State lawmakers in Arizona are considering legislation to mandate hospitals to ask patients whether they are in the country legally.

Rep. John Gillette, R-Flagstaff, noted while the proposal includes a provision to let patients know their answer would not affect the type of care they receive or lead to any immigration enforcement, it is a needed measure to collect information on the effect undocumented immigration is having on the state's health care system, including the state's Medicaid program, the Arizona Health Care Cost Containment System, commonly referred to as AHCCCS.

"Right now in Yuma County, there's 1,676 people receiving some type of benefits on AHCCCS from the same address, but we don't know who they are and we don't know where they live," Gillette stated. "We just know they have the same address, but we haven't been provided that access. This bill aims to do that."

Gillette explained the bill is intended to track Medicaid spending with the purpose of uncovering if taxpayer dollars are being used to treat those who are not in the U.S. legally. Opponents of the measure argued it could deter patients from seeking and accessing essential medical care. The legislation is headed to Democratic Gov. Katie Hobbs' desk.

Rep. Mariana Sandoval, D-Yuma, fears the bill could have unintended consequences and the data collected could be used for ulterior motives. Republicans have modeled the legislation after a similar Florida law which highlighted the cost of undocumented migrants to the state.

Sandoval pointed out the legislation is not taking place in a vacuum.

"They conveniently overlook that undocumented workers contribute significantly to the state and local taxes," Sandoval emphasized. "These workers contributed an estimated $766 million in combined state and local taxes, just in 2022 alone."

Sandoval contended the bill would directly target those who she called some of Arizona's hardest working and vulnerable residents such as agricultural, hospitality and construction workers. She added hospitals should remain places of healing, not become ports of entry.

Immigrants' rights advocates are voicing concerns that migrant communities in Washington may be avoiding visiting food banks or getting food assistance due to fear of detention by federal immigration agents.

Jacob Sperati, senior manager of community markets for the nonprofit Northwest Harvest, runs two food distribution programs serving local communities, including many immigrants, in Seattle and Yakima. He said migrants, whether they are documented or not, already encounter many obstacles in accessing food, from language barriers to a lack of familiar options, to needing to show an ID.

"We believe that access to food is a basic human right, and people shouldn't fear needing to get food," Sperati contended. "We just continue to make our spaces as open and welcoming as we can."

Research shows immigrants make up more than 75% of Washington's agricultural workforce and yet, immigrants and refugees are more likely to experience food insecurity.

Washington's sanctuary laws limit the involvement of local law enforcement in federal immigration efforts. A statement by Washington Republican Party Chairman Jim Walsh said federal laws should override state immigration laws.

Jay Stansell, a retired public defender and immigration defense attorney, argued the pressure on immigration officers to detain more people is leading to illegal tactics.

"We've seen the behavior of immigration enforcement, whether it's ICE or Homeland Security or the Border Patrol, carried out in increasingly lawless ways, unconstitutional ways," Stansell asserted.

Stansell stressed no one is required to answer questions from law enforcement. He added businesses, including food banks and grocery stores, are allowed to ask immigration agents to leave.

"Say, 'Well, you are not here for food, and your presence is disrupting our mission to provide food for the public. We're asking you to leave, you do not have permission to be here,'" Stansell suggested.

Gov. Bob Ferguson signed three bills last week aimed at further protecting immigrants' rights.

While Florida's immigration debates center on mostly Hispanic communities, the state's Black immigrant populations, including more than 300,000 Haitian-born residents, are facing heightened fear and dwindling support services, according to advocates.

Shanika Houlder-White, deputy executive director of the National Black Worker Center, said legal immigrants report withdrawing from banks, hospitals and schools amid increased scrutiny, even as they lack language-accessible resources available to Spanish-speaking peers.

"The sad part about it all, especially for Black immigrants, is we are a demographic of people that often feel silenced in the spaces that we are either really needed or the spaces that we need the most," she explained.

Black immigrants make up 12% of Florida's foreign-born population but often find mainstream immigrant assistance programs ill-equipped to serve them. The challenges compound economic pressures. Nearly half of Black immigrants nationally earn less than $40,000 annually despite high education levels. Forty percent of African-born immigrants hold bachelor's degrees, according to Pew Research.

Houlder-White's family embodies these contrasts. Her Trinidadian-born father, a master tailor, carpenter and boiler technician, and her health-care worker mother came legally through family sponsorship. Now, she says, they face suspicion:

"They are in a moment where they are being shunned to the point that they want to just stay hidden and not pour their gifts into our economy in ways that will help this country grow and that we can only benefit from," she continued.

In Florida, Haitian immigrants disproportionately work in health care and construction, sectors facing critical labor shortages. The state's new immigration laws, including hospital status checks and driver's license restrictions, have deepened the anxiety.

Florida's Department of Children and Families reports a 19% drop in Haitian-Creole speakers accessing health programs since 2023, although officials attribute this to "outreach challenges."

Immigrant rights advocates are calling on state leaders to do more to protect Washington farmworkers from U.S. Immigration and Customs Enforcement, including the release of Alfredo 'Lelo' Juarez Zeferino.

Zeferino is a farmworker and well-known union organizer who was detained by ICE in March.

Liz Darrow, participatory democracy coordinator for the Washington-based advocacy group Community to Community Development, which advocates for workers' rights, said there has been increased ICE activity since March and wants state government to take action.

"We really want the governor and the attorney general to take an active role in providing for the public a better picture," Darrow explained. "Because we really can't tell what's going on unless workers or their families reach out to us."

The Trump Administration said ICE raids are targeting criminals but critics pointed out migrants with legal status and no criminal history are also being detained. Darrow noted Zeferino has no criminal record.

Brenda Bentley, movement building coordinator for Community to Community Development, said one immigrant in Washington was taken by ICE as he was leaving church with his family. She added agents have been seen parked outside elementary schools.

"It's also a really chilling effect in the community because people are afraid to drive anywhere to do the basic necessities that they need to do," Bentley observed.

Zeferino has been detained for about two months and the charges against him are unclear. Darrow believes he was targeted because he has spent years publicly organizing farmworkers to improve working conditions.

"We see Lelo organizing all over the state and all over the country to try to help workers gain things like overtime and safety rules from heat stress and wildfire smoke," Darrow noted.

Darrow's organization is calling for Gov. Bob Ferguson to continue to enforce the "Keep Washington Working Act," which restricts local law enforcement from enforcing federal immigration laws.