Undocumented U.S. Immigrants and Covid-19

Post Date: 
New England Journal of Medicine

In 2019, as the “public charge” rule made its way through the U.S. court system, many low-income immigrant parents of American children in the Johns Hopkins pediatric practice asked our case managers to disenroll their children from the Supplemental Nutrition Assistance Program (SNAP), fearing it would affect their chances of obtaining legal status in the future or lead to deportation. The new public charge rule, which went into effect on February 24, 2020, states that “aliens are inadmissible to the United States if they are unable to care for themselves without becoming public charges” 

On the day of its implementation, there were 14 cases of Covid-19 in the United States. A month later, with more than 30,000 U.S. cases confirmed, the following message could be found on the U.S. Citizen and Immigration Services (USCIS) Public Charge web page: “USCIS encourages all those, including aliens, with symptoms that resemble Coronavirus Disease 2019 (Covid-19) (fever, cough, shortness of breath) to seek necessary medical treatment or preventive services. Such treatment or preventive services will not negatively affect any alien as part of a future Public Charge analysis.”1

This statement may feel like vindication for those of us who have been warning about the negative impact of anti-immigration policies on public health,2 but we fear this change is too little, too late. 

Page KR, Venkataramani M, Beyrer C, Polk S. Undocumented U.S. Immigrants and Covid-19. N Engl J Med. 2020 Mar 27. DOI: 10.1056/NEJMp2005953.