New York provides free and low-cost emergency medical care for its low-income residents, but as of February, healthcare could cost noncitizen immigrants a green card or a visa.
In January, the Supreme Court ruled that immigrants could be denied a visa or a green card if they are eligible for or likely to benefit from forms of public assistance such as food stamps, housing assistance, and Medicaid. The purpose of this policy, known as the public charge rule, is to prevent those who are likely to become dependent on the government in the future from becoming eligible to receive that aid. The policy only applies to those seeking entry to the country, those waiting for permanent residence, and those classified as a nonimmigrant—including people in the country on work or tourism visas—who wish to extend their stay or switch to a different status.
But widespread confusion has instilled fear in undocumented immigrant communities, which have a higher likelihood of being segregated and low-income and whose members are more likely to be exposed to viral infections given that many of them are essential workers.
“The public charge regulations coming out so close in time to this COVID crisis has meant that folks that are immigrants, and particularly undocumented folks, are less likely to want to go to the hospital to get the benefits that they need,” Carrie Tracy, senior director of Health Initiatives at the Community Service Society of New York, said.
Meanwhile, these populations are also significantly more at risk of contracting the coronavirus. Out of the 1.8 million immigrants working in New York state’s essential workforce, 458,400 are legal noncitizens and 342,100 are undocumented. Seventy percent of New York’s undocumented labor force is essential, and one out of every three delivery workers is undocumented. According to Seongeun Chun, the senior manager of health policy at the New York Immigration Coalition, many of these immigrants do not have the privilege of choosing to social distance.
“Their jobs, in and of themselves, do not allow them to social distance,” Chun said. “They can’t collect unemployment, [and] they may not be able to get the stimulus payments, so they have no choice but to work.”
The most recent federal stimulus bill, the Coronavirus Aid, Relief, and Economic Security Act, is a $2 trillion spending package that excludes those without legal status, as well as their families, from receiving stimulus checks. In total, 1.2 million citizens have been disqualified from receiving stimulus money because their spouses file with an individual taxpayer identification number, a tax processing number used by nonresident and resident immigrants.
“They’ve been shut out at the federal level in many of the stimulus packages,” Chun said. “So they are not able to take time off from work. Their kids have to stay home, but they have to work and put food on the table. They’re the ones that are doing our deliveries [and] keeping our city running.”
Although they form a substantial portion of the essential workforce, noncitizen immigrants—both undocumented and those awaiting permanent status—continue to face significant disadvantages during the COVID-19 pandemic due to the persistence of U.S. Immigration and Customs Enforcement activity, fears of public charge status preventing the use of public benefits, and exclusion from federal stimulus bills.
In New York state alone, nearly half a million undocumented immigrants remain uninsured and ineligible for coverage, causing them to be more likely to rely on public hospitals and public benefits to support their care. However, immigrants have become less willing to use public services as a result of the public charge ruling.
As the number of COVID-19 cases continued to grow in March, U.S. Citizenship and Immigration Services clarified that immigrants in need of medical testing or treatment will not be penalized if they apply for green cards or visas.
Experts fear that such an announcement is not enough, asserting that as long as distrust of immigration officials is fueled by news of U.S. Immigration and Customs Enforcement raids and harrowing accounts of detention and deportation, noncitizen immigrants will continue to avoid medical care—even though they are the population most vulnerable to fatalities.
Even without the disadvantages that arise from immigration status, a 2018 study reported that about 304,000 low-income citizens and green-card holders could be discouraged from seeking public benefits due to a lack of knowledge surrounding healthcare options.
“The way that the chilling effect is impacting so many immigrants, it is doing exactly what the federal government wants—having people act on that fear even if they are not impacted by it,” Chun said.
According to Carlyn Cowen, chief policy and public affairs officer at the Chinese-American Planning Council, many immigrants are relying on inaccurate or outdated channels of information.
“It’s harder when it takes a couple of days for the translated information to come out,” Cowen said. “A lot of our community members are relying on things like WeChat and other social media channels to get healthcare information, which is just not the most reliable.”
Cowen said that a fear of continued ICE activity has complicated several of her community members’ ability to receive services—including food delivery—from the local government. Organizations like Cowen’s provide “know your rights” programming that teaches immigrants to avoid answering their doors when strangers or government officials come by.
“For community members that are used to getting their meals from a community-based organization or a pantry, they’re left with the choice of, ‘Do I open the door and get food because I’m hungry or do I not open the door because I’ve been trained I shouldn’t open the door because it might be ICE?’” Cowen said.
Instead of slowing down in the face of COVID-19, Cowen says ICE has continued “its deportation machine with business as usual.” Chun noted a February ICE operation at a Brooklyn hospital that resulted in a shooting victim and the arrest of two people and said it was part of the “continuing attack from the federal government that has compounded with COVID,” which has prevented people from seeking the care that they need.
The unique challenges exacerbated by the coronavirus pandemic that undocumented immigrants face were present prior to the onset of the outbreak. A crumbling economy, a broken healthcare system, and increasingly hostile immigration law enforcement have only served to amplify these challenges.
“We cannot protect New Yorkers from COVID-19 and its economic impact if we deny healthcare and financial relief to our communities—and that means everybody,” Chun said.