Immigrants in New York between invalid U.S. stay and potential health crisis

Article written per coursework at Columbia Graduate School of Journalism

In a busy pediatric clinic in Astoria, Queens, nurses exchange shifts and the phone keeps ringing non-stop while several parents hustle for doctor consultation on the right vaccinations for their children required by their schools amid a new school year.

While parents opt for good systems for disease-prevention care and medical treatment for their children, they were left with hard decisions at the end of the day: dis-enrolling from Medicaid. The program is a health benefit targeted for low-income communities, to avoid complications when changing their immigration status.

As the U.S. administration continues to tighten immigration policies amid a new public assistance rule that is set to come into effect in October, several immigrants are left torn between avoiding the use of public assistance or risking their chance of a legal stay in the country.

“We saw a significant drop out of people using these services out of fear that they would be penalized and picked out of the country. They are literally refusing our services because of the public charge rule,” said vice president of Development and Marketing at Public Health Solutions Lisa Jakobsberg.

New York’s largest public health organization, Public Health Solutions witnessed the main dis-enrollment taking place in Queens, according to Jakobsberg.

Announced on August 12, the new rule stipulated that immigrants will be denied green cards, visa extension and/or immigration status adjustment, if they access or are likely to access benefits of the public assistance which includes Medicaid, food stamps, and housing vouchers among others for over 12 months during any 36-months period.

Acting director of Citizenship and Immigration Services Ken Cuccinelli said during a press conference earlier that an immigrant receiving more than one benefit in one month will be accounted as an additional month, thus increasing chances of entry-denial to the U.S.

“The administration is currently targeting visa holders who are about to adjust to a green card status, specifically those who come on visas on humanitarian basis from Yemen and Syria” said immigration attorney at Marc S. Albert Law Offices Ramy Aqel.

New York State health centers serve at least 3 million patients on an annual basis, 59% of which are enrolled in Medicaid, according to a report by the Community Healthcare Association of New York State (CHCANYS). Around 20% of Medicaid enrollers in New York live in a family with at least one non-citizen.

A survey conducted by CHCANYS revealed that more than half of New York health centers reported an increase in the number of individuals who are eligible for Medicaid but are not enrolling out of fear of deportation.

A taxi driver who lives in Brooklyn, Omar Ibrahim came to New York a year ago on asylum status after fleeing Egypt where he was detained for a while on charges of being affiliated with the now defunct Muslim Brotherhood. He enrolled himself in Medicaid upon his arrival and while the new rule exempts refugees and asylum seekers, he plans to dis-enroll.

“I feel cornered and unwelcomed in the country with every new immigration policy that Trump is issuing; I need to feel more safe and I don’t want to take risks that could affect my status. I am even considering directing my refugee procedures in Canada all together,” he irritably said.

As an alternative, Ibrahim consults his friends who work as licensed doctors in the country for free medical advice and treatment whenever he gets sick.

The implications of public assistance have long existed before the new rule was drafted.

Jakobsberg pointed out that about 20% of immigrants dealing with Public Health Solutions dropped out of food stamps last September and October, adding “during the time when public charge was receiving heavy media attention, around 300 people abandoned the WIC (Women, Infants & Children) program.

Some health centers have even reported that some parents have refused benefits to their citizen children. The fear having the inability to gain legal status for themselves or for other family members in the country.

While many immigrants are worried about the impacts of the new rule on their dreams for a better life in the U.S, 46-year old Soufiane, an undocumented Algerian immigrant who has been in the U.S for 20 years, believes that the rule will not affect anyone.

“This is just a political agenda played by the conservatives as part of Trump’s re-election campaign. Nothing should concern immigrants unless they held criminal acts during their stay in the U.S.,” said Soufiane who claims that he never used Medicaid.

During the quest of achieving what he described as his “American dream”, making a lot of money, Soufiane now works in a furniture manufacturing company. He has previously worked in a meat distribution facility in which both places covered his medical expenses.

Although immigration attorneys have been receiving a heavy flow of worried calls from immigrants whether they should cut off their public assistance enrollment, executive director at Immigration Advocacy Services Antonio Meloni believes that worries should be controlled as the rule can still be overturned amid the current lawsuits filed against it.

Several lawsuits have been raised against federal agencies that will enforce the new rule including that of New York’s Attorney General Letitia James.

“Immigrants who used Medicaid for a short period of time, such as staying in the hospital for a few days, are less likely to be affected by the new rule than those who used it long-term,” he added.

Over seven million New Yorkers receive Medicaid or a subsidized health program, according to a report issued by state Comptroller Thomas DiNapoli late 2018, highlighting 57% rise throughout the past decade.

Medicaid and Children Health Insurance Program (CHIP) make up around 53% of revenues incurred by New York State (NYS) health centers, according to CHCANYS which estimates that NYS health centers may see some 95,000 former enrolled Medicaid individuals become uninsured.

Long-term implications of the new rule include poor sick immigrants leading to a health crisis in New York.

“The city has the highest rates of diabetes, high blood pressure, and asthma and if immigrants are not getting the required medication and preventative care measures, a health crisis will be on the rise." said an allergy and immunology doctor in a clinic in Bronx who was asked to be mentioned anonymously because she was not authorized to speak to press. "I don’t see how patients can afford asthma medication without Medicaid," she added.

With around 544,000 people applying annually for a green card including 382,000 who will be subjected to a new review, according to the U.S government, the future of the new rule remains bleak amidst immigrants’ will to thrive for preserving their lives in the U.S.

However, the issue of receiving public assistance is not new and will come up in visa interviews whether the rule goes into effect or not, according to Aqel who advises his clients to stop using Medicaid now and apply for the green card as soon as possible.