New York Immigrants Weigh Health and Hunger Against Deportation Risk

For years, Susanna Saul has been reassuring some of her clients that it’s safe to apply for public benefits, even if they’re not citizens. Now, she isn’t sure what to say.

Saul directs legal programs at Her Justice, a Manhattan-based nonprofit that provides free legal assistance to impoverished women and their children. Its clients include victims of trafficking and domestic violence who, unlike most undocumented people, are eligible for Medicaid under decades-old federal exceptions.

“They’ve always been worried about the immigration consequences of accessing public benefits, even before Trump won,” she said. “They always ask us if that’s going to hurt their ability to pursue a pathway to legal status. We’ve always said, ‘no.’”

But as President Donald Trump’s administration has ramped up immigration enforcement, she has more often found herself having to say, “I can’t answer that question, because I don’t know.”

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Jie Jenny Zou is reporting on New Yorkers' access to public benefits. Do you have a story to share? Reach out at [email protected]; we won't use your name without permission.

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This summer, US Immigration and Customs Enforcement was quietly granted access to sensitive Medicaid enrollment information as part of the agency’s efforts to root out “the location of aliens.” Federal officials have also begun collecting more detailed information from households enrolled in the Supplemental Nutrition Assistance Program, or SNAP, including immigration status.

New York and other states are challenging the new data-sharing policies in court, arguing that “if members of our community cannot trust that the government will keep their medical history and other personal data safe, they will think twice about going to the doctor when needed.”

Advocates say they’re seeing a chilling effect, with immigrants across the state delaying or avoiding health care to protect themselves — or others in their households — from immigration enforcement.

“This is literally about life and death,” Saul said. “We have clients who are cancer survivors who are in active treatment. We have clients caring for children who have special needs.”

Saul shared the story of one long-time client who has lived in the US for decades and is working toward a green card. The client reported intimate partner violence to the police and has undergone several surgeries as a result of the abuse. Her injuries require ongoing physical therapy, which is covered by Medicaid because she’s a domestic violence survivor — but she’s stopped going to appointments, out of fear of being detained by ICE.

“She basically doesn’t go anywhere,” Saul said. “She stopped going to church. She relies on her son, who is a US citizen, for a lot of things. She relies on neighbors.”

Adding to the uncertainty, hundreds of thousands of immigrants could soon lose their health coverage. In July, Trump signed a bill enacting over $1 trillion in cuts to Medicaid and SNAP. Starting January 1, the federal government will rescind support for certain legal immigrants enrolled in the state’s free Essential Plan. Over 200,000 immigrants could go uninsured as a result.

Trump also issued an executive order that would cut off access for many immigrants — including Deferred Action for Childhood Arrival recipients and people granted temporary protected status — to a wide array of federally funded social services, from mental health clinics to substance abuse treatment to child care. The Trump administration paused enforcement of the new policy pending a court challenge led by New York State Attorney General Letitia James; a judge is expected to rule in that case soon.

Governor Kathy Hochul and state legislators have so far declined to say how they plan to deal with federal cuts to public benefits, and have tabled the matter until next year.

Meera Venugopal, communications director for the Asian American Federation, said rampant misinformation coupled with a lack of proactive communication from state leaders has fostered extreme uncertainty.

“We are in a low-information environment while people are completely panicked and anxious,” she said of benefit recipients concerned about changes to eligibility, new work rule requirements, and increased immigration enforcement.

Her organization represents nonprofits serving the state’s 2.1 million Asian residents, 63 percent of whom are foreign-born. It’s estimated that 24 percent of the state’s unauthorized immigrants are from Asia.

“Nobody’s gotten a single letter from the government or anyone, really, about what’s coming,” Venugopal said. “We are always the intermediary, and we don’t have the staff or capacity to handle all the people coming to our doors.”

Venugopal is urging state leaders to communicate a clear path forward about how they plan to handle federal cuts so that community organizations — which serve as hubs for public benefit recipients with limited English proficiency and poor digital access — can adequately prepare.

Meanwhile, some organizations are afraid they could be swept up in the immigration crackdown themselves.

The Trump administration has signaled increased interest in investigating nonprofits and has issued a flurry of executive orders canceling grants and contracts, as well as directing federal agencies to block funding for sanctuary cities. In New York, Republican Congressmembers have urged the IRS to investigate prominent nonprofits for pushing a statewide sanctuary bill, among other actions the lawmakers said may aid unlawful residents.

A director from one Queens nonprofit that works closely with immigrant groups said that his organization is “laying low” and asked to not be identified in this story for fear of reprisal.

Earlier this month, his organization made its annual round of calls reminding clients of the upcoming deadline to renew their Medicaid coverage. The routine calls were met with suspicion, even from longtime clients.

“Three people just hung up.… One of them turned off their cell phone,” he said. Many had questions they haven’t had before: “‘What are you going to do with my information? Is my information safe? Should I recertify?’”

More clients are requesting home-delivered groceries, he said, fearing that ICE agents could be waiting for them at the organization’s food distribution line.

People on the Essential Plan have questions he can’t answer about what will happen to their coverage next year, like one client undergoing dialysis.

“What happens to this individual?” he asked.