Dear Honorable Members of the Conference Committee:
Thank you for the opportunity to submit testimony on behalf of Children’s HealthWatch regarding the reconciliation of An Act promoting rule of law, oversight, trust, and equal constitutional treatment, or the “PROTECT Act” (H.5316 and S.3086). We are grateful to the Black and Latino Legislative Caucus and the leadership of both chambers for developing this legislation and all elected officials who have used their positions to support immigrant communities during a time of increased targeting, fear, and hardship. As a network of pediatricians and public health researchers, we urge you to move forward the most robust version of the PROTECT Act, including the following provisions as included in S.3086:
- Ban on civil arrests at health care, schools, child care, and places of worship
- Allow parents and guardians to pre-arrange guardianship for their children in case parents are deported
Children’s HealthWatch seeks to achieve health equity for young children and their families by advancing research to transform policy. We accomplish this mission by interviewing caregivers of young children on the frontlines of pediatric care in urban emergency departments and primary care clinics in four cities: Boston, Minneapolis, Little Rock, and Philadelphia. We then share our findings with policymakers, researchers, and the public to drive evidence-based policy change. Headquartered at Boston Medical Center, since 1998, we have interviewed over 80,000 caregivers and analyzed data from those interviews to determine the impact of public policies on the health and development of young children and their families’ well-being. Approximately one-third of families we interview have at least one immigrant caregiver.
Immigration Enforcement Harms Child and Family Health
In speaking with parents, we hear directly about the ways in which fear of deportation or immigration-related violence affects their families’ health and well-being. Families may disenroll from safety net programs, even when they are still eligible, and stop going to work, the grocery store, or sending their children to child care or activities. Research shows that this phenomenon, referred to as the “chilling effect”, harms children’s and parents’ mental and physical health. Our research shows that following proposed changes to immigration and safety net policies under the first Trump Administration, compared to children of US-born mothers, children of immigrant mothers were less likely to get the preventive health care they needed – jeopardizing early childhood health monitoring, vaccination, and chronic disease diagnosis and prevention–the building blocks for all future health outcomes. In this way we see that federal-level policy choices are felt deeply at the local level, and impact families’ ability to feel safe and participate in our communities.
Children in particular bear the health costs of immigration-related stress in unique and dangerous ways. Immigration-related fear and violence is devastating for mental and relational health, causing children to regress developmentally.For those who have already been separated from their parent, or who live in constant fear of them being detained, imagine thinking: When will mom or dad be taken from me? Even children whose families are not directly targeted are traumatized, disrupting brain development with long-term negative effects on health. Ultimately, the compounding effects of broad scale immigration enforcement make our communities less healthy.
Since the beginning of the second Trump Administration, pediatricians across the country have seen the impact of increased immigration enforcement in their clinics.12 Previously, protections were in place that barred immigration enforcement at or near “sensitive locations”, including health care offices, but also schools, child care, and churches. This policy was rescinded in January 2025, giving Immigration and Customs Enforcement (ICE) agents authority to take enforcement actions in any of these spaces.13,14 As a result, children are missing well child visits, pregnant moms are foregoing pre/post-natal appointments, and children are showing up alone to Emergency Departments due to fear—all of which have current, medium, and future-term health and life consequences.
We also see this fear in our sample of caregivers who bring their children in for care at Boston Medical Center. In our survey, we measure chilling effects by asking immigrant caregivers questions about a variety of situations, such as: “I thought I could be deported if I went to social/government agency” and whether those situations had caused parents no, a little, or a lot of stress over the past year. Since 2025, we have seen an uptick in caregivers’ stress score, showing that immigrant caregivers are feeling higher levels of stress related to their immigration status, compared to other periods of time.
PROTECT Act Priorities to Reduce Chilling Effect
While ICE enforcement decisions are made at the federal level, the climate of fear around accessing local services is very much shaped by state and local policy. Right now, families need legislation that protects their safety and ensures that interacting with community institutions and services will not put them in danger. We urge the Conference Committee to include the following provisions in the final bill:
- Ban civil arrests at health care, schools, child care, and places of worship: It is critical that all children and their families feel safe to access community spaces and institutions to receive needed healthcare and attend education, child care and religious services without fear of deportation or immigration enforcement-related violence. Healthcare is of particular importance, as not going to an emergency department out of fear can literally be the difference between life and death. This provision aligns with policy recommendations from the American Academy of Pediatrics, the largest professional pediatric organization in the United States.12
- Allow parents/guardians to pre-arrange guardianship for their children in case parents are deported: Should parents be deported or detained, this provision would enable parents to pre-arrange guardianship for their children. In a circumstance in which dignity is often strippedaway, this measure would give parents the opportunity to place the care and wellbeing of their children in the hands of a trusted relative, neighbor, or friend to ensure children are cared for in a stressful, traumatic, destabilizing moment.
Passing the PROTECT Act is not only the right thing to do – it is an evidence-based strategy to protect our residents and support child health and family stability. Massachusetts leaders can and should implement guardrails and protections within their ability to ensure our vibrant immigrant communities feel safe and welcomed in this state. Thank you for your leadership in pushing forward this legislation.