DOVER – Delaware hospitals are working in uncharted waters as President Donald Trump and other legislators are rapidly working to reshape fiscal policy – and likely to disrupt patient treatments.
As Trump continues to make sweeping changes on immigration policy and health care funding via executive order, health care officials are quietly trying to navigate day-to-day business. Early in his term, Trump had revoked sanctuary status for hospitals which had previously allowed undocumented immigrants to seek care without fear of deportation.
Now the Trump administration has promised to punish those who do not comply with his orders through lawsuits and has followed through. On Wednesday, the U.S. Justice Department filed a lawsuit against New York which had been allowing people to get driver’s licenses without legal residency.
The fear has trickled down into other parts of society, as well, as Delaware’s health care leaders have seen recently. They are now tasked with ensuring that the health, and safety, of each patient is a top priority while maintaining high quality care at a reasonable cost.
Delaware Healthcare Association (DHA) President and CEO Brian Frazee told the Delaware Business Times in an email that hospitals in the First State “have and always will open their doors to all 24 hours a day, 7 days a week, 365 days a year. That’s our job and we take it seriously.”
The organization represents Delaware’s six nonprofit health care systems and has recently gone to bat on several major issues facing the group collectively, including funding and access to health care.
“We are unwavering in our commitment to providing care with compassion and dignity and remain deeply committed to respecting the privacy of our patients and their families. Our members are following their day-to-day protocol to uphold the safety of anyone who walks through their doors,” he said in the email on behalf of the health care systems DHA supports.
One of the biggest worries on the minds of Delaware health care leaders is their sources of federal funding. Medicaid, the nation’s public health insurance program for low-income adults and children, is the largest factor in that.
It is a lifeline for 230,000 Delawareans, according to the Delaware Healthcare Association. Delaware spent more than $3.4 billion on Medicaid in Fiscal year 2023.
House Republicans announced Wednesday that it is considering $1.5 trillion cuts in Medicaid and Medicare to fund tax cuts- which would have a deep impact to Delaware, according to DHA President and CEO Brian Frazee.
“We know that uninsured individuals are less likely to seek preventative care and more likely to delay needed care,” he wrote the Delaware Business Times in an email. “That’s a dangerous precedent to set.”
With less funds available and the reimbursement for Affordable Care Act subsidies expiring, there could be fewer health care resources for those who may soon be uninsured and a spike in emergency room visits. Frazee said that it with lower or no reimbursement for medical services to patients, it would cause an even deeper strain on Delaware’s medical staff and facilities that already exists.
Half of all immigrant adults in the United States without documents are reported to be uninsured, compared to 6% of naturalized citizens, according to the largest nongovernmental survey of immigrants that found their ways into U.S. to date by the KFF-Los Angeles Times Survey of Immigrants.
“Our nonprofit hospitals care for every person that enters our doors 24/7/365 regardless of their ability to pay. Delaware hospitals will serve as a backstop against harmful federal policies, but we must all work together to try to maintain needed healthcare programs,” he said.
“Federal funding cuts and more uninsured will mean hospitals will be needed to step in to bridge the gap to continue to provide needed care and support for our communities,” he continued.
The issue of federal funding has become more tied to the Trump administration’s policies on immigration as well as diversity, equity, and inclusion and other matters. In his first days in office, the president signed an executive order that stripped many sanctuary locations like hospitals but also schools and churches from the right to shield undocumented immigrants.
The Delaware Business Times reached out to four hospitals in the state on their policies regarding the potential for sanctuary policies. ChristianaCare, Bayhealth and Beebe Healthcare all referred DBT to the DHA for a statement.
There are two health care organizations that have operations in both Maryland and Delaware: ChristianaCare and TidalHealth. In Maryland, Maryland Attorney General Anthony Brown has released a series of guidelines on how to handle Immigrations and Customs Enforcement (ICE). Guidelines include allowing ICE agents to enter waiting rooms and lobbies, but not patient rooms and doctor offices.
“TidalHealth has established guidelines for our organization in accordance with the Maryland Office of the Attorney General Guidance Memorandum on Immigration Enforcement Activity for Maryland Healthcare Providers should any of our entities be contacted by immigration enforcement,” TidalHealth Strategic Communications Director Roger Follebout said in an email. “Our public safety director and general counsel will validate the authenticity of the request and the credentials of the ICE agent, and will assist as required by law.”
