{"id":743524,"date":"2026-06-18T02:11:09","date_gmt":"2026-06-18T02:11:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/au\/743524\/"},"modified":"2026-06-18T02:11:09","modified_gmt":"2026-06-18T02:11:09","slug":"how-trumps-immigration-crackdown-puts-americans-healthcare-at-risk-us-immigration","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/au\/743524\/","title":{"rendered":"How Trump\u2019s immigration crackdown puts Americans\u2019 healthcare at risk | US immigration"},"content":{"rendered":"

In a state plagued by high rates of cancer and low life expectancies, Ali\u2019s colleagues say he\u2019s exactly the kind of doctor West Virginia<\/a> needs. Ali, who comes from Afghanistan, moved to the state in 2020 with a visa status that requires him to work in communities or hospitals without enough doctors.<\/p>\n

\u201cI realized there is a shortage of physicians in general,\u201d said Ali, who is in his late 30s and one day hopes to become a specialist and treat patients with cancers and other diseases in his adopted home, where the rolling hills remind him of rural Afghanistan. For now, he cares for patients at a large hospital in a coalfield region of the state.<\/p>\n

Last year, he treated more than 1,600 patients, more than 80% of whom are on Medicare or Medicaid, the US government health insurance schemes that largely serve older and low-income patients. Many live in rural areas shaped by the mixed legacy of a declining coal mining industry. Patients sometimes travel up to two hours to receive care at the hospital where he works because they have limited access to doctors and, particularly, specialists.<\/p>\n

Ali is a pseudonym and the Guardian is also withholding his location as a precaution in his immigration case. He routinely treats people with liver diseases, often caused by heavy drinking, and manages the complications of obesity-driven diabetes, both widespread health problems in the state.<\/p>\n

\u201cHe\u2019s a stellar caregiver \u2026 with great foundational knowledge and ability to take care of West Virginians,\u201d said a senior colleague who works with Ali, whose identity the Guardian is also withholding because of the sensitivity of the situation. \u201cHe\u2019s been dedicated to taking care of folks here.\u201d<\/p>\n

But Ali may not be able to continue to work in the US. Still on a visa, he has applied for a green card but has not yet been approved. Last year, the Trump administration banned entry<\/a> for people from more than a dozen countries and later expanded the restrictions to 39 nations, including Afghanistan. The administration gave a range of reasons for why these countries were subject to the ban, including that they do not have internal systems in place to properly issue identity documents or vet people who may pose national security threats, or that they don\u2019t accept deportees being returned.<\/p>\n

Then in January of this year, the administration paused <\/a>applications filed by immigrants from those same countries who were already in the United States and seeking green cards and other immigration benefits.<\/p>\n

Suddenly, Ali found himself in limbo, his whole livelihood in jeopardy.<\/p>\n

Typically, people who have applied for a green card can remain in the country until their application is reviewed. But if the government doesn\u2019t renew Ali\u2019s visa status or approve his green card application this fall, when his current status expires, he will lose his job, even though he and his wife can legally stay in the US with their two children, who were born here.<\/p>\n

The policy implemented by US Citizenship and Immigration Services, part of the Department of Homeland Security (DHS), to pause processing of applications for immigrants already in the US, has been met with a wave of legal challenges. The government recently lost in one major case where a judge ruled it had to start processing applications. But the Trump administration is appealing the decision, sowing further confusion and uncertainty.<\/p>\n

A central promise of Donald Trump\u2019s second term as US president has been the mass deportation of immigrants in the country illegally. Less publicized is the administration\u2019s effort to strip people<\/a> living here legally of their legal status \u2013 and what that means for people seeking medical care in the US, especially the neediest and most vulnerable Americans.<\/p>\n

The USCIS pause is just one of many Trump administration policies making it harder for immigrants to legally enter or stay in this country \u2013 and straining a fragile multi-trillion dollar US healthcare system, as about one in six<\/a> hospital workers directly involved in patient care is an immigrant, and an estimated 4% of hospital workers are not naturalized citizens.<\/p>\n

The US has long been unable to recruit all the doctors it needs. According to the Association of American Medical Colleges, a non-profit organization representing physicians in North America, nearly one in four<\/a> doctors in the country was trained abroad. Hospitals across the US are looking to people from other countries to fill their open positions. Hospitals in rural areas, where few American doctors want to move, are at a greater disadvantage. They have come to rely even more on immigrants. Ali and other foreign-born doctors have been part of the solution.<\/p>\n

\u201cWe\u2019re worried about the impact of the administration\u2019s frequently changing immigration policies,\u201d says Dr Jan Carney, president of the American College of Physicians<\/a>, a national organization of internal medicine physicians. \u201c[The physicians] are absolutely critical for the health of our communities, especially of our rural and under-served\u201d residents.<\/p>\n

\u2018My whole childhood was wars\u2019<\/p>\n

Ali\u2019s typical day starts before most people are awake. At 5.30am, he begins a 35-minute drive through the lush, green mountains near his home to the internal medicine unit at the hospital. When he arrives, the morning moves fast. He starts to review one of dozens of patient charts while he drinks his coffee and eats his homemade omelette and avocado breakfast sandwich. Meanwhile, the three residents he is training are checking on patients, before Ali joins them on rounds. \u201cThey are very complicated patients,\u201d Ali says, adding that some suffer from heart failure, liver diseases and other ailments at the same time.<\/p>\n

He repeats his rounds throughout the day. Ali never knows what time he will be home, but he always tries to be there to play with his two kids before their bedtime. After they go to sleep, he studies and writes papers in preparation for a medical fellowship, which is in jeopardy because of the hold on immigration-related applications. Before he goes to bed, he often talks via FaceTime to his parents and sisters in Afghanistan.<\/p>\n

Ali grew up in a small village north of Kabul, Afghanistan\u2019s capital. \u201cMy whole childhood was wars,\u201d he says. First the Afghan civil war, then the US invasion. \u201cI remember during the Taliban era, there were no hospitals running properly, and doctors left the country.\u201d<\/p>\n

An infantryman with the 15th Marine Expeditionary Unit lugs shoulder-launched missiles while moving with his company to a security position after seizing a forward operating base 25 November 2001, beginning Operation Swift Freedom, in Afghanistan. Photograph: Joseph R Chenelly\/DOD\/AFP\/Getty Images<\/p>\n

His father was the only doctor in the village. \u201cKids would die from infections. My father tried his best, but he didn\u2019t have all the resources that he needed,\u201d Ali said. \u201cAs a child, I had a cataract in one of my eyes, and we couldn\u2019t find an eye doctor in Kabul under the Taliban. My father took me to Pakistan for eye surgery, and that experience also reinforced my feeling at that time to become a doctor and help.\u201d An international scholarship for people affected by the war in Afghanistan allowed him to attend medical school in the Middle East region.<\/p>\n

Ali first moved to the US in 2009 for a university research program in Pennsylvania, where he was part of a group of researchers who worked on a medication that was eventually approved by the US Food and Drug Administration (FDA). In 2013, he moved to a university in the midwest, where he researched cancer genetics. In 2020, he was able to upgrade his visa to an H-1B, which is used to hire high-skilled foreign workers and joined a rural hospital in West Virginia at the peak of the Covid-19 crisis. He later moved to the larger hospital where he now works.<\/p>\n

Ali\u2019s journey to rural America is common among foreign doctors. Many of them came to the US through programs that require foreign doctors to work in an underserved area for at least three years in exchange for the opportunity to stay in the US. Often, they never leave, says Dr Carney. \u201cInternational medical graduates are more likely than US medical graduates to practice in rural areas.\u201d<\/p>\n

Like Ali, many of these foreign doctors have few connections in the US, but over time often become part of the community. Ali, his wife and children have settled happily into their area.<\/p>\n

In late May, the family attended their six-year-old son\u2019s celebration for the end of the school year. The little boy bounced along to the Beach Boys\u2019 Surfin\u2019 USA, more or less in sync with his classmates. Ali filmed the choreography from the back of the small, brightly decorated school gym. Ali\u2019s wife smiled as she held their toddler daughter, dressed in a Mickey Mouse T-shirt \u2013 her big eyes staring with some confusion at her brother\u2019s antics.<\/p>\n

At the end of the ceremony, the son trotted over with his Spider-Man backpack to hug his father. The boy and his sister only speak English. \u201cThey don\u2019t know they are different. That\u2019s the beauty of kids,\u201d says Ali\u2019s wife. One of the teachers approached the parents to ask whether the son will enroll in next year\u2019s class, but Ali said he didn\u2019t know. Come September, the family will have to move. If they are lucky, they will move closer to the city where he works for Ali\u2019s fellowship. If not, they might have to leave the country. But go where? He said he fears going back to Afghanistan because he belongs to an ethnic group that opposes the Taliban and worked with the US during its time in Afghanistan. If he goes back, \u201cthe Taliban probably will kill me,\u201d he said.<\/p>\n

Foreign doctors fill need for physicians<\/p>\n

Some of Ali\u2019s patients make a long drive to his hospital from more remote parts of West Virginia, to get care they can\u2019t receive at home. For example, in parts of McDowell county, thin roads cut through the Appalachian mountains for miles. Branches reach over some roads, creating a thick, green roof. Every now and then, the tree line breaks to reveal the wreckage of a train, a rusting school bus, or a somewhat dilapidated house, always with a porch, but rarely with anyone in it.<\/p>\n

The county is in one of the state\u2019s poorest regions. Some towns here have been without safe drinking water<\/a> for two years.<\/p>\n

\u201cThere\u2019s so much poverty,\u201d says Haven Walsh, a bartender at a popular tavern in one of the local towns. Behind her, friendly customers jump off their all-terrain vehicles, still dirty from the ride or their work in the mines. \u201cThe only jobs here are in coal or hospitals,\u201d Walsh says. \u201cAnd if you want to leave, you go into the military.\u201d In his effort to escape the war in Afghanistan, Ali ended up in West Virginia, while many West Virginians left for military service in Afghanistan after the US invaded soon after the terrorist attacks of September 11 2001.<\/p>\n

In the 1940s, McDowell county had more than 100,000 residents, and had bustling, prosperous towns, such as Welch, which was nicknamed \u201cLittle New York\u201d<\/a>. Today, the county has fewer than 17,000 people left. And McDowell is not an outlier. Many of West Virginia\u2019s rural areas are depopulating at the same time that the health of the remaining residents is on the decline.<\/p>\n

West Virginia has the second-highest cancer death rate<\/a> in the US, with about one in eight adults being cancer survivors. It also has one of the lowest life expectancies<\/a> in the US.<\/p>\n

The setting sun illuminates a portion of the rural community of Iaeger in McDowell county, West Virginia, in 2020. Photograph: Lexi Browning for The Washington Post via Getty Images<\/p>\n

Recruiting physicians in small towns can be especially hard. Some specialties in rural communities rely entirely on one doctor, said Jim Kaufman, president and CEO of the West Virginia Hospital Association, which represents 78 hospitals and healthcare systems in the state. \u201cI know one hospital, they\u2019ve been trying to recruit an OB-GYN for four years, and they\u2019ve not had any luck.\u201d Now, the obstetrics program is closing, \u201cbecause they can\u2019t get a physician\u201d, he said.<\/p>\n

Rural West Virginia\u2019s healthcare problems are compounded by the fact that there are not many hospitals here. \u201cOver 50% of our residents are in healthcare deserts,\u201d says Dr April Vestal, referring to areas where people don\u2019t have local access to basic medical care, doctors and pharmacists. Vestal heads an institute<\/a> to improve rural health in the state. People like Vestal are coming up with creative solutions, like financial incentives for local medical students to stay, a mobile cancer screening unit,<\/a> and even a fleet of helicopters<\/a> to quickly provide people with medical care.<\/p>\n

But foreign doctors like Ali remain part of the answer to the region\u2019s needs.<\/p>\n

Dr Kate Waldeck, a pediatrician who has worked in several hospitals across the state, said she filled in for a foreign doctor who was the only pediatrician in his clinic. He worked 50 weeks a year. \u201cThey asked me to come in so that he could have a week of vacation,\u201d Waldeck says. In another place where she works regularly, \u201cthe only full-time physician is in his 60s, and he\u2019s from Syria\u201d, she says. \u201cAll of these places are anchored by international physicians.\u201d<\/p>\n

Hospitals risk losing doctors<\/p>\n

The expansion of the Trump administration\u2019s travel ban<\/a> came after an incident that involved Ali\u2019s native Afghanistan. In November 2025, two national guard members<\/a> were shot in Washington DC and an Afghan national was charged.<\/p>\n

\u201cWe are not going to put up with these kind of assaults on law and order by people who shouldn\u2019t even be in our country,\u201d Trump said in an address in the wake of the shooting.<\/p>\n

The attacks rattled Ali. \u201cUnfortunately, one of the guards was from West Virginia,\u201d he said. \u201cWe from Afghanistan here in this community were on edge.\u201d He said his wife wouldn\u2019t leave the house for a month.<\/p>\n

Intealth, an organization that helps bring international medical graduates to the United States, said some of the countries affected by the travel ban, such as Nigeria and Iran, were near the top of US hospitals\u2019 recruiting lists.<\/p>\n

Then came the move this January to pause various immigration applications for people from the banned countries.<\/p>\n

USCIS said<\/a> anything that would require the approval of the federal government was paused \u201cto vet and screen aliens to the maximum degree possible\u201d. Physicians who had been legally working in the US for years found themselves facing unemployment.<\/p>\n

Ali\u2019s job was at risk. He and many others<\/a> affected by the policy sued the government.<\/p>\n

Medical organizations such as the American Medical Association (AMA) and the American College of Physicians (ACP) wrote letters to USCIS requesting an exemption for physicians. Doctors challenged the administration\u2019s pause in federal court.<\/p>\n

The government later updated its website to say that following an internal review process, holds were lifted on several groups of people including \u201cmedical physicians\u201d. USCIS told the Guardian that it was \u201cprocessing certain applications associated with medical physicians\u201d, but did not say when pending cases would be resolved.<\/p>\n

Just days ago, a federal court ruled<\/a> that USCIS can no longer suspend the processing of immigration benefits for nationals of 39 countries, adding that the policy reveals \u201canti-immigrant sentiments that it is forbidden from letting influence its decision-making\u201d. USCIS is appealing the decision, but in the meantime, the agency said it would comply with the court ruling.<\/p>\n

In response to questions to the DHS about the ruling, James Percival, DHS\u2019s general counsel, said in an emailed statement that \u201cthe Left\u201d has been using arguments about racial \u201canimus\u201d to go after \u201cvirtually every Trump-era Department of Homeland Security policy\u201d. He called it \u201csabotage dressed in legal clothing\u201d.<\/p>\n

It\u2019s not clear what will happen in the many relevant lawsuits following the national ruling. Curtis Morrison, an attorney representing Ali and dozens of other physicians from countries affected by the travel ban and subsequent USCIS pause, said in his experience he has only seen the agency processing applications of plaintiffs in the lawsuits. He is concerned USCIS is \u201cslow-walking the implementation of the order\u201d.<\/p>\n

So far, only one of the 21 doctors the Guardian interviewed for this story had their application processed. Ali and the other 19 are still waiting.<\/p>\n

People participate in a protest on the first day of the Trump administration\u2019s full ban against travel from 12 countries and a partial ban on seven others, at Los Angeles International Airport on 9 June 2025 in Los Angeles, California. Photograph: David McNew\/Getty Images<\/p>\n

All this is leaving hospital directors reeling in communities like the one where Ali works. \u201cIn healthcare, we always have to adapt. So we\u2019ll keep up. But it\u2019s getting more and more challenging,\u201d says the vice-president of the hospital where Ali works, whose identity the Guardian is also withholding as a precaution because the hospital receives some federal funding.<\/p>\n

Other immigration policy changes are compounding the problems for hospitals.<\/p>\n

The Trump administration also imposed a $100,000 fee<\/a> on H-1B visas for people applying for them from abroad<\/a>. Before, the cost was about $2,000 to $5,000.<\/p>\n

\u201cWe have one [doctor] right now that we\u2019re actually processing the $100,000 [fee for],\u201d the hospital executive said, adding that they were desperate. The effects are already visible. \u201cIf we were able to do 150 kidneys last year, right now, because of limited physicians, we\u2019re only able [to do] maybe 80 [transplants]. That\u2019s 70 people who are not going to get a kidney this year,\u201d he said.<\/p>\n

On 8 June, a different federal judge struck down the $100,000 fee.<\/a> The government has also appealed that ruling.<\/p>\n

\u2018I\u2019m not even allowed to continue working at my free clinic\u2019<\/p>\n

West Virginia offers an especially stark example of a difficult situation, but similar cases can be found across the country. Many of the doctors interviewed for this article, all from countries impacted by the travel ban and the USCIS pause, perform jobs for which there are severe shortages or which serve communities with tremendous needs. They all are anxious about their future in the US.<\/p>\n

\u201cI was at the forefront of the Covid pandemic. I took care of veterans for six years. And the only reason for this [situation] is where I was born,\u201d says a Sudanese doctor who is a cardiology fellow in the upper midwest. His wife, a pediatric cardiologist, is expecting their second child soon. \u201cSince we cannot be employed, we won\u2019t have health insurance. So my wife will be vulnerable during a very critical time,\u201d her husband said, requesting that their identities be withheld.<\/p>\n

If her application is not approved soon, she will also lose her job in a specialty where there are not enough doctors in the US. According to her husband, the hospital that offered her a job had been looking for someone in her specialty for four years.<\/p>\n

Dr Faysal Al Ghoula, 38, is working in another specialty with severe shortages. He is a pulmonologist and intensive care unit physician from Libya, now serving patients in an underserved part of Indiana. \u201cMy hospital has been trying to recruit for a long time now, and we\u2019ve been unable to find coverage,\u201d he says, adding that if he leaves, it will be a struggle for the hospital to hire and train a new doctor.<\/p>\n

Another Sudanese doctor elsewhere in the upper midwest, who worked at a jail, had to stop working earlier this year because his application for a work permit was still on hold. He trained two nurse practitioners to take over his role, he told the Guardian. A jail official had lobbied for him to be able to renew his permit because recruiting another physician would be extremely difficult, he said.<\/p>\n

Outside of his work at the jail, he volunteered his time at a free clinic but said he believed all the uncertainty around the countries affected by the travel ban would affect that as well. \u201cWhat\u2019s been especially difficult is that, legally, I\u2019m not even allowed to continue working at my free clinic, even though I volunteer there without pay. That part has honestly been heartbreaking,\u201d he says, citing advice from his attorney. When the Guardian interviewed him, he had spent most of the day calling more than 36 patients from his clinic to tell them they had to find a new physician \u2013 and still had more calls to make. Many of these patients have serious medical conditions. Seven called him back saying they had been unable to find timely follow-up care.<\/p>\n

Ali, too, is worried about the people he has been treating for the last several years. But he\u2019s also concerned about his family and his future: \u201cYou do everything by the book, abide by the laws, and you end up in this deadlock,\u201d he said.<\/p>\n

Fatima Khan contributed to this report<\/p>\n

This story was produced in a partnership between Columbia Journalism Investigations and the Guardian<\/p>\n","protected":false},"excerpt":{"rendered":"In a state plagued by high rates of cancer and low life expectancies, Ali\u2019s colleagues say he\u2019s exactly…\n","protected":false},"author":2,"featured_media":743525,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[64,63,137,500],"class_list":["post-743524","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-au","tag-australia","tag-health","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/743524","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/comments?post=743524"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/posts\/743524\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media\/743525"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/media?parent=743524"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/categories?post=743524"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/au\/wp-json\/wp\/v2\/tags?post=743524"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}