Last week, President Donald Trump signed an executive order legalizing forced institutionalization for people who are unhoused or mentally ill, and granting federal agencies sweeping new powers to violate those citizens’ medical privacy rights. If it goes into effect, Trump’s new policy will mark a historic expansion of federal police power into services largely carried out by nonprofits and local governments.
By shifting the call on who should be forcibly hospitalized from local medical professionals to Attorney General Pam Bondi, Trump leaves no doubt that he wants homelessness and drug addiction treated as tough-on-crime policing issues.
If the White House is serious about enforcing this order, the number of homeless Americans in these camps could easily surpass 250,000.
The White House knows cash-strapped cities and states don’t have the money or the medical staff to rebuild the network of state asylums shuttered by President Ronald Reagan nearly 50 years ago. Trump’s executive order makes no provision for that problem because it isn’t really concerned with addressing homelessness or drug addiction. Rather, it’s a back door for the feds to collect an unprecedented amount of sensitive health data under the guise of helping those in need. The American people shouldn’t fall for it.
You don’t need to read far into Trump’s order before it becomes clear that its true purpose is advancing his extreme anti-immigration agenda. One provision grants Bondi the power to demand local nonprofits provide her with the sensitive health data on the people they serve in order to receive any grant money, something the National Alliance to End Homelessness condemned on Friday as a “fundamental violation of the right to privacy.” Bondi can also demand nonprofits share that health data with law enforcement agencies like Immigration and Customs Enforcement.
In his order, Trump claims that federal law enforcement agencies need access to homeless and food-insecure Americans’ most sensitive health information in order to “provide appropriate medical care” and “connect individuals to public health resources.” But those are services already provided by the nonprofits and private sector food pantries the White House is now threatening with grant cancellations. And when did ICE become anyone’s first stop for help with their mental health?
If Bondi puts that provision into action, nonprofits across the country will face an impossible choice between providing lifesaving services and protecting the privacy of those who seek them out. Some nonprofits in Trump-targeted cities like Los Angeles and New York will likely close due to the loss of federal funds, adding to the over 10,000 nonprofit workers who have lost their jobs since January.
There’s also the thorny question of how far into our collective privacy this health data dragnet reaches. Many of the local nonprofits that receive federal homelessness assistance grants serve other communities in addition to unhoused or drug-addicted people. Over 50 million Americans used food banks in 2023, according to Feeding America, a nationwide network of more than 200 food banks. Few of them meet the definition of homelessness. Millions are children. Under Trump’s order, their health data would be scraped up and sent to the police just the same.
Things don’t get any better once agents start dropping homeless people off at overfilled, understaffed mental health clinics that can’t begin to care for them. Major cities like New York and Washington, D.C., suffer from the most acute lack of psychiatric bed space. Towns across rural Missouri are struggling to provide rehab services to drug users who come to local clinics seeking help. In January, homeless shelters in Kentucky buckled under the surge of rural residents seeking refuge from freezing winter temperatures.
Those problems will get worse now that Trump’s One Big Beautiful Bill Act has brought down the budgetary axe on rural health clinics. Republicans’ $1 trillion in Medicaid cuts are already leading to rural shelter and free clinic closures, with red states especially at risk of losing basic public services like dental care, food banks and homeless shelters. Trump’s order to involuntarily commit the homeless saddles states with a huge upfront cost just as his spending bill strips away their ability to pay for it. Republicans’ $1 trillion in Medicaid cuts are already leading to rural shelter and free clinic closures, with red states especially at risk. Trump’s answer is to empower Bondi to free up federal resources and funds to “assist” localities that lack the beds and resources to handle the influx of new people the order calls “detainees.” In reality, that will likely mean using federal funds to build more detention facilities like the notorious Alligator Alcatraz, the Florida immigration detention center built on the cheap by federal contractors. If the White House is serious about enforcing this order, the number of homeless Americans in these camps could easily surpass 250,000. That’s a staggering number of people held against their will without being charged with any crime, and the costs of feeding and caring for them would be a massive new expenditure in Trump’s already debt-choked second term. Of course, that’s the optimistic view. History has shown us that marginalized, unsympathetic detainees are rarely treated with dignity and respect. Trump’s order “Ending Crime and Disorder on America’s Streets” isn’t about connecting the homeless with medical services or protecting our cities from imagined disorder. It’s one more step in Trump’s campaign to separate Americans from their privacy rights and use their most sensitive health information against them. The White House is dividing our country into people it feels deserve to be here and those who don’t — while laying the groundwork to strip away legal agency from those on Trump’s growing list of undesirables. With Congress disabled by dysfunction and the courts hopelessly compromised, it falls to the American people themselves to resist Trump’s latest authoritarian power grab.
Max Burns is a Democratic strategist and founder of Third Degree Strategies. Find him on X, @themaxburns. 
