Protecting Oral Health Access for Undocumented Immigrants

 

Widespread fear and uncertainty prevent many undocumented immigrants and their families from seeking routine health care. These families may face difficult choices—whether to stay hidden, plan for childcare if deported, or even consider self-deportation. Children in undocumented families experience constant anxiety, uncertain if they can remain in the country or if a parent will be taken away. Many are exhausted and unsure where it is safe to live or seek care. Places once considered safe (e.g., healthcare facilities, schools, and daily routines) now carry the risk of family separation.1,2  Dental public health professionals can help reduce barriers by communicating policy changes clearly and strengthening clinic practices that protect immigrant patients.2 

A public health dentist protected under DACA (Deferred Action for Childhood Arrivals), who often provides dental care for undocumented patients, shared with us: “It’s a stark reality for my patients, my community, and myself. I personally have been living with this for so long; it takes a toll on my mental health, and I’m fortunate to still have DACA. Scary times, regardless of what little “protection” marginalized folks have when racial profiling was made permissible by the Supreme Court. It’s disheartening to see many of my undocumented patients lose their dental coverage this summer. I am trying my best to show up to work, live through some anxiety of even being out and about, and creating plan B options should things not go to plan. Thank you for sharing this opportunity to comment. It’s meaningful to have allies supporting our struggles.”

Described below are recent policy changes affecting undocumented immigrants3, 4, and strategies to mitigate health impacts of exclusionary immigration policies from a policy brief titled “Mitigating The Health Impacts Of Exclusionary Immigration Policies: An Evidence Review,” published in Health Affairs.2

Policy changes affecting undocumented immigrants: Federal law prohibits states from using federal funds to cover healthcare for undocumented immigrants, but some states use their own funds.3, 4 As of 2025, 14 states and D.C. extended Medicaid eligibility to cover all income-eligible children regardless of immigration status, and seven states and D.C. offered some coverage to income-eligible undocumented adults.3 Budget constraints and policy changes have led some states to reduce these benefits.3, 4 For example, California paused Medicaid eligibility for undocumented, non-pregnant adults in January 2026 and will end comprehensive Denti-Cal benefits for undocumented adults July 2026, leaving only emergency dental services. Illinois ended the Health Benefits for Immigrant Adults (HBIA) program and coverage (including dental) for undocumented adults aged 42-64 July 2025, though seniors remain covered. Minnesota ended MinnesotaCare eligibility for undocumented adults, with coverage for existing enrollees ending December 31, 2025.

Strategies that Healthcare and Social Service Organizations can use to support care for undocumented immigrants2:

Limit data collection and sharing: Avoid collecting information on birthplace or immigration status unless necessary, and carefully assess whether photo ID is required. Clearly communicate how patient information is protected (e.g., under HIPAA).

Develop privacy protocols: Adopt privacy protections both in physical spaces, such as waiting rooms, and in patient data collection and storage.

Explain program eligibility and coverage: Clearly explain program eligibility and coverage to ease fears about accessing services, including for citizen children, who are fully eligible regardless of their parents' immigration status.

Establish legal partnerships: Collaborate with legal organizations to connect people with legal resources, immigration representation, or other needs.

Expand community health worker initiatives: Community health workers have shown to build trust by identifying patient concerns and priorities, navigating access to services, and advocating for systems change.

Adopt practices that promote language justice: Create linguistically and culturally welcoming spaces by offering translation and interpretation services, multilingual materials, and staff who reflect the communities served.

Provide information on immigrant rights: Inform immigrants and the broader community about their rights. In one study, a “know your rights” educational session in a health center waiting room improved patient confidence and strengthened partnerships supporting immigrant patients.

References: 

  1. Garsd J. How undocumented families are navigating the looming threat of ICE [podcast episode]. In: Code Switch. Washington (DC): National Public Radio; 2025 Nov. Available from: NPR.

  2. Novak NL, Kline N, LeBrón AMW, Lopez W, Michelen M, De Trinidad Young ME. Mitigating the health impacts of exclusionary immigration policies: An evidence review. Health Aff (Millwood). 2025 Nov 6.

  3. Pillai A, Pillai D, Artiga S. Recent State Actions Impacting Immigrants’ Access to State-Funded Health Coverage and Other Public Programs. KFF; 2025 Jul 16. 

  4. Coleman A, Richards C, Collins SR, Leonard F. What Recent Policy Changes Mean for Immigrant Health Coverage. The Commonwealth Fund; 2025 Oct 15 [cited 2026 Feb 10]. 

  5. California Department of Health Care Services. Immigration Status and Changes to Medi-Cal Eligibility. Sacramento (CA): California Department of Health Care Services; 2026 Jan 6. 

  6. Illinois Department of Healthcare and Family Services. Health Benefits For Immigrant Adults. Springfield (IL): Illinois Department of Healthcare and Family Services.

  7. MNsure. MinnesotaCare coverage changes for undocumented adults in Minnesota took effect June 15. St Paul (MN): MNsure; 2025 Jun 17.

Authored by: The AAPHD Equity, Diversity, and Inclusion Committee