This week, the Supreme Court will hear oral arguments in the legal battle over Deferred Action for Childhood Arrivals, the 2012 policy that has temporarily protected from deportation many undocumented individuals who were brought to the United States as children. As a physician, I’m deeply concerned about the impact this decision will have on the health of the nation.
Since the administration announced rescission of the program in 2017, the national discussion has focused, appropriately, on the impact that terminating DACA would have on the hundreds of thousands of young adults who rely on it to live, work and study in the United States. These undocumented young people, sometimes referred to as “dreamers,” were brought to the United States as children and raised as Americans. But it’s not only their lives that hang in the balance. DACA recipients also play an essential role in our health care system.
Today, there are approximately 27,000 doctors, nurses, dentists, physician assistants and other health care workers whose DACA status allows them to work and contribute to patient care. The program also is enabling nearly 200 current medical students and medical residents to pursue careers in medicine.
Jirayut “New” Latthivongskorn is one such example. Born in Thailand, Latthivongskorn is a first-year resident at Zuckerberg San Francisco General Hospital and Trauma Center. He is also, it is fair to say, a rising star: In addition to receiving his medical degree from the University of California at San Francisco, he received a master’s in public health from Harvard and co-founded Pre-Health Dreamers — an organization that provides support to undocumented students who are pursuing careers in health care.
One of his co-founders, Denisse Rojas, is pursuing a medical degree at the Icahn School of Medicine at Mount Sinai and is also a candidate for a master’s degree in public policy at Harvard’s Kennedy School of Government. Rojas, who testified about DACA in Congress, is another of the exceptional, accomplished and U.S.-trained DACA recipients who would be prevented from serving people without the work authorization that DACA confers.
Excluding these talented individuals from the workforce would do more than simply thwart their professional aspirations. It would also deprive a huge number of Americans of accessing quality care. In fact, research indicates that the physicians and trainees who stand to lose their eligibility if DACA is eliminated would, collectively, serve as many as 5.1 million patients over the course of their careers.
The demographic demands of America’s growing and aging population make capable DACA recipients even more indispensable. By 2032, the United States is projected to confront a shortage of as many as 122,000 physicians, compromising our ability to combat the rise in chronic health conditions or withstand a public-health crisis. Every single U.S.-educated and -credentialed health professional — DACA or otherwise — is a precious asset to our country.
Worse, this physician deficit will be concentrated most heavily in communities with the greatest need, including rural areas and low-income neighborhoods. As a result, some of our nation’s most vulnerable patients will be hardest hit. These are the patients that DACA recipients — who are often bilingual and have connections to these communities — are likely to serve.
The rescission of DACA would also strike a significant blow to the medical schools that play a vital role in meeting America’s health care needs. Physicians are not made overnight; in many cases, they require a decade’s worth of rigorous training and education. Schools for health professionals have dedicated millions of dollars and thousands of hours to the training of DACA students under the assumption that their investment would improve the system’s ability to serve a diversifying U.S. population.
Instead, a rescission of DACA would achieve the opposite — wasting the time, money and potential vested in these future doctors, while leaving future patients with fewer avenues to robust, reliable health care.
The Association of American Medical Colleges, which represents the nation’s medical schools, teaching hospitals, and academic societies, led 32 other medical organizations in submitting an amicus brief to the Supreme Court calling for the preservation of DACA. We’ve done so because we do not believe the administration considered the impact the rescission of DACA would have on patients and the health professionals who care for them.
A key tenet of medicine is to do no harm. The rescission of DACA falls well short of this ethical imperative.
David J. Skorton is a cardiologist and president and CEO of the Association of American Medical Colleges.