Set aside for a moment that with the passage of the so-called “Big Beautiful Bill” (BBB), Planned Parenthood was effectively cut off from receiving any Medicaid funding — funding that paid for pap smears, birth control, and cancer screenings, not abortion. That alone is alarming. But more telling is what it reveals: The federal government’s long war on Planned Parenthood wasn’t just an isolated campaign against a reproductive health provider. It was a blueprint — and a warning — for a much broader agenda: how to punish organizations and individuals for providing services and care to people the government doesn’t like and wants to control.
In Planned Parenthood’s case, since Medicaid was never used to pay for abortion care (except in cases of rape or incest), the effort to strip its funding was about punishing women for seeking basic health care that offended the political sensibilities of far-right politicians. Now, that same punitive logic is being applied more broadly: to punish all health-care providers who dare to serve undocumented people or trans people — even when the services in question are not paid for by the federal government.
Federally Qualified Health Centers (FQHCs) are the cornerstone of America’s health-care safety net. These community-based clinics serve low-income individuals, the uninsured, rural families, and communities of color. They provide essential services: primary care, behavioral health, dental, reproductive health, pediatric care, and more. These are not luxury providers. They are lifelines.
Here in Santa Barbara County, we are served by many FQHCs, including trusted and respected providers like Neighborhood Clinics, American Indian Health & Services, and the county’s own Health Centers. These clinics offer a wide range of services for adults, teens, children, and infants, including:
• Primary care and internal medicine
• Clinical laboratory and pharmacy
• Immunizations
• Obstetrics, family planning, and gynecology
• Well-child exams
These clinics do not turn people away. That has always been the point. But now, they’re being asked to screen the immigration status of the people they serve.
Planned Parenthood was the warning. For years, they raised the alarm about what happens when politicians insert themselves into doctors’ offices and exam rooms — when care decisions are no longer guided by medical need, but by ideology. The cruelty is no longer confined to reproductive health care. It’s metastasizing across the entire health-care system.
During debate over the BBB, an effort was made to insert language explicitly barring Federally Qualified Health Centers (FQHCs) from serving undocumented people. But Congress’s parliamentarian ruled that such language could not be included. So instead, on July 10, U.S. Department of Health and Human Services (HHS) Secretary Bobby Kennedy Jr. issued a unilateral memo instructing FQHCs that they cannot serve undocumented individuals — at all. Not even with private pay, donations, or state funds. Not even when the services are completely unrelated to federal reimbursement.
This marks a dramatic — and alarming — reversal of long-standing federal policy dating back to the Clinton Administration, which recognized the public health imperative and broad societal benefits of allowing people to seek health care without fear. Under that guidance, providers followed a de facto “don’t ask, don’t tell” approach to immigration status. But now, clinics are being told to do what they’ve never done before: ask immigration questions. And they’re scrambling. What does this policy mean in practice? Are they legally liable for unknowingly treating an undocumented person? Could they lose their funding? No one knows — because HHS hasn’t made it clear.
The result is confusion, fear, and paralysis across the very system meant to care for the most vulnerable.
Let’s be clear: This is not about cost. The federal government is not being asked to pay for these services. This is about control and exclusion. The same logic that targeted Planned Parenthood is now being expanded to gut the entire infrastructure of safety net health care. The goal is not fiscal responsibility — it is to send a message: if you help or serve a group of people we don’t like, we will punish you.
Everyone has a right to medical privacy — immigration status should not matter in a medical setting. The government is invading our privacy, intruding into our doctor’s offices, and weaponizing health care to divide us.
We ignore this pattern at our peril. We must stand against a government that punishes people simply because the ruling class doesn’t like them. We must get politics out of health care delivery. The warning signs were always there. Now the consequences are arriving — in real time, and at great human cost. If large swaths of people are blocked from — or too afraid to seek — basic care or immunizations, it’s not just dangerous for them. It’s dangerous for all of us.
And besides, it’s morally unconscionable.
