How Trump’s immigration crackdown puts Americans’ healthcare at risk

Illustration: Guardian Design / Getty Images View image in fullscreen Illustration: Guardian Design / Getty Images How Trump’s immigration crackdown puts Americans’ healthcare at risk ‘Ali’, from Afghanistan, is a ‘stellar’ doctor caring for patients in under-served West Virginia – but like many other foreign medics, his US future is now in peril I n a state plagued by high rates of cancer and low life expectancies, Ali’s colleagues say he’s exactly the kind of doctor West Virginia 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. “I realized there is a shortage of physicians in general,” 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. 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. 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. “He’s a stellar caregiver … with great foundational knowledge and ability to take care of West Virginians,” said a senior colleague who works with Ali, whose identity the Guardian is also withholding because of the sensitivity of the situation. “He’s been dedicated to taking care of folks here.” 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 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’t accept deportees being returned. Then in January of this year, the administration paused applications filed by immigrants from those same countries who were already in the United States and seeking green cards and other immigration benefits. Suddenly, Ali found himself in limbo, his whole livelihood in jeopardy. Typically, people who have applied for a green card can remain in the country until the