Political rhetoric often stigmatizes immigrants as a drag on the U.S. health care system, but the Colorado Health Access Survey (CHAS) finds that immigrants use less health care than U.S.-born residents. The pattern is consistent for every form of health care use measured by the CHAS. It reflects a mix of interconnected factors, such as cost, access, and, more recently, fears about federal immigration actions that have led many immigrant community members to delay or avoid care altogether.
By combining data from the 2023 and 2025 CHAS surveys, CHI examined interactions with the health care system through the lens of insurance coverage, care utilization, employment, education, and food and housing security. One of our strongest findings shows a 12-point gap between immigrants and U.S.-born Coloradans who had at least one health care visit in the previous year. For immigrants who speak Spanish at home, the gap is twice as large.
The environment has shifted even since the survey was in the field. One multistate survey found that 84% of health care workers reported a significant or moderate decrease in immigrant patient visits following the January 2025 executive orders on immigration. Physicians have reported increased no-show rates among immigrant patients, and the presence of Immigration enforcement near health care settings has been driving care avoidance, including among people with legal status.
These fears carry real health consequences. When people avoid care, conditions go unmanaged, and outcomes worsen. This is an important issue for public health professionals because health care settings have long been understood as spaces where safety and care are guaranteed regardless of background. When patients fear that seeking care could lead to an immigration enforcement encounter, the result is a chilling effect that extends well beyond undocumented people and into mixed-status families and communities broadly.
