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healthcare
Trump Deportation Campaign Forcing Immigrants to Avoid Healthcare and Change Daily Routines
“We are grateful for everything this country has given us and our children,” said one man. “But the system has become downright cruel toward immigrants.”
Nov 19, 2025
For people who have immigrated to the United States—regardless of whether they have legal status—life under the second Trump administration has provoked daily anxiety and fear—forcing many to make choices about whether it's safe to go to church services that once provided a sense of community, seek medical care, and send their children to school.
As federal immigration agents continued raiding communities in Charlotte, North Carolina—the latest target of the administration's mass deportation campaign—as well as other cities across the US, the New York Times/KFF poll released Tuesday gave a comprehensive look at how President Donald Trump's anti-immigration policies have impacted both undocumented immigrants and people who have green cards and other legal documentation.
Nearly 80% of undocumented immigrants reported negative health impacts due to worries about being deported, separated from their families, or otherwise harmed due to their immigration status.
Health impacts they reported include problems sleeping or eating, worsening health conditions such as high blood pressure and diabetes, and worsening anxiety or stress.
Immigrants with legal documentation also reported these impacts in large numbers, with 47% saying they have experienced health issues stemming from worries about Trump's policies. Nearly a third of naturalized citizens said the same.
A 34-year-old Colombian woman in New York said her family is "scared of going out."
“We’re getting depressed," she said. "We’re scared that they’ll separate us, they’ll mistreat us.”
While experiencing increased negative health impacts, immigrants have become more likely to avoid getting medical care—as viral videos have shown US Immigration and Customs Enforcement (ICE) agents making arrests at medical offices.
Under the Biden administration, ICE and other federal agents were barred from conducting immigration enforcement at sensitive locations like schools and hospitals, but Trump rescinded those limits.
Between 2023-25, the share of adult immigrants who reported skipping or delaying healthcare increased from 22% to 29%. One in five said it was due to immigration-related worries.
Nearly a third of parents also said they had delayed or avoided medical appointments for their children; the share rose to 43% for undocumented immigrant parents.
About half of all adult immigrants and nearly 80% of undocumented immigrants said they were "somewhat" or "very" concerned about healthcare providers sharing information with immigration enforcement officials.
Two years ago, about 26% of immigrants reported fears that they or a family member could be deported or detained, and that number has jumped to 41%.
One-third of noncitizen immigrants said they have begun avoiding aspects of everyday life, and nearly 60% of undocumented immigrants said the same.
"We have been the workforce in construction, restaurants, janitorial,” Ana Luna, an immigrant who has lived in Los Angeles with her family for nearly two decades, told the Times. “Now we have to run, hide, or stay inside. And it’s especially heartbreaking for our children.”
Luna told the Times that her youngest child's school had recently informed her that immigration enforcement was nearby.
“We are grateful for everything this country has given us and our children,” her husband, Gabriel Lorenzo, told the Times. “But the system has become downright cruel toward immigrants.”
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Report Details How 'Half-Baked' GOP Healthcare Scheme Would Further Enrich Insurance Giants
"No matter how Republicans design their plan, their promise to take money out of the hands of big insurance companies and put it in the hands of patients will go unfulfilled."
Nov 19, 2025
US President Donald Trump and his Republican allies in Congress have made a show of criticizing insurance company greed as they stand firm against extending Affordable Care Act tax credits and offer ill-formed alternatives.
But a report published Wednesday by the office of Sen. Ron Wyden (D-Ore.) explains how a scheme endorsed by Trump and some top Republicans would further enrich insurance giants and big banks.
The report focuses on growing GOP support for a proposal that would give Americans money in tax-advantaged vehicles such as health savings accounts (HSAs) to help cover out-of-pocket costs. Last week, Trump championed the idea in the Oval Office, characterizing the proposal as a way to "forget this Obamacare madness."
In a social media post on Tuesday, Trump railed against "BIG, FAT, RICH INSURANCE COMPANIES" and doubled down on the idea of funding health savings accounts instead of extending the enhanced ACA tax credits.
But Wyden's report argues that "no matter how Republicans design their plan, their promise to take money out of the hands of big insurance companies and put it in the hands of patients will go unfulfilled, because the very arrangements they tout are administered by large financial institutions and the same big insurance companies."
The report notes that Optum Bank, a subsidiary of the corporate behemoth UnitedHealth Group, is one of the nation's largest administrators of HSAs and would be well-positioned to profit from the Republican plan.
"The numerous fees OptumBank charges, including a $20 Outbound Transfer Fee, a several-dollar monthly account maintenance fee, and a $2.50 ATM Transaction fee, flow directly out of consumers’ and patients’ pockets and into the coffers of the nation's largest health insurer," the report observes. "Even a fraction of these revenues adds up to massive profits."
"While some big insurance companies own HSA providers directly, others partner with large financial institutions to operate similar arrangements. Centene, for example, partners with Fidelity; Anthem partners with Bank of America," the report continues. "The common theme across these arrangements is massive profits for financial institutions and big insurance companies."
Wyden's report came as congressional Republicans worked to translate Trump's all-caps social media ramblings into coherent policy. Sen. Bill Cassidy (R-La.), chair of the Senate committee with jurisdiction over healthcare, is leading the effort as tens of millions of people brace for massive premium increases stemming from Republicans' refusal to extend enhanced ACA subsidies.
Cassidy has explained to reporters that the emerging GOP plan would entail Americans using existing ACA tax credits—not the enhanced subsidies that are set to lapse at the end of the year—to purchase high-deductible "bronze" plans on the insurance marketplace.
HSA funding from the federal government would then help enrollees cover out-of-pocket costs (HSA funds generally cannot be used to cover monthly premiums). Under the recently enacted Trump-GOP budget law, tax-advantaged HSAs are now available to everyone who buys a bronze plan on the ACA marketplace.
The average deductible for a bronze plan is $7,476 in 2026.
"Half-baked ideas that put more taxpayer dollars into health tax accounts will enrich big banks and insurance companies while saddling Americans with high premiums and deductibles," Wyden said in a statement on Wednesday. "Sending a few thousand dollars to Americans isn’t going to do them much good when they face a giant medical bill for a serious health diagnosis or even routine but expensive care, like giving birth in a hospital."
In a Fox News appearance on Wednesday, Cassidy likened his vision of an ideal health insurance marketplace to bargain-hunting for shampoo.
"By giving the patient the money herself... she becomes a wiser consumer," said Cassidy. "If she goes and gets two types of shampoo and one's a dollar cheaper, she'll get the cheaper one and the other one lowers their price."
Cassidy: "By giving the patient the money herself, she becomes a wiser consumer. If she goes and gets 2 types of shampoo and one is a dollar cheaper, she'll get the cheaper one and the other one lowers their price. One you give her the power of making the decision, she's gonna… pic.twitter.com/52u7IMJkFk
— Aaron Rupar (@atrupar) November 19, 2025
Ryan Cooper, managing editor of The American Prospect, wrote in response to the GOP healthcare scramble that "the stupidity is the point."
"For decades now, the Republican Party has been dedicated to the proposition that rich people are too highly taxed and the working and middle classes get too many benefits from the government. With the passage of the One Big Beautiful Bill, they have finally caught the car," Cooper wrote Tuesday. "Medicaid and Obamacare have been slashed to free up budget headroom for tax cuts heavily slanted to the wealthy."
"Republicans don’t have a 'healthcare plan' per se because this is their plan: to take your healthcare funding and give it to Elon Musk, Donald Trump, and the rest of the fascist billionaire class," he added.
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Gigs That Work For All
A California pilot program offers a new blueprint for workforce development.
Nov 19, 2025
For over a decade, academics and progressive policymakers have been fretting about the “future of work” and the “gigification” of labor. And for good reason. Since the ascendance of companies like Uber, Lyft, DoorDash, and Instacart in the early 2010s, hundreds of thousands of people have taken on the work of fulfilling “gigs” provided by such apps. Consumers have become habituated to getting their rides, groceries, and household goods at the push of a button.
Workers often turn to “gig” jobs because they need flexible work schedules due to caregiving responsibilities or the need for multiple jobs to make ends meet. However, this work is usually low paying, precarious, and unprotected by employment or labor laws. That’s by design, and it’s a big problem: Those laws were created with the intention of protecting just these sorts of workers. The companies behind the apps argue that this is simply the price of flexibility.
There’s no reason that flexible work should require sacrificing the protections, rights, and opportunities provided by employment, like a guaranteed minimum wage and overtime for long hours; the right to a healthy and safe workplace; protections against discrimination and harassment; and insurance against the downside risks arising from the loss of jobs or workplace injuries.
Treating workers as independent contractors without rights and protections has become standard practice for many platform companies. Promoted by venture capital funders, the practice feeds a narrative that the acquisition of skills, experience, and on-the-job savvy—traditionally a responsibility of employers—falls on individual workers to “entrepreneurially” pick up such training on the job. Yet this perspective contradicts a fundamental principle of workforce development, which recognized the wider economic benefits arising from building a skilled workforce.
The Long Beach pilot demonstrates that flexibility can also come with good jobs and opportunities to enhance skills while meeting pressing employer staffing needs.
An innovative public pilot in Long Beach has shown it is possible for gig work to benefit workers, employers, and the broader community. The Workers Lab, an organization that funds innovations for and with workers, and Pacific Gateway, the City of Long Beach’s public workforce board, have invested in a platform called WorkLB. The technology behind the platform, originally developed with the British Labor government, plays a matchmaking role by connecting employers and workers based on needs, skills, and schedules.
Pacific Gateway is demonstrating that flexible schedules and the opportunity to do short-term work can go hand in hand with decent earnings, protections, rights at work, and upward mobility. Moreover, the program shows that such opportunities can also benefit businesses and public agencies looking for workers and seeking to improve the workforce development system.
This simultaneously undermines the dominant narrative of a trade-off between flexibility and workers’ rights, and shows how government intervention can effectively address issues arising from the so-called Gig Economy.
The Long Beach model allows Pacific Gateway to either act as, or delegate the responsibility to vet and oversee workers, ensure proper payroll management, provide healthcare, abide by labor law, and pay for liability insurance.
To participate, employers must be willing to pay the local minimum wage (currently $16.50 per hour in Long Beach), with a markup of 2.5% ($0.40 per hr) to help defray the costs of administration. For workers, this unique model helps them find the best work opportunities based on their skills, interests, and scheduling needs. Whether short or long-term, these work opportunities are W-2 jobs providing good wages, benefits, and labor protections. All that, and flexibility.
Pacific Gateway credentials workers through its formal intake process, awarding them “badges” to market their skills. Unlike traditional, for-profit staffing agencies, which have also proliferated in the gig economy space, that treat workers’ skill levels as proprietary data, Pacific Gateway makes this information readily available to prospective employers.
By using a public workforce agency in this staffing agency role, Pacific Gateway is fulfilling the original intention of the federal Employment Services program—to match workers with employers, connect workers to the appropriate training opportunities, and then place them in actual jobs.
In a reversal of gig work common sense, WorkLB’s app allows workers to review their employers, which helps ensure that Pacific Gateway recruits employers providing good jobs rather than placing workers in exploitative and precarious work. While the app currently does not allow employers to rate the workers, it enables them to track the progression of a worker to incentivize full-time work conversion where desired.
Participating workers in Long Beach report high satisfaction with the program, saying that it provides quality jobs with transparent pay, clear expectations, and legal protections and allows them to demonstrate their skills to prospective employers. Employers get a vetted, skilled workforce for on-demand jobs that serve their longer-term workforce needs. The federal workforce system was created to do this, but perpetually lacks the funding to do so at the appropriate scale.
Given its success thus far, there is growing interest in adopting similar pilots in other parts of the country. Additionally, these pilots may provide a salient avenue for much-needed workforce development at the state and local level that meets both workers' and employers’ needs, especially as the current Trump administration slashes federal programs, such as Supplemental Nutrition Assistance Program, Medicaid, and Temporary Assistance for Needy Families, and mandate greater work requirements that may impact state and local workforce funding. However, the greatest challenge is funding these pilots, especially as federal funding is cut. The Long Beach pilot was primarily funded through philanthropic dollars, but given the need to scale future efforts, public funding is critical. Now is the time for states and localities to think creatively, whether by developing sector-based partnerships with employers and unions where all partners have “skin in the game,” or identifying other public funding streams, to support this growing workforce.
Workers often accept low-paid and precarious gig jobs because they need them to shore up failing household budgets while juggling complicated schedules. The Long Beach pilot demonstrates that flexibility can also come with good jobs and opportunities to enhance skills while meeting pressing employer staffing needs, thereby benefiting workers, families, and the wider community.
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