Dr. Daniel Turner-Lloveras, assistant professor of medicine at the Harbor-UCLA/ David Geffen School of Medicine, expressed concern during a recent Ethnic Media Services briefing regarding   the state of the COVID-19 pandemic, and the impact of President Trump’s re-implementation of the public charge rule on patients seeking care. 

Targeting immigrants has been at the forefront of Trump’s campaigns and a focal point for his administration. His move to  re-implement the public charge rule during a pandemic has caused great concern among health officials.   

Immigrant rights advocates have called the enforcement of the public charge policy “cruel” and just another way for the Trump administration to forsake immigrants as a means to bolster his conservative base. 

Health officials are concerned that obstacles that deter people in need from seeking care can put more people in harm’s way.  

Dr. Turner-Lloveras emphasizes the importance of allowing access to publicly funded health insurance to everyone and not just those who are documented. He and other health professionals on the front lines of the pandemic believe there should be strategies in place to keep immigrant families healthy and safe. 

“This is an infection that affects everyone. The chain is only as strong as the weakest link, and so if we decide not to provide health insurance to certain populations, it’s only natural that will allow the virus to continue to spread in those who are not able to seek the same care as everyone else,” Turner-Lloveras said. 

He cites a study where 80% of adults surveyed didn’t know that their children could enroll in Medicaid without affecting their parents’ legal status.

Fear among immigrants has increased under the Trump administration. More evidence of the reluctance to seek beneficial programs, enrollment in Medicaid and the Children’s Health Insurance Plan, has dropped 31% in the last two years.

“Avoidance of these programs is particularly worrisome in families with children because the entire family faces the financial hardships, the psychological distress, and problems in accessing health care,” Turner-Lloveras said.

Under the Public Charge rule, immigrants living or entering the United States now feel they are under a microscope. Those who are classified as likely or liable in the future to become a “public charge” may be denied visas or permission to enter the country due to their disabilities or lack of economic resources. 

Their ability to successfully gain citizenship could be jeopardized if they are negatively categorized as a potential drain to the US Economy by seeking public benefits.  

The Public Charge regulations from the Department of Homeland Security and Department of State that went into effect on February 24 have changed the way immigration applications are examined, affecting individuals applying for or adjusting their visa, and those applying for a green card. In the meantime, litigation to challenge both agencies’ regulations is continuing. 

Following the re-implementation, the USCIS (United States Citizenship and Immigration Services) is a component of the United States Department of Homeland Security (DHS). Officials there announced that immigrants can seek testing, treatment, and prevention of COVID-19 without fearing immigration consequences due to Public Charge. But many immigrants don’t want to take that chance, especially with reports of ICE entering community health clinics and detaining immigrants. 

Even prior to the Public Charge enforcement, many immigrant families avoided health care out of fear of identifying themselves or jeopardizing their status.

Now the situation appears to have worsened, with one in three low-income immigrant families with children not applying for public health coverage or food stamps even if the public charge rule doesn’t apply to their particular circumstances. In particular refugees, asylees and many other categories of humanitarian immigrants are exempt from the public charge rules.   

Luvia Quiñones, health policy director at the Illinois Coalition for Immigrant and Refugee Rights, echoes the concern for how immigrants and communities of color are impacted by COVID-19 

“The new Public Charge rule, not only does it give authorization to immigration officials to predict, literally to look into the future, based on an individual’s current skills, current income, assets, etc., [but also] to predict if that person is going to ever in the future end up relying on the government for any kind of public benefit,” said Quiñones. 

The “skills” in question include but are not limited to level of education, income level, credit score, any assets owned, family size, health, if they’re currently insured. 

“The pandemic’s health and economic impact has fallen hardest on communities of color, including immigrant families,” said  Madison Allen, senior policy attorney at CLASP (The Center for Law and Social Policy).   

“Unfortunately, coronavirus legislation that’s been enacted so far doesn’t go far enough to help immigrant families, and it’s leaving millions without access to essential programs,” Allen said.

Access and eligibility for health care and benefits during the COVID-19 crisis is crucial. 

“Our message to immigrant families is that it is safe and smart to seek testing and treatment for COVID-19. We encourage everyone, including immigrants, to seek the care that they need during this difficult time,” Allen said

“Federal legislation has provided funds to healthcare providers, including community health centers and hospitals to cover COVID testing and treatment of uninsured people,” he said. “Immigrants can continue to access healthcare services at community health centers regardless of their immigration status. We do advise that before going to a clinic, people should call and ask about the availability of COVID-19 testing in advance.”

But with so many mixed messages communicated to the US immigrant community, and the constant barrage of negative comments hurled at them by Trump, many immigrants will only seek help when their health conditions worsen to the point of becoming dire emergencies.

Dr. Turner-Lloveras called for the detainment of immigrants seeking healthcare to stop. Though USCIS officials stated that no arrests will be made for undocumented immigrants seeking COVID-19-related healthcare, Turner-Lloveras says that presents two problems.

“If you have a fear of being deported by an entity for years and then suddenly they [Homeland Security] say, ‘we will not deport you if it’s for this one reason,’ we [have] to ask ourselves, if we think that this group would suddenly feel as if they could without fear, pursue [health ]care in this setting? Probably not,” said Turner-Lloveras. “The fear remains.”

For more information, go to: protectingimmigrantfamilies.org

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