As the issue of immigration continues to be a focal point in the Trump administration, healthcare professionals have started grappling with the question of whether or not they must report undocumented immigrants to authorities — or face Health Insurance Portability and Accountability Act (HIPAA) violations if they do.

In 2013, Arizona introduced a bill that would have required healthcare organizations to report undocumented immigrants to authorities, which would have increased clinicians’ participation in immigration enforcement.

In an article published in the AMA Journal of Ethics, Scott J Schweikart, JD, MBE, senior research associate at the American Medical Association Council on Ethical and Judicial Affairs in Chicago, Illinois, argued that immigration status is protected under the Health Insurance Portability and Accountability Act (HIPPA) Privacy Rule; sharing a patient’s immigration status should result in a penalty.

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“Under the HIPPA Privacy Rule, immigration status should be regarded as protected health information with no valid exception for unauthorized release,” wrote Mr Schweikart. “If the immigration status of a patient can be found to relate to the patient’s health condition it will be… subject to the Privacy Rule’s protections… Immigration status has a clear relationship to health.”

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The main goal of the HIPPA Privacy Rule is to protect patients’ sensitive health information. Undocumented immigrants face a multitude of challenges and stressors, particularly in the current political climate. They may worry that they or someone in their family will be deported or they may feel discriminated against in certain situations. These real fears can contribute to clinical factors relating to patients’ health and would then be protected under HIPPA, so healthcare organizations would face a penalty if they disclosed that information.

“It is important for clinicians and health care organizations to understand that release of a patient’s immigration status to authorities without valid exception is a HIPPA violation,” Mr Schweikart concluded.


Schweikart SJ. Should immigration status information be considered protected health information? AMA J Ethics. 2019;21(1):E32-E37.