The Trump administration shocked the conscience of America yesterday with a plan that threatens to deport 800,000 young immigrants brought to the US as undocumented children. More than 200,000 of them live here in California. Many commentators and advocates have pointed out the self-defeating nature of this malignant decision to exile friends, neighbors, and children who know no other country and who were brought to the US by the adults caring for them. The Deferred Action for Childhood Arrivals (DACA) decision was announced at the Department of Justice, but it is anything but just and does nothing to make our homeland more secure. On the contrary, this action amounts to willful intimidation and psychological abuse of these young people and their families.

If not for Congress’s multigenerational failure to adopt comprehensive immigration reform, yesterday’s announcement might not have happened. Years of congressional inaction finally prompted President Obama to circumvent lawmakers and use his executive authority to adopt the DACA policy in 2012. DACA relies on prosecutorial discretion to give eligible undocumented immigrants under age 31 protection from deportation and provides a two-year work permit. Whatever one thinks of the policymaking process used by President Obama to solve an urgent problem, it answered a crying need for modernization of outdated immigration rules.

DACA Boosts Supply of Physicians, Health Workers

About one in five Dreamers work in the health care and education sectors, and experts say that rescinding DACA will cost the economy tens of thousands of nursing assistants and home health aides — occupations whose numbers already lag behind demand. Without an adequate supply of these workers, some older and disabled Californians could be forced to move from their homes into health care facilities.

The American Medical Association (AMA) yesterday criticized the White House’s decision. DACA could help 5,400 formerly undocumented people become US physicians, which would help ease projected shortages, the AMA said. Removing the so-called “Dreamers” from this pipeline is likely to exacerbate shortages of doctors in rural and underserved areas — especially in diverse and multilingual communities. UCSF also protested, saying that student Jirayut “New” Latthivongskorn, the first Dreamer enrolled in the medical school, deserves the opportunity to live and learn freely and to practice medicine after he graduates next year.

The losses to the health care workforce are only part of the damage resulting from the DACA decision. New research suggests that ending DACA is likely to create mental health issues, post-traumatic stress, learning issues, and loss of economic activity in our communities. A Stanford University researcher recently published data showing how this scenario would pull the rug out from the Dreamers and their children by introducing major stress into their lives. Before DACA, rates of mental illnesses were similar across the board for the children of undocumented mothers. But after DACA took effect, the diagnoses among children of protected mothers dropped by half, from 7.9% to less than 4%. The study attributed the reduction to differences in children’s adjustment disorders, which are driven by external stressors.

Elected leaders from both sides of the aisle recognize the importance of a stable family structure to the health of communities. Members of Congress must choose whether to let the White House plan take effect and wreak havoc or to step in and repair the problem. Lawmakers now face a moral imperative to reverse this horrific decision. By doing the right thing for Dreamers, they will be doing the right thing to protect the cherished values that make America a great nation.

The California Health Care Foundation is dedicated to health and wellness and the promotion of a health care system that is universal and that focuses on the needs of the whole person, regardless of where they have come from. Rescinding DACA not only inflicts significant trauma on Dreamers and their families, it undermines our American values of justice, fairness, and inclusivity. Congress needs to take action, set a path forward for the Dreamers, and allow our families to heal. As we work to hold our elected officials accountable, we must show the same courage and resilience that the Dreamers have demonstrated, against all odds, throughout their young lives.

Sandra R. Hernández

Sandra R. Hernández, MD, is president and CEO of the California Health Care Foundation. Prior to joining CHCF, Sandra was CEO of The San Francisco Foundation. She previously served as director of public health for the City and County of San Francisco. Read More

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