Thirty-two people died in ICE custody nationwide last year, surpassing the previous high of 20 in 2005, according to federal data. Nearly a quarter of last year’s deaths occurred in Texas.   
  
Scott Shuchart, a former head of policy at ICE under Biden and senior adviser under Trump’s first term to DHS’ Office of Civil Rights and Civil Liberties, said the agency “struggled to ensure adequate medical care” when its detainee population was 35,000. Now it is more than doubling that number.  
  
The expansion of ICE detention is “coupled with a dissolution of oversight, a reduction in detention standards, and draconian restrictions on releases,” said Claire Trickler-McNulty, a former senior ICE official during the last three administrations. “That appears destined to lead to more deaths, medical issues and trauma for detainees.”  
  
The government last October also temporarily stopped paying many medical providers due to bureaucratic changes under the administration. As a result, ICE for months has been unable to reimburse health care officials, including for prescription medication, dialysis and chemotherapy, according to redacted ICE documents first reported by Popular Information.   
  
Texas is the last stop for most immigrants caught in the Trump administration’s dragnet, with more than 18,700 people detained in the state’s ICE facilities as of February the nation’s highest share, according to federal data analyzed by the Transactional Records Access Clearinghouse. And a significant percentage of growing unlawful detention cases filed in federal courts stem from Texas.   
  
The state is the “blueprint and the epicenter of the country’s immigration enforcement system, acting as the deportation funnel,” said Kristin Etter, director of policy and legal services at the statewide advocacy group Texas Immigration Law Council, “Texas is where immigration enforcement begins, where it ends, and sometimes, where it does both.”

Six deaths in six weeks: What to know about ICE detentions in Texas