The blog of the Urban Institute
May 19, 2020

Immigrant Families Hit Hard by the Pandemic May Be Afraid to Receive the Help They Need

The COVID-19 crisis has heightened the consequences of recent policies that have deterred immigrants from receiving federal safety net assistance and other supports. Before the pandemic, many immigrant families faced explicit barriers to or deferred from participating in programs such as Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and subsidized housing. Now, at a time when many immigrant families need assistance because they are disproportionately experiencing economic hardship and health risks from COVID-19, the newly implemented “public charge” rule threatens to further dampen participation.

New data from two nationally representative surveys of nonelderly adults reveal disproportionately high rates of job and income loss and material hardship among Hispanic families with noncitizens during the early stages of the pandemic, while spotlighting how immigrant families fear accessing public supports they may desperately need as the crisis unfolds.

Hispanic families with noncitizens have been hardest hit by the pandemic’s economic fallout

The Urban Institute’s Health Reform Monitoring Survey, fielded between March 25 and April 20, 2020, shows that Hispanic adults were far more likely than adults in other racial and ethnic groups we studied to report that their families lost work or work-related income because of the coronavirus outbreak—a finding confirmed by recent unemployment data (PDF). But the survey also found wide disparities among Hispanic adults by family citizenship status. More than two-thirds (69 percent) of Hispanic adults in families with noncitizens and about half (49 percent) of those in families where all members are citizens reported losing work or income.

Lost jobs, hours, income by citizenship status, race/ethnicity chart

Hispanic adults in families with noncitizens were also more likely than those with only citizens in the family to report facing material hardship in the 30 days before taking the survey. Four in 10 (42 percent) Hispanic adults in families with noncitizens reported food insecurity, meaning they lacked consistent access to enough food for an active, healthy life. One in 4 (25 percent) Hispanic adults in families with noncitizens reported going without medical care in the previous 30 days because of the cost, and nearly 1 in 5 (18 percent) did not pay their full rent or mortgage or were late with such a payment.

The expansion of the public charge rule had immigrant families on alert going into the COVID-19 crisis

The Urban Institute’s Well-Being and Basic Needs Survey (WBNS), fielded in December 2019 before the onset of the pandemic in the US, shows that many immigrant families went into the COVID-19 crisis afraid to access noncash public supports that might help them meet their family’s needs.

The December 2019 WBNS assessed how much adults in immigrant families (including both Hispanic adults and adults in other racial and ethnic groups) reported “chilling effects”—for example, avoiding programs such as Medicaid, SNAP, and housing subsidies—in the past year because of fear that participating would disqualify them or a family member from getting a green card.

The chilling effects we found in 2018 persisted into 2019, with one in seven adults in immigrant families reporting that they or a family member had avoided a noncash program for fear of risking future green card status. Among adults reporting chilling effects, nearly half said their families avoided Medicaid or the Children’s Health Insurance Program, nearly half reported avoiding SNAP, and one-third avoided housing subsidies.

Between 2018 and 2019, this chilling effect increased significantly, from 22 percent to 31 percent, in families most likely to be directly affected by the public charge rule–those in which one or more members do not have a green card and may be subject to a future public charge determination.

Chart: public charge affects

These reported chilling effects highlight the difficult decisions immigrant families were making about applying for public benefits in the context of changes to the public charge rule. The new rule expanded the criteria for determining whether applicants for permanent residency, or green cards, may be denied based on past or potential use of government benefit programs.

Other key findings from the December 2019 WBNS highlight the extent of misunderstanding about the public charge rule and who it applies to, suggesting chilling effects are likely to spill over not only to US citizen children and current green card holders but also to programs not considered in public charge determinations.

  • Some adults reported that their families avoided public programs not listed in the public charge rule, including free or low-cost medical care programs for the uninsured (21 percent); the Special Supplemental Nutrition Program for Women, Infants, and Children (16 percent); Marketplace health insurance coverage (14 percent); and free or reduced-price school lunches (13 percent).
  • Two-thirds of adults in immigrant families (67 percent) were aware of the public charge rule, and 66 percent were confident in their understanding about the rule. Yet, only 23 percent knew it does not apply to citizenship applications, and only 19 percent knew children’s enrollment in Medicaid will not be considered in their parents’ public charge determinations.

This means many immigrant families may be unnecessarily forgoing critical benefits they and their families need during this severe economic downturn.

The high stakes for all families and communities

Immigrant families are being disproportionately affected by the economic turmoil brought on by the pandemic, but so far, the supports included in federal stimulus legislation—including the economic impact payments and expanded unemployment insurance benefits—are not available to all immigrant families.

A policy environment in which immigrant families fear accessing critical supports for themselves or their children poses risks for all communities where immigrants reside and contribute, many as essential workers. Although the federal government released guidance on March 13 that clarified seeking testing for or treatment of COVID-19-related illness would not be considered in public charge determinations, the implementation details remain unclear. The US Supreme Court also rejected requests to suspend implementation of the public charge rule during the pandemic. The fear and confusion swirling around the rule will be difficult to resolve.

State and local government agencies—a trusted source of information for immigrant families, according to the WBNS—should engage immigrants and provide information in multiple languages and reassure them that taking part in certain critical services and supports will not affect their immigration status, and they should provide referrals to free or low-cost legal assistance to help families navigate decisionmaking.

Without that engagement, the public charge rule will discourage immigrant families from accessing existing safety net benefits that they or their citizen family members may be eligible for, making it harder for them to put food on the table and see a doctor when they get sick. Not only does excluding this group endanger many adults and children suffering hardships during the pandemic, it also limits the impacts of efforts to protect community well-being and boost the overall economy.

An undocumented Honduran immigrant reads her Bible during self-quarantine with her family for possible COVID-19 on March 30, 2020 in Mineola, New York. The nine immigrants who share the Long Island rental house self-quarantined after one became ill with fever, and the rest quickly followed. Most are largely recovered but never received tests for COVID-19. The coronavirus pandemic has been especially difficult for undocumented communities, who lack unemployment protections, health insurance, and fear deportation if authorities know their whereabouts. (Photo by John Moore/Getty Images)

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