Trump Will Deny Immigrant Visas to Those Who Can’t Pay for Health Care


Visa applicants will have to prove they have insurance or the financial resources for medical costs.

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CreditCreditT.J. Kirkpatrick for The New York Times

Michael D. ShearMiriam Jordan

WASHINGTON — The Trump administration will deny visas to immigrants who cannot prove they will have health insurance or the ability to pay for medical costs once they become permanent residents of the United States, the White House announced Friday in the latest move by President Trump to undermine legal immigration.

Mr. Trump issued a proclamation, effective Nov. 3, ordering consular officers to bar immigrants seeking to live in the United States unless they “will be covered by approved health insurance” or can prove that they have “the financial resources to pay for reasonably foreseeable medical costs.”

The president justified the move by saying that legal immigrants are three times as likely as American citizens to lack health insurance, making them a burden on hospitals and taxpayers in the United States. Officials cited a Kaiser Family Foundation study that said that among the nonelderly population, 23 percent of legal immigrants were likely to be uninsured, compared with about 8 percent of American citizens.

“The United States government is making the problem worse by admitting thousands of aliens who have not demonstrated any ability to pay for their health care costs,” Mr. Trump wrote, adding, “immigrants who enter this country should not further saddle our health care system, and subsequently American taxpayers, with higher costs.”

The president’s proclamation, which has been in the works for several months, is aimed primarily at immigrants seeking to join their families in the United States, according to a White House official who spoke under condition of anonymity to more openly discuss the new policy. It does not affect refugees, asylum seekers or students seeking to attend college in the United States, according to the White House.

Immigrant visas are the vehicle for receiving a green card in the United States for people who are processing their paperwork abroad. Once the policy is in place, people seeking those visas would be asked by consular officers to show how they intend to be covered by health insurance within 30 days of arriving in the United States. That could include proof that they will have health care through a job or will be covered under a relative’s insurance.

If they cannot show that to the satisfaction of the consular office, their visa will be denied, the White House official said. The State Department will develop standards and rules that consular officials will follow in making the determination, the official said.

Thousands of people annually would be denied green cards if the executive order takes effect, said Steve Yale-Loehr, an immigration scholar at Cornell Law School.

“President Trump has failed to build a physical wall along the U.S.-Mexico border to deter illegal immigrants,” he said, “but he has effectively built an invisible wall to keep out legal immigrants.”

The surprise order is the latest step in a long effort by Stephen Miller, the president’s top immigration adviser, and others in the administration, to limit what they consider the financial burdens of allowing immigrants into the United States.

After years of effort by Mr. Miller, the administration issued a regulation in August that would allow officials to deny permanent legal status to immigrants who are poor. The regulation, which imposes an aggressive wealth test on legal immigrants, has faced several legal challenges but will go into effect on Oct. 15 unless it is blocked by a court.

That policy, known as the “public charge” rule, says immigrants seeking to live permanently in the United States could be denied if officials deem it is likely they will be a burden on society by, for example, being unable to pay for health care or seeking food and housing assistance.

Under the new proclamation, which was earlier reported by The Wall Street Journal, officials are directed to use a similar approach in determining whether to grant immigrant visas to people seeking to live in the United States.

Immigration advocates were taken aback by the proclamation, noting there are already several steps that applicants for a green card must take to qualify, including passing background checks and health examinations.

Elizabeth Jamae, an immigration lawyer at Pearl Law Group in San Francisco, said she doubted the assertion in the proclamation that lawful immigrants were about three times as likely as United States citizens to lack health insurance.

“Most people who are receiving green cards already have a job waiting or have a spouse that is employed,” Ms. Jamae said. “When you apply for a green card you already have to meet certain financial requirements.”

People coming to the United States who are sponsored by companies for a specific job are likely to have insurance through their employer, and are unlikely to be affected. But many adults who are not immediately eligible for employment-based health insurance or who cannot afford private health insurance will be denied entry.

“Without the power to change U.S. law on his own, Trump is trying to find end runs around Congress and the legislative process to impose his will by fiat,” said Julie Dinnerstein, an immigration lawyer with CUNY Citizenship NOW, which provides free legal services to the public.

The president’s proclamation relies on the same immigration laws that he used in issuing his travel ban shortly after taking office. In that case, Mr. Trump asserted that the threat of terrorism required a ban on entry from certain majority-Muslim countries.

He cited the same code in Friday’s proclamation, writing that allowing immigrants without health care into the United States would “be detrimental to the interests of the United States, and that their entry should be subject to certain restrictions, limitations, and exceptions.”

Doug Rand, a former White House official who worked on immigration in the Obama administration, predicted that the president’s proclamation would be met by legal challenges.

“This came out of the same authority as the Muslim ban and the asylum ban,” said Mr. Rand, who co-founded Boundless, a technology firm that helps immigrants apply for visas.

Both bans were met with immediate litigation that was partly successful. A watered-down version of the Muslim ban was approved by the Supreme Court after several lawsuits. The asylum ban, which would have excluded most asylum seekers, was blocked by the courts.

The latest proclamation also has logistical obstacles, Mr. Rand said, noting that the State Department has a brief window to teach thousands of consular officers how to determine whether prospective immigrants can pay for their medical care.

“If this is not going to be enjoined by a court in the next month,” Mr. Rand said, “it will cause complete chaos.”

Michael D. Shear is a White House correspondent. He previously worked at The Washington Post and was a member of their Pulitzer Prize-winning team that covered the Virginia Tech shootings in 2007. @shearm

Miriam Jordan is a national immigration correspondent. She reports from a grassroots perspective on the impact of immigration policy. She has been a reporter in Mexico, Israel, Hong Kong, India and Brazil. @mirjordan

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