Fear of immigration enforcement in Minnesota is causing immigrants to postpone essential surgeries, administer insulin and avoid hospitals even for medical emergencies, often with life-threatening consequences. This is a structural public health crisis caused by the breakdown of trust between health systems and immigrant communities. In recent months, the US government has stepped up Immigration and Customs Enforcement (ICE) operations, deploying about 3,000 agents in one of the largest efforts in recent years. Armed agents raided residential areas, outside schools and near medical facilities. The raids included controversial use-of-force incidents, including the fatal shooting of ICU nurse Alex Pretti by Border Patrol in Minneapolis. East African, Latin American, and Hmong immigrant communities are experiencing unprecedented disruption. Doctors report the presence of federal agents near hospitals and clinics.