As ICE enforcement activities escalate in various regions, communities face significant repercussions on public health and access to medical care. In Minnesota, a shadow healthcare system has emerged in response to fears surrounding ICE detentions, leading many immigrants to avoid hospitals altogether. This reluctance to seek medical assistance has resulted in troubling trends such as missed check-ups, delayed pregnancy care, and a decline in services for vulnerable populations, including those living with HIV. Meanwhile, in Arizona, ICE arrests have more than tripled, exacerbating fears among immigrant families and prompting local physicians to raise alarms about the consequences for patient care. In light of these challenges, philanthropic efforts are stepping up to support essential services, but the question remains whether similar underground networks could benefit other cities facing similar issues.