Caring for Miami’s uninsured residents is hard enough for Dr. Fred Anderson without his also having to worry about placing immigrant patients in jeopardy of being separated from their families and losing their access to free and low-cost healthcare.

But with the Trump administration’s posting of a proposed rule Wednesday that would deny citizenship to immigrants who use certain public benefits, such as food stamps, housing assistance and Medicaid, Anderson said it has become much more difficult for him to do his job.

Fewer patients are seeking care, Anderson said, and those who do are increasingly reluctant to follow up with additional care when needed — raising the likelihood that their medical conditions will worsen.