Mar 6, 2020 - Health

Trump policies could scare immigrants away from coronavirus care

Photo: Drew Angerer/Getty Images

Democrats and public health experts are concerned that the Trump administration's immigration policies could scare immigrants away from getting medical help as the coronavirus spreads.

What we're watching: Ken Cuccinelli, the acting director of U.S. Citizenship and Immigration Services, told senators on Thursday that health care facilities are already "sensitive locations" where immigration enforcement isn't carried out, except in "exigent circumstances."

Why it matters: To slow the deadly coronavirus, Americans need to be able to get tested and see doctors. For immigrants, though, that can involve trusting the federal agencies that have made it harder for them to stay in the country.

  • "This administration has given immigrants very little reason to believe them," Migration Policy Institute's Sarah Pierce told Axios.

What they're saying: "It’s potentially a really large public health problem,” said Wake Forest's Christine Coughlin, who has written about unauthorized immigrants' compliance with quarantines. "I believe there is a perception that if you were to go and seek treatment or seek testing, you could be potentially reported and then potentially deported.”

  • The higher uninsured rate among non-citizens is "likely to be especially dangerous during a pandemic," Wendy Parmet, director of the Center for Health Policy and Law at the Northeastern University School of Law, wrote in an op-ed Wednesday.

Between the lines: Through new public charge rules, the administration has begun penalizing some immigrants and visa applicants who use or are considered likely to use certain public programs, including Medicaid programs.

  • Even before the policies took effect, immigrants were reportedly dropping out of Medicaid or public nutrition programs out of fear of being blocked from a green card — a sign that the chilling effect is real.
  • Democratic Senators sent letters this week to multiple administration officials calling for them to suspend "all immigration enforcement activities" near medical facilities, and to rescind the public charge rule.

The other side: A DHS spokesperson pushed back on the impact the public charge rule would have on immigrants seeking medical care. "Nowhere in the rule does it say an immigrant will be denied a change in status if they seek medical care," the spokesperson said.

In the past, Immigration and Customs Enforcement has issued public guidance during natural disasters to assure immigrants they would not be arrested for getting medical help, former acting ICE director John Sandweg told Axios.

  • He said the same should be done in response to the coronavirus.
  • "The reality is that ICE is very reluctant to arrest and detain anyone with a contagious disease," Sandweg said. "While the risks of arrest are low, the fear in the immigrant communities is real."

The bottom line: Immigrants are unlikely to be impacted by public charge or arrested by ICE while getting emergency medical help. But fear and uncertainty could be enough to stop them.

  • “In general, the very anxiety-ridden environment this administration has created for immigrants drastically decreases the likelihood that immigrants will come forward," Pierce said.

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