Strategies of containment: Financialization and Latinx immigrants' health care exclusion in Colorado's mountain resort region

This article examines the way public hospital staff in an elite new destination in Colorado, USA, conceptualized recent Latinx arrivals as a “threat” to the hospital's finances and image, implementing spatializing strategies to keep them far from its main campus and Emergency Room (ER). The literature on immigrants' “bureaucratic incorporation”—that is, the degree of institutional responsiveness to immigrant newcomers in new destinations— suggests that federal policy may make the ER relatively welcoming. However, based on interviews conducted between July 2018 and July 2023 with 17 Latinx immigrant women, 15 clinic staff, 13 area officials, a media review, and bureaucratic accompaniment of immigrants seeking care and financial assistance, I show that the hospital engaged in a suite of “strategies of containment” to distance immigrants from its ER: it attempted to confine immigrants to a “Latino clinic,” charged them up-front for care, diverted them to Denver, and excluded the undocumented from charity care. I argue that in a financialized landscape of frequent hospital consolidations and mergers, hospital officials viewed Latinx immigrants as portending uncompensated care that could jeopardize their independence and compromise their resort brand. By examining the responses of a resort hospital in a racially homogeneous new destination to the perceived “influx” of Latinx immigrant outsiders, the parallel between hospital practices and strategies of containment become clear. This article suggests the relevance of the literature on the spatialization of immigration enforcement to analyses of how hospitals evade their obligations to provide emergency care—whether through externalization, deterrence, or diversion.