Feature

DACA program in limbo after White House attitude changes


 

The fate of the Deferred Action for Childhood Arrivals (DACA) program remains uncertain after an unexpected change of tune by President Donald J. Trump to support of protecting young undocumented immigrants from deportation.

Earlier this month, President Trump announced he would phase out the Obama administration’s DACA program, a policy that protected immigrants who came to the United States as children from deportation and authorized them to work in the United States. In a Sept. 5 statement, President Trump said winding down the DACA program was in the nation’s best interest, and that there can be no principled immigration reform if the executive branch is able to “rewrite or nullify federal laws at will.” The Trump administration allowed Congress 6 months to pass legislation that would replace DACA or preserve some of its provisions before the program terminated in March 2018.

President Donald J. Trump Gage Skidmore/flickr/CC BY-SA 2.0

President Donald J. Trump

But less than 2 weeks later, the President announced that he supports immigrants with DACA status and that he is working on a “DACA deal” with Democrats that would support young, undocumented immigrants brought to the country as children. The change of direction came after a dinner meeting between President Trump, Senate Minority Leader Charles E. Schumer (D-N.Y.), and House Minority Leader Nancy Pelosi (D-Calif.) at which they discussed a potential replacement plan for DACA, according to a Sept. 14 White House press briefing. Following the meeting, the President said he could support legislation to protect DACA recipients from deportation if the law were accompanied by a “massive” border security upgrade.

In a series of tweets on Sept. 14, President Trump expressed support for those currently protected under DACA, stating an agreement to address the program was in the works.

“Does anybody really want to throw out good, educated, and accomplished young people who have jobs, some serving in the military?” President Trump tweeted. “They have been in our country for many years through no fault of their own – brought in by parents at young age. Plus BIG border security. ... No deal was made last night on DACA. Massive border security would have to be agreed to in exchange for consent. Would be subject to vote.”

Sen. Mitch McConnell

Sen. Mitch McConnell

Republicans expressed mixed opinions about a possible upcoming DACA deal. Senate Majority Leader Mitch McConnell (R-K.Y.) said he looks forward to seeing what President Trump has in mind for a DACA replacement bill.

“As Congress debates the best ways to address illegal immigration through strong border security and interior enforcement, DACA should be part of those discussions,” Sen. McConnell said in a statement. “We look forward to receiving the Trump administration’s legislative proposal as we continue our work on these issues.”

DACA demise could strand medical students

The DACA program was created by the Obama administration in 2012 as a way of protecting young, undocumented immigrants from deportation after Congress repeatedly blocked legislation that would develop such a safe haven. The policy allowed about 800,000 young adults brought to the United States illegally as children to work legally in the United States and remain in the country without fear of deportation.

If the Trump administration moves forward with termination, the program’s end will affect the growing number of medical students with DACA status and likely jeopardize the funding invested in their training. Sixty-two medical schools accept applications from DACA applicants, according to the Association of American Medical Colleges. For the 2016-2017 school year, 113 students with DACA status applied to U.S. medical schools, and there were 65 medical students enrolled who had DACA status. AAMC does not collect data on medical students with DACA status; the National Resident Matching Program, likewise, does not collect data on residents with DACA status.

Dr. Mark Kuczewski of Loyola

Dr. Mark Kuczewski

Loyola University in Chicago is one institute that could be significantly impacted by recension of DACA. The university has accepted more students with DACA status than any other U.S. medical school, and currently has 32 DACA students attending, said Mark Kuczewski, Ph.D., chair of medical education at Loyola University.

“It’s a tragic decision,” Dr. Kuczewski said of the President’s Sept. 5 announcement to end DACA. “It once again puts a cloud over these young people who DACA has given the first real opportunity to come out of the shadows, be educated, and serve the community. Now they’re returned back to the situation of uncertainty.”

If DACA ends, current DACA medical students may not be able to finish their training, and those close to completion may not be able to use their degrees in the workforce, Dr. Kuczewski said. Since they are not citizens, DACA students do not qualify for federal student loans, so medical schools must find ways to help DACA students finance their education. A major Catholic health system provides student loan packages for several DACA students at Loyola’s Stritch School of Medicine, Dr. Kuczewski said. However, such loan programs require DACA status. Without DACA or another path to citizenship, medical students in the middle of training will not be able to obtain financial aid to finish their training, he said. The work authorization that DACA provided will also be eliminated.

Dr. Kuczewski said his university plans to advocate strongly for Congress to pass legislation to protect DACA youth, such as the Development, Relief, and Education for Alien Minors (DREAM) Act. The legislation, which dates back to 2001 with a renewed bill in 2017, would shield young immigrants from deportation and offer a path to citizenship.

“We are going to advocate strongly because we believe this is common sense,” he said. “You don’t just throw away the talents of these young people and the investments they’ve made in their education and the investments we’ve made in them. DACA has given many people the chance to see these young people as students, as employees, as colleagues, and we hope that helps people to mobilize.”

Medical groups push for DREAM Act passage

Dozens of physician and medical associations are also pushing Congress to pass the DREAM Act. On Sept. 14, more than 50 medical and health care groups, including the American Medical Association, the American Academy of Family Physicians, the American College of Physicians, the American Academy of Dermatology Association, and the American Academy of Pediatrics sent a letter to congressional leaders urging them to pass the bill.

“On behalf of the undersigned health professions organizations, we urge you to ensure that all members of the health care workforce with Deferred Action for Childhood Arrivals (DACA) status are able to continue their employment, education, training, and research, with passage of a permanent legislative remedy, such as the bipartisan, bicameral Dream Act of 2017,” the letter stated. “By providing a legal pathway to permanent residency for undocumented Americans brought to the U.S. as children, Congress can help our country produce a diverse and culturally responsive health care workforce to meet the needs of underserved populations, improve cultural awareness, and promote health equity.”

The Immigration Reform Law Institute praised President Trump’s Sept. 5 decision to rescind the DACA program, calling the policy an affront to Congress and a violation of the U.S. Constitution.

“Contrary to former President Obama’s claims, not only is DACA not authorized by federal statute, but prior to the unlawful program, deferred action has only ever been applied to small numbers of illegal aliens on a case-by-case basis,” Dale Wilcox, executive director, said in a statement. “Applying it to approximately 15% of the illegal alien population was never a proper exercise of the president’s discretion under the Constitution and is inconsistent with the president’s duty to take care that the laws be faithfully executed. By rescinding DACA, President Trump has put an end to the previous administration’s flagrant violation of our immigration laws and its abuse of hard-working American taxpayers.”

On Twitter @legal_med

Recommended Reading

Noxious Nocebos in Dermatology
MDedge Dermatology
Trump administration ends DACA program, stranding medical students
MDedge Dermatology
Hurricane Harvey tests Houston physicians’ mettle
MDedge Dermatology
Sen. Alexander seeks quick, passable steps to stabilize individual markets
MDedge Dermatology
Florida health officials prepare for Hurricane Irma
MDedge Dermatology
Shinal v. Toms: It’s Now Harder to Get Informed Consent
MDedge Dermatology
Uninsured rate falls to record low of 8.8%
MDedge Dermatology
FDA moves to guard against abuse of ‘orphan drug’ program
MDedge Dermatology
Doctors testify on health insurance stabilization
MDedge Dermatology
Do you answer patient emails?
MDedge Dermatology