The White House late Friday issued a proclamation saying it would deny visas to immigrants who “will financially burden” the U.S. health-care system starting Nov. 3, demanding that foreign nationals prove that they have insurance or are affluent enough to cover their own health-care costs before entering the United States.
Trump said he is taking the action to “protect the availability of health care benefits for Americans,” and said “taxpayers bear substantial cost” in paying for medical expenses of people who lack health insurance.
“Immigrants who enter this country should not further saddle our health care system, and subsequently American taxpayers, with higher costs,” Trump said in the proclamation.
Analysts said the proclamation appears to target family-based migration, the type of “chain migration” that the Trump administration and White House aide Stephen Miller, an immigration hawk, have been unable to persuade Congress to reduce. The White House has pushed for policies that would favor wealthier immigrants with special skills over immigrants from poorer countries, including in Latin America.
Trump’s proclamation comes as the administration is also preparing to implement a new “public charge” rule Oct. 15 that seeks to deny green cards and U.S. citizenship to poor immigrants.
To obtain an immigration visa, foreigners must prove they will be covered by “approved health insurance,” such as a family or employment-based policy, within 30 days of entering the United States, unless they are affluent enough to cover their “reasonably foreseeable medical costs.”
Among the legal provisions Trump invoked to support his proclamation is Section 212(f) of the Immigration and Nationality Act, which grants the president authority to declare certain migrants ineligible for entry because it “would be contrary to the national interest” and “detrimental to the interests of the United States.”
The section is the same legal authority he invoked during the 2017 travel ban, which mainly limited travel of nationals of certain Muslim-majority countries.
Doug Rand, a former White House official in the Obama administration who worked on immigration policy, said Trump’s proclamation is likely to affect the immediate relatives of U.S. citizens waiting overseas for permission to come to the United States, including parents, spouses and siblings. Children are exempt.
He said the new rules would not affect the immigrants already in the United States.
The proclamation, which was previously reported by the Wall Street Journal, also does not appear to affect immigrants arriving on work visas, refugees or those seeking asylum at the Mexican border, he said, but he called the new rule “a gigantic, sweeping change to the legal immigration system.”
“As a matter of policymaking, this is an incredibly flimsy document,” he said. “We have no idea what the process was and it just kind of happened at 7 o’clock on a Friday. Where did this come from? What was the process? Who was involved in this?”
In the proclamation, Trump said “lawful immigrants are about three times more likely than United States citizens to lack health insurance,” without providing a source for the information. The White House did not immediately respond to a request for comment.
Scholars have long debated the costs and benefits of immigration to the United States, with some focusing on the costs of health care and education while others note that immigrants and their children contribute millions in income, property and sales taxes.
A Kaiser Family Foundation study said about 1 in 4 “lawfully present immigrants” lacked health insurance, compared with less than 1 in 10 U.S. citizens as of 2017.
But a National Academies of Sciences report in 2016 concluded immigration had a positive effect on economic growth overall in the United States, though immigrants were more likely to compete with less-educated Americans for jobs.
Trump required 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, to submit a report on the proclamation six months after it takes effect.