Immigrants and Interdependence: How the COVID-19 Pandemic Exposes the Folly of the New Public Charge Rule

Makhlouf, Medha D. & Sandhu, Jasmine | October 14, 2020

On February 24, 2020, just as the Trump Administration began taking significant action to prepare for an outbreak of COVID-19 in the United States, it also began implementing its new public charge rule. Public charge is an immigration law that restricts the admission of certain noncitizens based on the likelihood that they will become dependent on the government for support. A major effect of the new rule is to chill noncitizens from enrolling in public benefits, including Medicaid, out of fear of negative immigration consequences. These chilling effects have persisted during the pandemic. When noncitizens are afraid to (1) seek treatment or testing for COVID-19 or (2) access public benefits in order to comply with stay-at- home guidance, it impedes efforts to slow the spread of COVID-19, contributing to the strain on the health care system.

This Essay describes how the pandemic has exposed the folly of the public charge rule: Discouraging noncitizens from accessing public benefits to support their health and well- being is, and always has been, unwise from a public health perspective. The pandemic merely magnifies the negative consequences of this policy.
This Essay contributes to scholarly conversations about how immigration law and policy have framed the United States’ response to the COVID-19 pandemic. Specifically, it provides an in-depth analysis of the negative public health consequences of the new public charge rule during the pandemic.


Medha D. Makhlouf is an Assistant Professor and Director of the Medical-Legal Partnership Clinic at Penn State Dickinson Law, and an Assistant Professor in the Department of Public Health Sciences at Penn State College of Medicine. Jasmine Sandhu received her J.D. from Penn State Dickinson Law, where she worked as a Student Attorney at the Medical-Legal Partnership Clinic. She has a B.S. in Community and Regional Development from University of California, Davis. The authors are grateful to Christian Sweger for his excellent research assistance and to the staff of the Northwestern University Law Review for their incisive editing.

Copyright 2020 by Medha D. Makhlouf & Jasmine Sandhu

Cite as: Medha D. Makhlouf & Jasmine Sandhu, Immigrants and Interdependence: How the COVID-19 Pandemic Exposes the Folly of the New Public Charge Rule, 115 Nw. U. L. Rev. Online 146 (2020),