Encounters between U.S. Immigration and Customs Enforcement agents and Chicago residents have intensified in recent weeks, stoking fear across immigrant neighborhoods and prompting hospitals, clinics and city officials to re-evaluate protections for patients and students. Community organizers say the uptick — characterized by what they describe as more visible ICE activity near clinics and public facilities — is already changing how families use essential services.

"We're seeing people delay prenatal care and skip follow-up visits because they're afraid of being stopped on the way to the clinic," said Ana Ruiz, director of a community health center on the Southwest Side. "That fear has consequences for births, chronic disease management and public-health surveillance."

City leaders and health care institutions have responded with new guidance and expanded legal support. Mayor Brandon Johnson issued a statement this week directing municipal departments to reinforce privacy protections and to remind staff of limits on cooperation with federal immigration enforcement. Several hospitals and the Chicago Department of Public Health said they were distributing updated protocols clarifying when staff must comply with law enforcement requests and how to shield patient information.

An ICE spokesperson declined to comment on specific operations but said the agency "continues to focus on individuals who pose a threat to public safety." The lack of detailed explanation, however, has compounded local unease because federal enforcement priorities often shift and because Chicago has long sought to limit local participation in immigration enforcement.

The tensions pit federal authority against local policies designed to foster inclusion. Chicago’s status as a "welcoming city" and ordinances limiting police cooperation with ICE reflect a broader effort to protect public trust. Public-health experts warn that enforcement-focused approaches undermine such efforts. Research dating to the 2010s found links between heightened immigration enforcement and reduced prenatal care, increased stress-related health problems and lower vaccination uptake; clinicians and advocates say they are already seeing echoes of those trends.

Hospitals face an ethical quandary. Under federal law, emergency departments must provide care, but staff also must respond to valid warrants and court orders. "Clinicians are trying to balance patient safety with legal obligations, and that can be terrifying for patients and providers alike," said Dr. Maria Hernandez, an obstetrician at a large safety-net hospital. "When people fear the health system, the most marginalized suffer most."

Community groups have mobilized legal hotlines and transportation vouchers to help patients reach appointments safely and to connect families with rights information. Schools, too, are bracing: administrators say parents are increasingly reluctant to engage with school-based health services, potentially affecting childhood immunization and mental-health referrals.

Advocates call for clearer federal limits and better coordination. "We need transparent federal guidance that protects public health and respects local policies," said Julian Ortiz, a policy director at the Illinois Coalition for Immigrant and Refugee Rights. "Absent that, the fallout will be measured in worse health outcomes and deeper mistrust — especially in communities already bearing disproportionate burdens."

As Chicago navigates the standoff, clinicians, community leaders and city officials say their immediate priority is damage control: ensuring that fear does not translate into delayed care and preventable illness. For many residents, the question is practical and urgent. "I bring my kids to the clinic here because it's the only place I trust," said one mother who asked to remain anonymous. "Now I'm not sure who I can trust anymore.