Since implementation of the Affordable Care Act, commonly called Obamacare after President Obama, who signed it into law for his party, an unclear number of California doctors cap the number of patients they will accept under the program. If you can find a primary care physician, the wait times for visits may be long. That means emergency rooms have become popular for even minor things and since California gives free healthcare to illegal immigrants also, the state is being crushed by losses.
That declined since renewed U.S. Immigration and Customs Enforcement (ICE) efforts to deport illegal immigrants have been in effect. A new demography paper finds that emergency room visits by immigrants declined in 2025 compared to the later months of the Biden administration - and visits were more likely to be emergencies, so they led to hospitalization, rather than ERs being for less serious issues.
The authors contend that there is risk of more serious issues in the future, assuming they never go at all, which would mean higher costs later, but California has $1.6 trillion in debt and has pushed liabilities into the next fiscal year for the last three years to avoid a constitutionally illegal deficit, so the supermajority will publicly campaign against Trump(1) they are privately breathing a sigh of relief. With solar panels, electric cars, composting, and everything else the government has mandated and subsidized to shocking fiscal losses, saving money on healthcare is good.
Line Graphs of Unadjusted and Adjusted Estimates of Emergency Department (ED) Visits and Admissions Rates From the ED by Week Relative to Increased Immigration and Region of Birth
The authors used three safety-net hospitals - Harbor-UCLA Medical Center, Los Angeles General Medical Center, and Olive View-UCLA Medical Center, where being an illegal immigrant or having no insurance is okay(2) - and found that self-identified immigrant patients decreased over 20 percent more in mid-2025 compared than U.S.-born patients and by October the gap had narrowed to 10 percent. Either the immigrants were arrested for breaking the law or they were less likely to visit unless it was an actual emergency.
The largest declines were people who traveled over the border from Mexico. What remains in question is whether they were seeking less emergency care even if they had an acute emergency, they were using emergency care even for non-acute issues because immigration had never been enforced, or there were fewer of them in the general population and were getting medical care in a federal facility.
Citation: Sarah Axeen, PhD; Cameron Kaplan, PhD; Annie Ro, PhD, MPH; Anna Gorman, MPH; Daniel Cordova, MD; Manuel Pastor, PhD; Todd Schneberk, MD, MS, Emergency Department Visits After Heightened Immigration Enforcement in Los Angeles County. JAMA Netw Open. 2026;9(10):e2636734. doi:10.1001/jamanetworkopen.2026.36734
NOTES:
(1) Bizarre campaign ads say if you don't vote Democrat Trump will take away your vote, while others say he'll take away abortion, and one even says because she was interred in a Japanese camp - by Democrats - you must vote Democrat or Trump will do the same thing.
(2) Health insurance is required by law and free for the poor so uninsured people are usually wealthier illegal immigrants who'd rather pay the $950 per year penalty and go to a safety net hospital free than spend $3600 a year on premiums plus the deductible because they make too much money.
