Immigration enforcement at hospitals ‘fueling fear’ after Minneapolis shooting, AMA says

The American Medical Association (AMA) is speaking out against immigration enforcement in and around hospitals as physicians and nurses mourn the death of Minneapolis intensive care nurse Alex Pretti, RN, and demand answers about federal agents’ use of force.

In a statement released Monday, AMA Board of Trustees Chair David H. Aizuss, M.D., said the organization is “deeply concerned by reports of immigration enforcement activity in and around hospitals and emergency rooms — a tactic fueling fear among patients and hospital staff alike.

“When people are afraid to seek medical attention for themselves or their families, it threatens their health, impedes the ability of physicians to render care, and ultimately undermines basic trust in our health care institutions,” Aizuss said. “To fulfill our oath and best serve our patients, physicians must be able to work in spaces that create a sense of safety for all, not fear for our most vulnerable.”

A KFF/New York Times national survey of 1,805 immigrant adults released in November 2025 showed how those fears had already begun reshaping patient behaviors.

Roughly four in ten immigrant adults said immigration-related worries had harmed their health in the last year. That figure climbed to 77% among those classified as “likely undocumented.” Nearly 30% of immigrant adults reported skipping or postponing needed care in 2025, up from 22% in 2023.

Roughly half said they worry about hospitals or clinicians sharing their information with federal immigration authorities, and nearly 15% of immigrant adults overall — and almost half of likely undocumented respondents — said they or a family member had avoided seeking care since January 2025 because they did not want to draw attention to their immigration status.

While the latest AMA statement does not mention specific cases or agencies by name, it comes amid escalating concern about the conduct of U.S. Immigration and Customs Enforcement (ICE) and Border Patrol agents in Minneapolis and other cities, and just days following the fatal shooting of Alex Pretti.

ICU nurse’s death intensifies scrutiny of enforcement tactics

Pretti, 37, worked as an intensive care unit nurse at the Minneapolis VA Medical Center. He was shot and killed Saturday by a federal Border Patrol agent during an immigration-related operation in Minneapolis, according to federal officials and news reports.

Officials have said the agent fired “defensive” shots and initially suggested Pretti was armed. Video footage and witness accounts reviewed by multiple outlets, however, show Pretti holding a phone to record and tending to a person on the ground before he is tackled and disarmed by federal agents, then shot several times. The incident sparked protests and calls for an independent investigation.

The death followed the Jan. 7 killing of Minneapolis resident Renee Good, 37, who was fatally shot by an ICE agent in her vehicle. That incident — the footage of which also went viral online — similarly sparked protests and demands for accountability.

The American Nurses Association (ANA) said it is “deeply disturbed and saddened” by Pretti’s death and called for “a full, unencumbered investigation” with findings shared “promptly and clearly so Alex’s loved ones and the public have answers.” National Nurses United (NNU) said it is “horrified,” condemned the actions of federal immigration authorities, and demanded “justice and accountability.”

Other nursing groups, including the American Association of Critical-Care Nurses, the Oregon Nurses Association and the Washington State Nurses Association, also issued statements mourning Pretti, urging a transparent investigation and warning about the broader climate of fear facing clinicians.

Pretti’s parents, Michael and Susan Pretti, said in a statement that their son “was a kindhearted soul who cared deeply for his family and friends and also the American veterans whom he cared for as an ICU nurse at the Minneapolis VA hospital. Alex wanted to make a difference in this world. Unfortunately he will not be with us to see his impact.”

Dimitri Drekonja, M.D., MS, an infectious disease physician at the Minneapolis VA, described Pretti on social media as “a good kind person who lived to help.”

For more on nursing organizations’ responses and calls for federal investigations, see additional reporting from Medical Economics’ sister publication, Chief Healthcare Executive.

‘Chilling effect’ on patients who need care

Beyond the details of the Minneapolis shooting, physician and nursing leaders say a pattern of immigration enforcement near health facilities is already changing how patients behave.

The AMA has long urged policymakers to keep immigration enforcement away from hospitals, clinics and physician offices and has supported efforts to designate health care facilities as ‘sensitive locations’ where immigration enforcement should not occur, warning that fear of deportation can deter people from seeking care until conditions worsen.

The latest statement frames enforcement activity at or near emergency departments as directly at odds with physicians’ ethical obligations.

At the same time, Charles Miller, J.D., said the ability to show up at a clinic is not the same as having coverage to pay for care. In a recent conversation with Medical Economics about the health insurance and medical care needs of Texans, Miller, the director of health and economic mobility for Texas 2036, said it’s important to separate those issues.

“So, I want to separate out the issue of health care from, say, government-subsidized health insurance or coverage programs, because those are two different aspects of things,” Miller said. “There is no law, prohibition or barrier to anyone going and accessing health care in Texas or nationally. A lot of the restrictions that do exist center around how it will be paid for and what programs are eligible.”

He noted that in Texas “there is no eligibility for traditional Medicaid or certainly for ACA subsidies for those who are here without legal status.” Programs that do exist are generally limited to emergency situations, he said, while some other states have chosen to directly fund or subsidize coverage options for people without legal status.

For primary care, the result is a complex mix: patients who are legally able to walk into a clinic but may avoid doing so because of enforcement fears, lack of insurance, or both.

‘Have a plan in place’: Practices urged to treat readiness as compliance, not crisis

For practices, especially those serving immigrant communities or employing international medical graduates, the debate over enforcement comes to a point with a pressing question: what to do if immigration agents show up at the front desk.

In an October 2025 episode of Medical Economics and Physicians Practice’s “Off the Chart: A Business of Medicine Podcast,” immigration attorney Katie P. Russell, J.D., partner at Brown Immigration Law in Cleveland, said the first step is preparation, not improvisation.

“What I always tell my clients, whether they’re individuals, corporate clients or medical practices, [is] the most important thing to do is to have a plan in place if officers, law enforcement, ICE, whoever does decide to pay your office a visit,” Russell said. “It’s usually something that is unannounced, so you want to make sure that you’re prepared, and that element of surprise doesn’t throw you or your staff off in terms of how you respond.”

As part of that plan, she said, “every medical practice should designate a specific staff member, like an administrator or a member of the HR team, as the point of contact for any type of law enforcement interaction, and that’s including immigration officials.” That person, she added, should be prepared to review and verify any warrants, communicate with agents professionally, document what happens and follow up with legal counsel.

Russell also cautioned that “over cooperation, such as volunteering information or waiving rights, even inadvertently, can violate privacy laws and employee rights, it’s a big quagmire.” Practices, she said, “just don’t want to have [themselves] in a situation where something could get [them] in trouble by trying to be over cooperative.”

She shared that some of her clients have called while agents were already on site, and said having written protocols, staff training and an attorney on standby can “take a lot of the heat off of a visit like that” and help protect patients, clinicians and the practice.

• Related content: What to do if ICE visits your practice: A 7-step readiness plan, from Physicians Practice.

As investigations into Pretti’s death move forward and protests continue, national medical organizations are trying to draw a clearer boundary between law enforcement operations and the spaces where patients seek care.