when HR 1 included a provision defunding some family planning clinics, including Planned Parenthood health centers, by denying them federal Medicaid reimbursement for one year. (That provision expired July 2026.) Attacks like these, in concert with changes to the public charge rule, make affordable contraceptive care and related services less available, thereby undermining health equity and exacerbating health risks for immigrant communities.

Congress Must Act to End the Assault on Immigrants’ Access to Care

Policymakers at all levels of government have a responsibility to do all they can to support immigrants in their communities. Ideally, this would include proactive work to pass policies that ensure their legal protection and access to health care, including addressing practical challenges many immigrants face, such as language barriers, limited access to culturally responsive care, and overly complex systems of applying for and accessing services. It is equally important that policymakers hold the administration and anti-immigrant lawmakers accountable for defying existing laws and policies that provide people due process and civil rights.

Congress especially has a strong role to play. Unfortunately, in 2026, they passed legislation along party lines to massively fund ICE and the CBP for the next three years. As 80 gender justice organizations (including Guttmacher) wrote in an open letter earlier this year, Congress should halt funds to those agencies “until enforceable restrictions conditioned on compliance with civil rights, medical standards and due process are in place.” Not only must Congress take measures to ensure that ICE and CBP stop abuse on the ground, it needs to restore limits on immigration enforcement in sensitive locations, including health care settings, protect health care data and insurance coverage information from immigration authorities, and end the mistreatment and detention of pregnant, postpartum and nursing people.

Congress should also pass the HEAL For Immigrant Families Act which would remove discriminatory legal barriers to health coverage that were imposed in federal law thirty years ago and would help to ensure that immigrants can receive reproductive health care services. The bill would restore eligibility for full-benefit Medicaid and the Children’s Health Insurance Program (CHIP) to all lawfully present immigrants who are otherwise eligible, eliminate the long-standing “five-year bar” that delays lawful permanent residents from accessing Medicaid and Medicare benefits, and end the exclusion of undocumented immigrants from the Affordable Care Act's health insurance exchanges. Congress should also pass the Lifting Immigrant Families Through Benefits Access Restoration (Lift the Bar) Act, which would restore access to federal public benefits for lawfully present immigrants and similarly remove the five-year bar to programs such as Medicaid and the Children's Health Insurance Program (CHIP).

While a better and more just immigration system requires an end to the abuse and terror that immigrant families are experiencing, it also requires a proactive approach that guarantees full respect for people’s human rights and supports access to services that meet people’s basic needs. Policymakers should ensure access to comprehensive sexual and reproductive health care for all, regardless of immigration status.