State lawmakers in Arizona are considering legislation to mandate hospitals to ask patients whether they are in the country legally.

Rep. John Gillette, R-Flagstaff, noted while the proposal includes a provision to let patients know their answer would not affect the type of care they receive or lead to any immigration enforcement, it is a needed measure to collect information on the effect undocumented immigration is having on the state's health care system, including the state's Medicaid program, the Arizona Health Care Cost Containment System, commonly referred to as AHCCCS.

"Right now in Yuma County, there's 1,676 people receiving some type of benefits on AHCCCS from the same address, but we don't know who they are and we don't know where they live," Gillette stated. "We just know they have the same address, but we haven't been provided that access. This bill aims to do that."

Gillette explained the bill is intended to track Medicaid spending with the purpose of uncovering if taxpayer dollars are being used to treat those who are not in the U.S. legally. Opponents of the measure argued it could deter patients from seeking and accessing essential medical care. The legislation is headed to Democratic Gov. Katie Hobbs' desk.

Rep. Mariana Sandoval, D-Yuma, fears the bill could have unintended consequences and the data collected could be used for ulterior motives. Republicans have modeled the legislation after a similar Florida law which highlighted the cost of undocumented migrants to the state.

Sandoval pointed out the legislation is not taking place in a vacuum.

"They conveniently overlook that undocumented workers contribute significantly to the state and local taxes," Sandoval emphasized. "These workers contributed an estimated $766 million in combined state and local taxes, just in 2022 alone."

Sandoval contended the bill would directly target those who she called some of Arizona's hardest working and vulnerable residents such as agricultural, hospitality and construction workers. She added hospitals should remain places of healing, not become ports of entry.

While Florida's immigration debates center on mostly Hispanic communities, the state's Black immigrant populations, including more than 300,000 Haitian-born residents, are facing heightened fear and dwindling support services, according to advocates.

Shanika Houlder-White, deputy executive director of the National Black Worker Center, said legal immigrants report withdrawing from banks, hospitals and schools amid increased scrutiny, even as they lack language-accessible resources available to Spanish-speaking peers.

"The sad part about it all, especially for Black immigrants, is we are a demographic of people that often feel silenced in the spaces that we are either really needed or the spaces that we need the most," she explained.

Black immigrants make up 12% of Florida's foreign-born population but often find mainstream immigrant assistance programs ill-equipped to serve them. The challenges compound economic pressures. Nearly half of Black immigrants nationally earn less than $40,000 annually despite high education levels. Forty percent of African-born immigrants hold bachelor's degrees, according to Pew Research.

Houlder-White's family embodies these contrasts. Her Trinidadian-born father, a master tailor, carpenter and boiler technician, and her health-care worker mother came legally through family sponsorship. Now, she says, they face suspicion:

"They are in a moment where they are being shunned to the point that they want to just stay hidden and not pour their gifts into our economy in ways that will help this country grow and that we can only benefit from," she continued.

In Florida, Haitian immigrants disproportionately work in health care and construction, sectors facing critical labor shortages. The state's new immigration laws, including hospital status checks and driver's license restrictions, have deepened the anxiety.

Florida's Department of Children and Families reports a 19% drop in Haitian-Creole speakers accessing health programs since 2023, although officials attribute this to "outreach challenges."

Immigrant rights advocates are calling on state leaders to do more to protect Washington farmworkers from U.S. Immigration and Customs Enforcement, including the release of Alfredo 'Lelo' Juarez Zeferino.

Zeferino is a farmworker and well-known union organizer who was detained by ICE in March.

Liz Darrow, participatory democracy coordinator for the Washington-based advocacy group Community to Community Development, which advocates for workers' rights, said there has been increased ICE activity since March and wants state government to take action.

"We really want the governor and the attorney general to take an active role in providing for the public a better picture," Darrow explained. "Because we really can't tell what's going on unless workers or their families reach out to us."

The Trump Administration said ICE raids are targeting criminals but critics pointed out migrants with legal status and no criminal history are also being detained. Darrow noted Zeferino has no criminal record.

Brenda Bentley, movement building coordinator for Community to Community Development, said one immigrant in Washington was taken by ICE as he was leaving church with his family. She added agents have been seen parked outside elementary schools.

"It's also a really chilling effect in the community because people are afraid to drive anywhere to do the basic necessities that they need to do," Bentley observed.

Zeferino has been detained for about two months and the charges against him are unclear. Darrow believes he was targeted because he has spent years publicly organizing farmworkers to improve working conditions.

"We see Lelo organizing all over the state and all over the country to try to help workers gain things like overtime and safety rules from heat stress and wildfire smoke," Darrow noted.

Darrow's organization is calling for Gov. Bob Ferguson to continue to enforce the "Keep Washington Working Act," which restricts local law enforcement from enforcing federal immigration laws.

While Gov. Ron DeSantis touts "Operation Tidal Wave" as a success, advocates for Florida's immigrant families say the crackdown is tearing them apart - and ignoring their legal rights.

In a Thursday news conference at Miramar's ICE facility, where immigrants routinely report on their cases, officials celebrated the operation - even as community members now fear detention for keeping appointments.

Cuban mother Heidy Sanchez was deported after checking in and forced to leave her 1-year-old U.S.-citizen daughter behind, according to Renata Bozzetto, deputy director of the
Florida Immigrant Coalition.

"Heidy was just like every other immigrant going to that facility in Miramar to do what she was told to do - to present herself, follow the rules and be in constant contact with ICE agents - only to be trapped and deported," she said, "and that is absolutely heartbreaking."

Bozzetto said many immigrants who comply with ICE check-ins are being swept up. DeSantis claimed the operation has led to a 63% arrest rate of people with prior criminal convictions, but Bozzetto argued the state is obscuring the real impact - of families torn apart, workers disappearing from jobs, and U.S. citizens caught in the dragnet.

The operation has also raised concerns about racial profiling and what critics see as the state's disregard for court orders. Bozzetto pointed to constitutional violations and the lack of information about the 1,120 people Operation Tidal Wave claims to have taken into custody.

"When these stories are not given to us with the detail and the transparency that they deserve, we have various questions," she said, "including, did these individuals have the right to due process?"

Florida's aggressive approach includes its embrace of what are known as 287-G agreements, which allow local law enforcement to act as federal immigration agents. DeSantis has called these a key tool in immigration enforcement.


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