As the government shutdown grinds on, the questions being asked of the Donald Trump administration are getting more and more challenging. For instance, White House Press Secretary Karoline Leavitt was recently asked if, in line with Trump’s cuts, undocumented people who go to the ER should first be met with an immigration status check before treatment. Leavitt at first sidestepped, but then called out undocumented people’s supposed “complete abuse” of the American healthcare system.
This government shutdown will define what Americans understand Republicans’ and Democrats’ approaches to healthcare to be for a long time — especially in the short term, with the midterm elections slowly creeping up. For the Democrats, this is about tax benefits for people who buy healthcare plans from the Affordable Care Act, better known as Obamacare.
Republicans in the Senate refused to extend those ACA tax benefits. According to NPR, that means about 24 million Americans will see their premium payments rise by as much as 114%. Republicans, however, have reframed the issue as one of immigration, claiming the tax benefits were just a covert way for the Joe Biden administration to fund healthcare for undocumented immigrants — a stance Democrats have dismissed as a distraction.
That claim opened a can of worms that brought back to the spotlight the Ronald Reagan–era Emergency Medical Treatment and Labor Act (or EMTALA, as it’s colloquially known). This law has since grown into the cornerstone of U.S. healthcare: hospitals don’t turn down anyone who needs care — whether they can pay or not, regardless of their immigration status. And that has since spread throughout the world as a basic standard in healthcare.
A reporter was referencing that act when she asked Leavitt whether that has since changed. He specifically asked if doctors should now ask for immigration status before proceeding to provide care at the ER. Leavitt suggested that the question should instead be forwarded to “legal and medical experts.” On X, a user was deeply concerned and reminded people: “That’s not a no!” Leavitt then went on a tangent, pontificating about how illegal aliens are getting free Medicaid benefits because of the Joe Biden administration.
REPORTER: Should ERs check immigration status before treating a dying patient?
— Aaron Rupar (@atrupar) October 2, 2025
LEAVITT: That's probably not a question for me to answer. That's a question for healthcare professionals and legal experts to answer.
(That's not a no!) pic.twitter.com/EOebtDZKkT
Whether this means the Trump administration has now drifted to the right of Reagan-era policies is up for debate. But it’s worth mentioning that Leavitt was just recently on the back foot, trying to argue that the Trump administration’s treatment of immigrants cannot be considered “inhumane,” despite Pope Leo XIV seemingly disagreeing. For Pope Leo, that behavior does not align with a party that claims to be pro-life.
Leavitt’s main job is politically framing Trump’s positions in a legal and ethical manner. Sometimes she’s in a position where her statements are simply untenable for critics of the administration. Because ultimately, none of what she said was actually responding to the question she was asked — does Trump believe doctors should delay their lifesaving work to also moonlight as ICE agents at the ER? That should be a fairly simple question to answer. For some reason, though, it isn’t for the Trump administration.
