Aug 13, 2019

Health of immigrants at risk in changes to public assistance policies

A patient visits a clinic in Solana Beach, Calif., that serves a large immigrant population. Photo: Sandy Huffaker/Corbis via Getty Images

The Trump administration's recently finalized “public charge” rule — which would make use of certain public assistance programs by immigrants grounds for denying lawful permanent residence — extends a series of policy changes that could negatively affect the health of both legal and undocumented immigrants in the U.S.

Why it matters: Health insurance, nutrition benefits and housing assistance are all linked to health outcomes, particularly in children. Although the 46 million immigrants in the U.S. are generally healthier and use fewer health resources than native-born residents, additional barriers to care could increase rates of obesity, malnutrition and transmission of communicable diseases.

What’s happening: The administration's policy shifts would impact a range of programs.

  • Revised White House guidance requires sponsors of legal immigrants to reimburse the government for benefits such as Medicaid and the Children’s Health Insurance Program, likely decreasing participation.
  • The Department of Justice is reportedly considering allowing deportation based on “public charge” status, which also applies to enrollment in the Supplemental Nutrition Assistance Program, known as food stamps.
  • The Department of Housing and Urban Development released a proposed rule that would evict undocumented immigrants and their families from public housing, even if households include a citizen spouse or child. Stable housing contributes to better physical and mental health, and homelessness is associated with lower life expectancy.

Where it stands: Although many of these policies are not yet promulgated, their effects are already being felt.

What to watch: The Homeland Security Department's “public charge” rule is likely to be challenged in court before it goes into effect on October 15.

Dave A. Chokshi is the chief population health officer at New York City Health + Hospitals and a primary care physician at Bellevue Hospital.

Go deeper

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Global: Total confirmed cases as of 2 p.m. ET: 5,453,784 — Total deaths: 345,886 — Total recoveries — 2,191,310Map.
  2. U.S.: Total confirmed cases as of 2 p.m. ET: 1,651,254 — Total deaths: 97,850 — Total recoveries: 366,736 — Total tested: 14,163,915Map.
  3. World: Top Boris Johnson aide defends himself after allegations he broke U.K. lockdown — WHO suspends trial of hydroxychloroquine over safety concerns.
  4. 2020: Trump threatens to move Republican convention from North Carolina — Joe Biden makes first public appearance in two months.
  5. Public health: Officials are urging Americans to wear masks over Memorial Day.
  6. Economy: White House economic adviser Kevin Hassett says it's possible the unemployment rate could still be in double digits by November's election — Charities refocus their efforts to fill gaps left by government.
  7. What should I do? Hydroxychloroquine questions answeredTraveling, asthma, dishes, disinfectants and being contagiousMasks, lending books and self-isolatingExercise, laundry, what counts as soap — Pets, moving and personal healthAnswers about the virus from Axios expertsWhat to know about social distancingHow to minimize your risk.
  8. Other resources: CDC on how to avoid the virus, what to do if you get it, the right mask to wear.

Subscribe to Mike Allen's Axios AM to follow our coronavirus coverage each morning from your inbox.

Updated 11 mins ago - Politics & Policy

Joe Biden makes first public appearance in over two months

Photo: Oliver Douliery/AFP via Getty Images

Former Vice President Joe Biden made his first in-person appearance in over two months on Monday to honor Memorial Day by laying a wreath at a Delaware veterans park, AP reports.

Why it matters: Biden, the Democratic Party's presumptive nominee, has taken the unprecedented step of campaigning from his home during the coronavirus pandemic, ever since canceling a rally in Cleveland on March 10.

WHO temporarily suspends trial of hydroxychloroquine over safety concerns

Photo: Fabrice Coffrini/AFP via Getty Images

The World Health Organization is temporarily pausing tests of the anti-malarial drug hydroxychloroquine as a coronavirus treatment in order to review safety concerns, the agency's director-general Tedros Adhanom Ghebreyesu said Monday.

Why it matters: The decision comes after a retrospective review published in The Lancet found that coronavirus patients who took hydroxychloroquine or its related drug chloroquine were more likely to die or develop an irregular heart rhythm that can lead to sudden cardiac death, compared to those who did nothing.