Trump cuts Head Start, health care for immigrants

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Federal officials are halting access by undocumented immigrants to a wide variety of health care programs, from Head Start to community health centers, a change potentially affecting tens of millions of people a year.

The move announced July 10 by Health and Human Services Secretary Robert F. Kennedy. Jr. would strip an estimated $374 million in Head Start funding from families that no longer qualify. The move is part of President Donald Trump's ongoing immigration crackdown, which has seen the borders tightened and more aggressive detention and deportation of people living in the United States without permission.

The federal Department of Labor on July 10 also announced new rules limiting who can access its programs, as did the Justice, Education and Agriculture departments. White House officials said the aggregate changes would save $40 billion in benefits that would have otherwise gone to undocumented immigrants.

"For too long, the government has diverted hardworking Americans' tax dollars to incentivize illegal immigration,” Kennedy said in a statement. "Today's action changes that ‒ it restores integrity to federal social programs, enforces the rule of law, and protects vital resources for the American people."

Federal law still requires hospitals to treat any patient who is suffering a medical emergency, regardless of their immigration status or ability to pay.

Many federal programs, including the one formerly known as food stamps, are already limited to citizens and legal residents only. HHS officials said this change brings Head Start and the community Health Center Program into compliance with that existing policy, which is designed to limit public services to legal citizens. It was not immediately clear how many people would lose services under the new rules, or whether American citizen children of undocumented immigrants would lose access to Head Start and other programs.

"As President Trump has ordered, 'the American people deserve a federal government that puts their interests first and a government that understands its sacred obligation to prioritize the safety, security, and financial and economic wellbeing of Americans,'" HHS wrote in issuing the new rules.

Reaction to the changes

The change stunned health care workers across the country as they scrambled to understand the implications of the decision.

In a statement, the National Association of Community Health Centers said it's working with its legal team to understand the impact of the new rules, given that federal law requires the centers to accept "all residents of the area served by the center."

The association said its members serve approximately 10% of the overall U.S. population, and as much as 20% in some rural areas.

The access change also applies to some mental health treatment, homelessness transition and drug-treatment programs.

The White House argues that federal spending and taxes could be lower if Americans didn't have to pay for health care and other services provided to people living illegally in the United States. Both Florida and Texas already require hospitals to ask the immigration status of people seeking help.

Migrant-rights groups point out that anyone living in the United States already pays some level of tax, from sales tax on groceries to gas tax on fuel, and that many of those undocumented people also pay federal income taxes and Social Security, even though they will never collect that Social Security upon retirement.

Undocumented immigrants contributed $100 million in taxes in 2022, according to an analysis by Americans for Tax Fairness, an advocacy group.

Head Start this year served 754,819 students across every state, and provides both educational and health care assistance to children. HHS officials said it would cost about $22 million to change Head Start operations to begin tracking citizenship, and $115 million to $175 million to make those changes agencywide.

The community Health Center Program funds about 1,400 clinics nationally, offering basic health care and dental services to anyone regardless of their ability to pay. According to the National Association of Community Health Centers, 90% of their clients earn less than 200% of the federal poverty level.

Public health experts have repeatedly noted that routine access to health care improves overall national health while helping keep costs down by paying for preventative care. Health care systems providing high levels of care to uninsured people have to raise the rates they charge to insured customers to cover the shortfall.

"Proponents claim this ensures accountability for public resources, but the truth is far more complex and potentially harmful," Dr. Peter Sangeyup Yun of George Washington University's Department of Emergency Medicine wrote in a March essay. "Such policies disproportionately affect our most vulnerable populations, posing challenges to individual lives and the well-being of entire communities."