A Shameful Ban
APLAN THAT would direct about $50 billion over the next five years to halt the spread of HIV-AIDS in developing countries has dodged multiple challenges from Republican lawmakers and is set to become one of the Bush administration's finest accomplishments. The Senate voted overwhelmingly last week to approve the President's Emergency Plan for AIDS Relief (PEPFAR), and the House is expected to do the same as early as today. But one of PEPFAR's most significant provisions, the elimination of a 21-year-old ban on HIV-positive visitors and immigrants that puts the United States in the company of countries such as Libya and Sudan, may not take effect even if the legislation passes. The bill leaves to the Department of Health and Human Services (HHS) the decision as to whether HIV-positive visitors may enter the country. HHS officials have previously expressed a willingness to remove the ban but may delay a decision until the next administration takes office.
The ban is a relic of the myth and hysteria surrounding HIV-AIDS in the late 1980s, and HHS officials should not hesitate to remove this blot from the country's immigration history. In 1987, the Centers for Disease Control and Prevention (CDC) added HIV to a short list of dangerous, contagious diseases, including leprosy and tuberculosis, that disqualify visitors from admission to the country. The CDC announced in 1991 that HIV is not transmitted casually and that "admission of people with HIV would not significantly increase the risk of HIV infection to the U.S. population." But two years later, there was an AIDS scare, and Congress amended the Immigration and Nationality Act to turn the ban into law. HIV-AIDS is the only medical condition specifically named in U.S. immigration law as a bar to admission to the country. Offsetting the billions spent on AIDS relief, the ban has diminished the United States' humanitarian reputation abroad.
Opponents of PEPFAR have expressed concern that an influx of HIV-positive immigrants would increase public health outlays. They have a point. The Congressional Budget Office has estimated that lifting the restriction would cost the government $83 million over the next 10 years. But PEPFAR raises immigration fees by a few dollars to cover the cost. Making private health insurance a requirement for HIV-positive immigrants would be another way to lower government costs.
President Bush has an impressive legacy of combating HIV-AIDS. If PEPFAR passes, he could further burnish that legacy by urging the Department of Health and Human Services to end the ban on U.S. admission for would-be visitors and immigrants who are HIV-positive.