Medha MakhloufSeptember 2021 — The American Society for Law, Medicine & Ethics and the Network for Public Health Law hosted the virtual Public Health Law Conference from September 20-23, 2021. Professor Medha D. Makhlouf presented on a panel devoted to Immigration Law and Public Health.

The purpose of the biennial conference was to bring together experts in law and public health “to learn about how the strategic use of legal and policy tools can address fundamental drivers of inequity, promote health and well-being, and save lives.” Professor Makhlouf’s panel focused on how interactions between immigration policy and health policy shape immigrant health as well as the health of the larger community, especially in light of the COVID-19 pandemic. The session began with Wendy Parmet of Northeastern Law describing several pathways through which immigration law negatively impacts public health and suggested concrete reforms for improving public health preparedness. Then, Eunice Cho of the ACLU National Prison Project discussed the treatment of immigrant detainees during the pandemic. Professor Makhlouf’s presentation focused on the negative public health consequences of immigration surveillance in health care.

Professor Makhlouf’s presentation was based on her article, “Health Care Sanctuaries,” which was recently published in the Yale Journal of Health Policy, Law & Ethics. In it, she argues that immigration surveillance in health care is a poor choice of resource allocation for immigration enforcement because it has severe collateral consequences for the U.S. healthcare system and compromises the legitimacy of the state vis-à-vis its noncitizen residents. When noncitizens delay seeking care, they put their own health and the health of the larger community at risk, especially during an outbreak of infectious disease. Immigration surveillance in health care also contributes to the inefficient use of healthcare resources, creates ethical dilemmas for healthcare providers, and intensifies the vulnerability of immigrant communities during public health crises. The COVID-19 pandemic starkly illustrates these points, but the population-level externalities of immigration surveillance in health care exist even in the absence of a novel disease outbreak.

In the presentation, Professor Makhlouf provided an overview of the evidence indicating that laws that permit immigration surveillance in health care are deterring noncitizens from their family members from accessing health care. She then described the legal and policy framework of immigration surveillance in health care. She concluded by discussing the promise and perils of “health care sanctuaries,” the term she uses to refer to durable legal or institutional protections against immigration surveillance in health care.

Professor Medha D. Makhlouf is an Assistant Professor and Founding Director of the Medical-Legal Partnership Clinic at Penn State Dickinson Law. She has a joint appointment in the Department of Public Health Sciences at Penn State College of Medicine. Professor Makhlouf’s research and teaching interests lie at the intersection of health law, immigrants’ rights, and poverty law and policy. Her recent scholarship has been published in the New York University Law Review, the California Law Review Online, the Northwestern University Law Review Online, and the American Journal of Law and Medicine.