President Donald Trump signed an executive order directing the denial of immigrant visas and banning foreigners who do not have health coverage or can afford to pay for their medical expenses in the United States from entering the country.
In his presidential proclamation "Suspension of Entry of Immigrants Who Will Financially Burden the United States Healthcare System," issued late on Friday, Oct. 4, Trump claims that uninsured immigrants are overburdening the nation's healthcare system and hurting American taxpayers.
The announcement affects immigrants applying for immigrant visas from abroad, not those already in the country.
The Executive Order does not apply to several classes of aliens, including non-citizen children of U.S. citizens, refugees and asylum seekers. But it does apply to spouses and parents of U.S. citizens and immediate family members of lawful permanent residents.
The order is effective as of November 3.
The proclamation states that the Government will only accept immigrant visa petitions made abroad if petitioners demonstrate that they will have the ability to obtain health insurance within 30 days of their arrival in the United States. If that is not possible, petitioners would have to demonstrate that they have the "financial resources to pay reasonably foreseeable medical costs."
As has happened with other Trump administration orders proposing changes to immigration processes, it is anticipated that this measure will also face legal action to block its implementation.
Below is President Trump's proclamation issued on October 4, 2019 (Spanish translation from Google Translate):
Presidential proclamation on suspending the entry of immigrants who will financially burden the U.S. health care system
Health care : Issued on: October 4, 2019
Health care providers and taxpayers bear substantial costs in paying for medical expenses incurred by individuals who lack health insurance or the ability to pay for their medical care. Hospitals and other providers often administer care to the uninsured without any hope of receiving reimbursement from them. The costs associated with this care are passed on to the American people in the form of higher taxes, higher premiums and higher fees for medical services. In total, uncompensated care costs, the overall measure of unreimbursed services hospitals provide to their patients, have exceeded $ 35 billion in each of the past 10 years. These costs amount to approximately $ 7 million on average per hospital in the United States, and can drive hospitals into insolvency. Beyond uncompensated care costs, the uninsured strain federal and state government budgets through their reliance on publicly funded programs, which are ultimately funded by taxpayers.
Beyond imposing higher costs on hospitals and other health care infrastructure, the uninsured often use emergency rooms to seek remedies for a variety of non-emergency conditions, causing overcrowding and delays for those who truly need emergency services. This non-emergency use places a large burden on taxpayers, who reimburse hospitals for a portion of their uncompensated emergency care costs.
While our health care system faces challenges caused by uncompensated care, the U.S. Government is making the problem worse by admitting thousands of foreign nationals who have demonstrated no ability to pay their health care costs. In particular, the data show that legal immigrants are three times more likely than U.S. citizens to lack health insurance. Immigrants entering this country should no longer be mucking up our health care system, and subsequently the American taxpayers, with higher costs.
The United States has a long history of welcoming immigrants who come legally in search of brighter futures. We must continue that tradition while addressing the challenges facing our health care system, including protecting both it and the American taxpayer from the burdens of uncompensated care. Continuing to allow entry into the United States of certain immigrants who lack health insurance or the demonstrated ability to pay for their health care would be detrimental to these interests.
NOW, THEREFORE, I, DONALD J. TRUMP, by the authority vested in me by the Constitution and the laws of the United States of America, including sections 212(f) and 215(a) of the Immigration and Nationality Act (8 USC 1182(f) and 1185(a)) and section 301 of title 3, United States Code, hereby determine that the unrestricted immigrant entry into the United States of the persons described in section 1 of this proclamation, except as provided in section 2 of this proclamation, is detrimental to the interests of the United States, and that their entry shall be subject to certain restrictions, limitations, and exceptions. Therefore, I proclaim the following:
Section 1. Suspension and limitation of entry. (a) The entry into the United States as immigrants of aliens who will financially burden the United States health care system is hereby suspended and limited, subject to section 2 of this proclamation. An alien shall financially burden the United States health care system unless covered by approved health insurance, as defined in subsection (b) of this section, within 30 days after the alien's entry into the United States, or unless the alien possesses financial resources to pay reasonably foreseeable medical costs.
(b) Approved health insurance means coverage under any of the following plans or programs:
(i) an employer-sponsored plan, which includes a retiree plan, an association health plan and coverage provided by the Consolidated Omnibus Omnibus Budget Reconciliation Act of 1985;
(ii) a non-subsidized health plan offered in the individual market within a State;
(iii) a short-term health policy of limited duration, effective for a minimum of 364 days, or until the commencement of planned extended travel outside the United States;
(iv) a catastrophic plan;
(v) the plan of a family member;
(vi) a health plan under chapter 55 of title 10, United States Code, including coverage under the TRICARE program;
(vii) a visitor's health insurance plan that provides adequate coverage for medical care for a minimum of 364 days, or until the beginning of planned extended travel outside the United States;
(viii) a health plan under the Medicare program; o
(ix) any other health plan that provides adequate coverage for medical care as determined by the Secretary of Health and Human Services or his or her designee.
(c) For persons over 18 years of age, approved health insurance does not include coverage under the Medicaid program.
Second. 2. Scope of suspension and limitation of entry. (a) Section 1 of this proclamation shall apply only to aliens seeking to enter the United States pursuant to an immigrant visa.
(b) Section 1 of this proclamation shall not apply to:
(i) any alien who holds a valid immigrant visa issued prior to the effective date of this proclamation;
(ii) any alien seeking to enter the United States pursuant to a special immigrant visa, whether in the SI or SQ classification, who is also a national of Afghanistan or Iraq, or his or her spouse and children, if any;
(iii) any alien who is the child of a United States citizen or who seeks to enter the United States pursuant to an IR-2, IR-3, IR-4, IH-3 or IH-4 visa;
(iv) any alien seeking to enter the United States pursuant to an IR-5 visa, provided that the alien or the alien's sponsor demonstrates to the satisfaction of the consular officer that the alien's medical care will not impose a substantial burden on the United States medical care system;
(v) any alien seeking to enter the United States pursuant to an SB-1 visa;
(vi) any alien under 18 years of age, except any alien accompanying a parent who is also immigrating to the United States and subject to this proclamation;
(vii) any alien whose entry is most important to the law enforcement objectives of the United States, as determined by the Secretary of State or his or her designee based on a recommendation of the Attorney General or his or her designee; o
(viii) any alien whose entry would be in the national interest, as determined by the Secretary of State or his or her designee on a case-by-case basis.
(c) Pursuant to subsection (a) of this section, this proclamation does not affect the entry of aliens entering the United States by means other than immigrant visas, including lawful permanent residents. In addition, nothing in this proclamation shall be construed to affect an individual's eligibility for asylum, refugee status, withholding of deportation, or protection under the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, in accordance with the laws and regulations of the United States.
Second. 3. Implementation and application. (a) An alien subject to this proclamation must establish that he or she meets its requirements, to the satisfaction of a consular officer, prior to the adjudication and issuance of an immigrant visa. The Secretary of State may establish rules and procedures governing such determinations.
(b) The review required by subsection (a) of this section is separate and independent from the review and determination required by other statutes, regulations, or proclamations to determine the admissibility of an alien.
(c) An alien who circumvents the application of this proclamation by fraud, intentional misrepresentation of a material fact, or illegal entry shall be a priority for removal by the Department of Homeland Security.
Second. 4. Reports on the financial burdens imposed by immigrants on the health care system. (a) The Secretary of State, in consultation with the Secretary of Health and Human Services, the Secretary of Homeland Security, and the heads of other appropriate agencies, shall submit to the President a report on:
(i) the continuing need for and any adjustments that may be warranted to the suspension and limitation of entry in section 1 of this proclamation; and
(ii) other measures that may be warranted to protect the integrity of the U.S. health care system.
(b) The report required by subsection (a) of this section shall be submitted within 180 days after the effective date of this proclamation, and subsequent reports shall be submitted annually throughout the effective duration of the suspension and the limitation on entry set forth in section 1 of this proclamation. If the Secretary of State, in consultation with the heads of other appropriate executive departments and agencies, determines that circumstances no longer warrant the continued effectiveness of the suspension or limitation on entry set forth in section 1 of this proclamation or that circumstances warrant additional measures, The Secretary shall immediately inform the President.
(c) The Secretary of State and the Secretary of Health and Human Services shall coordinate any policy recommendations associated with the reports described in subsection (a) of this section.
Second. 5. Divisibility. It is the policy of the United States to enforce this proclamation to the fullest extent possible to promote the interests of the United States. Consequently:
(a) if any provision of this proclamation, or the application of any provision of this proclamation to any person or circumstance, is held invalid, the remainder of the proclamation and the application of its other provisions to other persons or circumstances shall not be affected thereby; and
(b) if any provision of this proclamation, or the application of any provision to any person or circumstance, is held invalid due to failure to comply with certain procedures, the relevant executive branch officials shall implement those procedural requirements to comply with existing requirements. law and any applicable court order.
Second. 6. General provisions. (a) Nothing in this proclamation shall be construed to impair or otherwise affect:
(i) Obligations of the United States Government under applicable international agreements;
(ii) the authority granted by law to an executive department or agency, or the head thereof; o
(iii) the functions of the Director of the Office of Management and Budget related to budgetary, administrative or legislative proposals.
(b) This proclamation shall be implemented in accordance with applicable law and subject to the availability of appropriations.
(c) This proclamation is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies or entities, its officers, employees, or agents, or any other person.
Second. 7. Effective Date. This proclamation is effective at 12:01 am Eastern Time on November 3, 2019.
IN WITNESS WHEREOF, I have hereunto set my hand this fourth day of October, in the year of our Lord two thousand nineteen hundred and nineteen, and of the Independence of the United States of America the two hundred and forty-fourth.
DONALD J. TRUMP
