At Gardner Health Services, a community clinic in San Jose, Calif., staff noticed their immigrant patients were withdrawing from health coverage and growing increasingly nervous in recent months. Could they make payments in installments, they asked. Would their names be entered on a government list? The number of patients plummeted.
Now the clinic, located in the California county with the most deaths from the new coronavirus, can’t persuade their immigrant patients who call in with cold symptoms to get examined.
“We get patients who call and say, I’m a bit sick, but I’d rather stay home than come in,” said Ranjani Chandramouli, the clinic’s medical director. “They’re afraid.”
Public-health officials say a Trump administration policy meant to discourage immigrants from using public-health resources is deterring people from getting medical treatment for fear of hurting their immigration status, making it harder to test and treat possible cases of the new coronavirus.
Anita Monoian, chief executive of Yakima Neighborhood Health Services, a network of clinics in Yakima County, Wash., one of the states at the center of the outbreak, said she fears warnings about that policy could overshadow what her patients are now hearing about the virus.
“If you’re fearful, you’re not likely to come in for something you think is a routine sore throat or cough,” Ms. Monoian said. “Why would you risk it?”
The administration policy, known as the public-charge rule, makes it tougher for immigrants to become permanent residents if they have used forms of public assistance, including Medicaid. The administration has said the policy is necessary to prevent immigrants from becoming dependent on the government, and more recently has framed it as a safeguard to ensure American hospitals aren’t overwhelmed with uninsured patients as they respond to Covid-19, the illness caused by the coronavirus.
The rule is “critical to defending and protecting Americans’ health and its health-care resources,” read a recent bulletin from U.S. Citizenship and Immigration Services, the Department of Homeland Security agency that handles green-card applications.
The policy isn’t designed to affect most of the nation’s 11 million unauthorized immigrants, who aren’t eligible to enroll in most benefits—programs like Medicaid only become available five years after an immigrant has become a permanent resident—and in any case have no pathway to apply for legal status.