Public Health and Medical Education At Particular Risk
Jack Ende, MD, MACP
President, American College of Physicians
Washington, D.C. (September 5, 2017)—President Trump’s decision to end the federal government’s program of deferred action for childhood arrivals (DACA) threatens to deny the United States of the talents of more than half a million individuals who are making enormous contributions to our country, and will particularly undermine public health and medical education. A six-month delay before elimination of the program will be fully enforced by the administration in no way mitigates the harm that will be done to the 800,000 law-abiding persons who have achieved permits under DACA to work or study in the United States without fear of deportation. They are now at risk of losing their jobs, being forced to drop out of school, and being deported in just a matter of months. The American College of Physicians urges the President to immediately reverse his decision. We also call on Congress to promptly enact legislation to block the administration from deporting “Dreamers” and to provide a pathway for them to become citizens.
In 2012, President Obama issued an executive order to protect men and women who were born in another country and brought illegally to the U.S. at a young age—commonly called “Dreamers.” Deferred Action for Childhood Arrivals (DACA) grants lawful presence in the U.S. including work authorization, Social Security numbers, and in many cases state IDs and driver’s licenses, which make attending medical school and residency training possible for individuals with DACA status.
According to the Association of American Medical Colleges, in 2016, 108 students with DACA status applied to medical school, and 34 matriculants with DACA status entered medical school, bringing total medical school enrollment to approximately 70 students. Without the protections afforded to them by DACA, these students would be forced to discontinue their studies and may be deported. As these students train to become physicians, they will have the experience and background necessary to treat an increasingly racially and ethnically diverse patient population to fulfill the cultural, informational, and linguistic needs of their patients, something ACP has longstanding policy supporting. Many other “Dreamers” are studying to be nurses, first-responders, scientists, and researchers, and approximately 1000 foreign-born recruits who enlisted in the military under the protections offered by DACA could face deportation, according to the Washington Post. Denying the United States the talents of thousands of “Dreamers” will bring great harm to the country, as well as to those directly affected.
Today’s decision also has the potential to gravely impact public health. We know that noncitizens and undocumented immigrants are more likely to lack health insurance coverage. If the nearly 800,000 people who are currently benefiting from DACA have their protections removed, many will avoid seeking health care in order to reduce the risk of detection and deportation, and as noted above, those who seek to serve in the health care professions will be denied that opportunity. Many will be forced to return to violent, war-torn and dangerous countries with poor health care services. In a 2011 paper calling for a national immigration policy, ACP stated, “Restricting undocumented immigrants from having health insurance will not prevent them from falling ill and needing health care.”
ACP opposes deportations of undocumented medical students, residents, fellows, practicing physicians, and others who came to the United States as children due to the actions of their parents ("Dreamers") and have, or are eligible for, DACA status; and we call on President Trump to reverse today's decision and continue protections for those with DACA-status. We also call on Congress to enact legislation to block the deportation of Dreamers and to create a pathway for citizenship, as proposed by S. 128, the Bar Removal of Individuals who Dream and Grow our Economy (BRIDGE) Act, and S. 1615, the DREAM Act of 2017.
About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 152,000 internal medicine physicians (internists), related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter and Facebook.
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