President Donald Trump signed a $2 trillion coronavirus relief bill last week that promises to mitigate the impact of the crisis on workers — but it leaves out many immigrants.

The bill, known as the CARES Act, delivers direct payments to most taxpayers, vastly expands unemployment benefits, and makes testing for the virus free, among other provisions. But although unauthorized immigrants are no more immune from the effects of the current crisis, the stimulus bill conspicuously leaves them out in the cold — potentially putting them at greater economic and health risk, and impeding public health efforts to stop the spread of coronavirus.

The unauthorized worker population is particularly vulnerable to the virus due to inadequate access to health care. Noncitizens are significantly more likely to be uninsured compared to US citizens, which may dissuade them from seeking medical care if they contract the virus. Compounding matters are the Trump administration’s hardline immigration policies — including wide-scale immigration raids and a rule that can penalize green card applicants for using Medicaid — which have made noncitizens afraid to access care. These factors pose a problem for America’s efforts to slow the spread of the virus, which has killed more than 3,400 in the US as of March 31.

“We’re operating in an environment where we’re constantly having to reassure patients that they can access services,” Jim Mangia, CEO and president of St. John’s Well Child and Family Center — a network of community health centers in the Los Angeles area that serve about 32,000 undocumented immigrants annually — said in a press call. “It’s a constant struggle and in the midst of a pandemic, it’s even more difficult and more dangerous.”

While many immigrants are continuing to work in essential fields, ranging from medical care to cleaning to grocery stores, they may take an economic hit like many other workers who are facing layoffs, furloughs, and pay cuts. And absent financial relief for the population of unauthorized immigrants workers in particular, many may try to continue going to work despite public health warnings to stay home, which could further spread the virus and pose a risk to public health.

“Those who cannot obtain relief are likely to continue going out and trying to earn a living, at the risk of themselves and spreading the virus to others,” Theresa Cardinal Brown, director of immigration and cross-border policy at the Bipartisan Policy Institute, told Vox. “The cost of providing this benefit to them has to be weighed against the need to keep up the restrictions to stop the virus spread.”

Immigrants are eligible for some free testing

Here’s one thing the bill does offer to unauthorized immigrants: free coronavirus testing at government-funded community health centers through a $1 billion federal program. But some community health centers have already reported shortages of tests; Mangia said St. John’s only had 39 tests last week when almost 900 patients presented with symptoms of Covid-19, the illness caused by the novel coronavirus.

There is also a larger, state-level testing program funded through Medicaid, but that’s only available to Medicaid-eligible immigrants — green card holders who have lived in the US for at least five years, immigrants who come to the US on humanitarian grounds such as asylum, members of the military and their families, and, in certain states, children and pregnant women with lawful immigration status. Those groups, however, make up only a small proportion of immigrants living in the US.

US Citizenship and Immigration Services has announced that it won’t consider use of free testing services when evaluating whether immigrants will likely end up relying on public benefits under the “public charge” rule, which went into effect in February. That rule gives immigration officials much more leeway to turn away those applying to enter the US, extend their visa, or convert their temporary immigration status into a green card if it is deemed they would likely use public services now or in the future.

The agency also said it won’t weigh Covid-19 treatment or preventive care, such as a vaccine if it is eventually developed, under the rule — even if those services are covered under Medicaid. It’s a welcome loosening of standards for a Trump administration rule that has taken aim at legal immigration.

The importance of widespread testing, including among immigrant populations, can’t be overstated, as my colleague Julia Belluz writes:

Once one person with the disease is identified, they can be treated in isolation so as not to spread the disease further. Family members and other contacts can be notified and placed under self-quarantine in case they are already infected but have yet to show symptoms. But without adequate testing, that’s not happening.

Many immigrants won’t receive cash-based benefits

But the centerpiece provisions of the bill — the expanded unemployment benefits and up to $1,200 in cash payments to taxpayers — won’t be accessible to millions of immigrants.

“Immigrant workers and families who are paying taxes have been cut out from receiving a single dollar,” Marielena Hincapié, executive director of the National Immigration Law Center, said in a statement.

The bill increases unemployment benefits by $600 for all workers for up to four months, on top of what they would get from unemployment insurance. As my colleague Dylan Matthews writes, this is a huge increase from January, when the average UI check was $385 per week.

But only immigrants who can show that they’re authorized to work in the US can file for unemployment, including green card and temporary visa holders. For visa holders who have been laid off during the crisis, they will only be eligible for unemployment for as long as their visa stays valid. That’s a period of 60 days for those on H-1B skilled worker visas, unless they find another job in that time — an unlikely prospect given that many businesses have already instituted hiring freezes.

Only some states, including California and Texas, allow beneficiaries of the Deferred Action for Childhood Arrivals (DACA) program, which offers work permits to some 700,000 unauthorized immigrants who came to the US as children, to file for unemployment. Unauthorized immigrant workers more broadly — who number some 7.6 million, according to the Pew Research Center — are also typically ineligible for unemployment, but policies differ by state.

Under the stimulus bill, the government will also start sending out checks to most taxpayers starting in April. The amounts range based on income, but they’re phased out for individuals making more than $99,000 and couples making $198,000.

Only immigrants who have Social Security numbers can receive those checks, including green card holders and “resident aliens” who have lived in the US long enough (usually five years) to file taxes as residents. Temporary visa holders, DACA recipients, and beneficiaries of Temporary Protected Status — which the US has historically offered to citizens of countries suffering from catastrophes such as natural disasters or armed conflict — could therefore qualify.

But there is a big exclusion for those in households with people of mixed immigration status, where some tax filers or their children may use what’s called an Individual Taxpayer Identification Number (ITIN).

The IRS issues ITINs to unauthorized immigrants so they can pay taxes, even though they don’t have a Social Security number. If anyone in the household uses an ITIN — either a spouse or a dependent child — that means no one in the household will qualify for the stimulus checks, unless one spouse served in the military in 2019.

The stipulation could impact an estimated 16.7 million people who live in mixed-status households nationwide, including 8.2 million US-born or naturalized citizens.

This also includes those with deportation protections under the Obama-era DACA program, children and young adults whose parents often don’t have legal status. They’re left wondering how they can help support their families so that their parents don’t have to go to work, where they risk getting sick, and how they can help cover the costs of their parents’ medical care should they need it, Sanaa Abrar, advocacy director at the immigrant advocacy group United We Dream, told Vox.

“With the national health crisis and what’s becoming a national unemployment crisis, folks are concerned about how they’re not only going to stay healthy and safe but also how they’re going to keep their jobs and how they’re going to find means of financial support,” she said.