A woman reaches for some bread at the Prince of Peace Lutheran Church’s food shelf in Burnsville, Minnesota, which offers food, clothing, and other services to thousands of residents, including Latino and Russian immigrants.

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Physicians hearing from immigrants that they fear seeking medical care for symptoms associated with COVID-19, the disease caused by the novel coronavirus. Lawyers fielding questions from clients about whether seeking care for the disease puts their immigration status at risk. Community organizations answering calls from immigrants wondering whether even obtaining COVID-19 testing will impact their ability to stay in the country.

The detailed accounts from doctors, lawyers, and community organizations come from the New York state attorney general's filing with the Supreme Court on Monday in a lawsuit challenging the Trump administration’s sweeping policy that allows the government to deny permanent residency to immigrants who officials believe are likely to use public benefits, such as food stamps, housing vouchers, and Medicaid.



New York Attorney General Letitia James requested that the court rethink its decision in January allowing the policy to go into effect. James argued that the court should lift the stay during the coronavirus pandemic or allow a federal court to block the rule due to the medical emergency that had already caused whole swaths of the United States to effectively shut down.

James said that the policy “deters access to public benefits, including nutrition benefits, that are critical for both immigrants and the country as a whole to weather the economic crisis triggered by COVID-19. These irreparable harms have tipped the balance of the equities decidedly against maintaining the stay during the national emergency concerning COVID-19.”

In January, the five conservative justices voted to allow the Trump administration to implement the “public charge” policy as a legal challenge continued in the federal courts. A federal judge in New York had instituted a nationwide injunction blocking the policy in October, just days after the Trump administration had hoped to roll it out.

The Immigration and Nationality Act has long allowed the government to reject granting permanent residency to immigrants who were determined to be a financial burden on society or a public charge — meaning they’re dependent on the government for financial support.

The new rule, however, alters how the government decides if someone is a public charge, allowing officials to deny green cards to those who are determined likely to use the Supplemental Nutrition Assistance Program (SNAP), Section 8 housing vouchers and assistance, public housing, or most forms of Medicaid.

Experts have said that the policy will change the face of immigration and chill people from seeking public benefits.

The filing explains that immigrants have already started to avoid any publicly funded health care program for fear of the consequences. In recent weeks, the lawyers wrote, doctors have seen immigrants avoid “COVID-19 testing and treatment altogether, even if they might be able to obtain publicly funded care, due to the substantial fear generated by the Public Charge Rule.”

The effects on COVID-19 prevention due to the public charge rule are not speculative or hypothetical, the attorneys argued, citing multiple declarations from doctors, attorneys, and community advocates.

Pedro Moreno, a doctor serving patients in parts of Monterey County — a region that's home to farmworkers who have been unable to take time off work — believed many of his patients in the fields were already impacted by the disease.

“I believe some of my farmworker patients have already been infected with COVID-19 by other farmworkers in the fields. Unfortunately, many of them are afraid to seek medical care due to the public charge rule, and are already spreading the infection in our community,” he wrote in a declaration attached to the filing.

In Connecticut, Eden Almasude, a resident physician, wrote that he’s received similar concerns from immigrant patients.

“As part of my work, I have received reports of multiple patients who had symptoms consistent with COVID-19 but were afraid to go to the hospital or even obtain COVID-19 testing because they were concerned about the public charge consequences of testing and treatment and feared that a huge hospital bill would leave their families destitute,” he wrote. “Immigrants’ concerns and fears are ongoing during this crisis.”

In Chicago, community advocates have received calls from immigrants who are “expressing concern that receiving Covid-19 related medical testing or treatment for themselves, their families or their family members will subject them to public charge.” In New York, advocates have heard that immigrants “were afraid to seek out and obtain COVID-19 testing due to fear about how that might impact their status.”

In March, Department of Homeland Security officials clarified that they would not consider “testing, treatment, nor preventative care (including vaccines, if a vaccine becomes available) related to COVID-19 as part of a public charge inadmissibility determination ... even if such treatment is provided or paid for by one or more public benefits, as defined in the rule.”

But James and the advocates believe the clarification did not go far enough in assuring immigrants that seeking care would not adversely affect them. In fact, they argued, the clarification bolstered the argument that the rule will dissuade immigrants from getting the care they need.

“By revising its application of the Public Charge Rule during the current COVID-19 crisis, USCIS has effectively acknowledged the Rule’s deterrent effect on immigrants’ willingness to obtain necessary medical care,” James wrote.

More than 4 million noncitizens were in families receiving SNAP benefits between 2014 and 2016, according to an analysis by the Migration Policy Institute. More than 39 million people were enrolled in the program in June 2018, according to the Department of Agriculture’s most recent statistics. It did not break out the numbers by immigration status.