Suspension of Entry of Immigrants Who Will Financially Burden the United States Healthcare System, in Order To Protect the Availability of Healthcare Benefits for Americans
| Published date | 09 October 2019 |
| Citation | 84 FR 53991 |
| Record Number | 2019-22225 |
| Section | Presidential Documents |
| Court | Executive Office Of The President |
Federal Register, Volume 84 Issue 196 (Wednesday, October 9, 2019)
[Federal Register Volume 84, Number 196 (Wednesday, October 9, 2019)]
[Presidential Documents]
[Pages 53991-53994]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-22225] Presidential Documents
Federal Register / Vol. 84 , No. 196 / Wednesday, October 9, 2019 /
Presidential Documents
[[Page 53991]]
Proclamation 9945 of October 4, 2019
Suspension of Entry of Immigrants Who Will
Financially Burden the United States Healthcare System,
in Order To Protect the Availability of Healthcare
Benefits for Americans
By the President of the United States of America
A Proclamation
Healthcare providers and taxpayers bear substantial
costs in paying for medical expenses incurred by people
who lack health insurance or the ability to pay for
their healthcare. 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
that hospitals give their patients--have exceeded $35
billion in each of the last 10 years. These costs
amount to approximately $7 million on average for each
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 ultimately are financed by taxpayers.
Beyond imposing higher costs on hospitals and other
healthcare infrastructure, uninsured individuals 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 usage places a large burden on
taxpayers, who reimburse hospitals for a portion of
their uncompensated emergency care costs.
While our healthcare system grapples with the
challenges caused by uncompensated care, the United
States Government is making the problem worse by
admitting thousands of aliens who have not demonstrated
any ability to pay for their healthcare costs. Notably,
data show that lawful immigrants are about three times
more likely than United States citizens to lack health
insurance. Immigrants who enter this country should not
further saddle our healthcare system, and subsequently
American taxpayers, with higher costs.
The United States has a long history of welcoming
immigrants who come lawfully in search of brighter
futures. We must continue that tradition while also
addressing the challenges facing our healthcare 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 healthcare 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 U.S.C.
1182(f) and 1185(a)) and section 301 of title 3, United
States Code, hereby find that the unrestricted
immigrant entry into the United States of persons
described in section 1 of this proclamation would,
except as provided for in section 2 of this
proclamation, be detrimental to the interests of the
United States, and that their entry should be subject
to certain restrictions, limitations, and exceptions. I
therefore hereby proclaim the following:
[[Page 53992]]
Section 1. Suspension and Limitation on Entry. (a) The
entry into the United States as immigrants of aliens
who will financially burden the United States
healthcare system is hereby suspended and limited
subject to section 2 of this proclamation. An alien
will financially burden the United States healthcare
system unless the alien will be covered by approved
health insurance, as defined in subsection (b) of this
section, within 30 days of the alien's entry into the
United States, or unless the alien possesses the
financial resources to pay for reasonably foreseeable
medical costs.
(b) Approved health insurance means coverage under
any of the following plans or programs:
(i) an employer-sponsored plan, including a retiree plan, association
health plan, and coverage provided by the Consolidated Omnibus Budget
Reconciliation Act of 1985;
(ii) an unsubsidized health plan offered in the individual market within a
State;
(iii) a short-term limited duration health policy effective for a minimum
of 364 days--or until the beginning of planned, extended travel outside the
United States;
(iv) a catastrophic plan;
(v) a family member's plan;
(vi) a medical plan under chapter 55 of title 10, United States Code,
including coverage under the TRICARE program;
(vii) a visitor 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 medical plan under the Medicare program; or
(ix) any other health plan that provides adequate coverage for medical care
as determined by the Secretary of Health and Human Services or his
designee.
(c) For persons over the age of 18, approved health
insurance does not include coverage under the Medicaid
program.
Sec. 2. Scope of Suspension and Limitation on 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 holding a valid immigrant visa issued before the effective
date of this proclamation;
(ii) any alien seeking to enter the United States pursuant to a Special
Immigrant Visa, in either 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 is
seeking 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 healthcare will not
impose a substantial burden on the United States healthcare system;
(v) any alien seeking to enter the United States pursuant to a SB-1 visa;
(vi) any alien under the age of 18, except for any alien accompanying a
parent who is also immigrating to the United States and subject to this
proclamation;
(vii) any alien whose entry would further important United States law
enforcement objectives, as determined by the Secretary of State or his
designee based on a recommendation of the Attorney General or his designee;
or
[[Page 53993]]
(viii) any alien whose entry would be in the national interest, as
determined by the Secretary of State or his designee on a case-by-case
basis.
(c) Consistent with subsection (a) of this section,
this proclamation does not affect the entry of aliens
entering the United States through means other than
immigrant visas, including lawful permanent residents.
Further, nothing in this proclamation shall be
construed to affect any individual's eligibility for
asylum, refugee status, withholding of removal, or
protection under the Convention Against Torture and
Other Cruel, Inhuman or Degrading Treatment or
Punishment, consistent with the laws and regulations of
the United States.
Sec. 3. Implementation and Enforcement. (a) An alien
subject to this proclamation must establish that he or
she meets its requirements, to the satisfaction of a
consular officer, before the adjudication and issuance
of an immigrant visa. The Secretary of State may
establish standards 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 in determining the admissibility of an
alien.
(c) An alien who circumvents the application of
this proclamation through fraud, willful
misrepresentation of a material fact, or illegal entry
shall be a priority for removal by the Department of
Homeland Security.
Sec. 4. Reports on the Financial Burdens Imposed by
Immigrants on the Healthcare 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 regarding:
(i) the continued necessity of and any adjustments that may be warranted to
the suspension and limitation on entry in section 1 of this proclamation;
and
(ii) other measures that may be warranted to protect the integrity of the
United States healthcare system.
(b) The report required by subsection (a) of this
section shall be submitted within 180 days of the
effective date of this proclamation, with subsequent
reports submitted annually thereafter throughout the
effective duration of the suspension and 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 so advise the
President.
(c) The Secretary of State and Secretary of Health
and Human Services shall coordinate any policy
recommendations associated with the reports described
in subsection (a) of this section.
Sec. 5. Severability. It is the policy of the United
States to enforce this proclamation to the maximum
extent possible to advance the interests of the United
States. Accordingly:
(a) if any provision of this proclamation, or the
application of any provision to any person or
circumstance, is held to be invalid, the remainder of
the proclamation and the application of its other
provisions to any 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 to be invalid because of the
failure to follow certain procedures, the relevant
executive branch officials shall implement those
procedural requirements to conform with existing law
and with any applicable court orders.
Sec. 6. General Provisions. (a) Nothing in this
proclamation shall be construed to impair or otherwise
affect:
[[Page 53994]]
(i) United States Government obligations under applicable international
agreements;
(ii) the authority granted by law to an executive department or agency, or
the head thereof; or
(iii) the functions of the Director of the Office of Management and Budget
relating to budgetary, administrative, or legislative proposals.
(b) This proclamation shall be implemented
consistent 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.
Sec. 7. Effective Date. This proclamation is effective
at 12:01 a.m. eastern daylight 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, and of the Independence of the
United States of America the two hundred and forty-
fourth.
(Presidential Sig.)
[FR Doc. 2019-22225
Filed 10-8-19; 8:45 am]
Billing code 3295-F0-P
