Under Presidential Proclamation 9945, Suspension of Entry of Immigrants Who Will Financially Burden the United States Healthcare System (PP 9945), effective November 3, 2019 applicants for immigrant visas must show to the satisfaction of a consular officer, before an immigrant visa is issued, that either:

  • They will be covered by approved health insurance, as defined in Presidential Proclamation 9945, within 30 days of entry into the United States, or
  • They possess the financial resources to pay for reasonably foreseeable medical costs.

Holders of valid immigrant visas issued before the effective date are not subject to PP 9945, and there are several other limited exceptions. Presidential Proclamation 9945 applies only to immigrant visas, and does not apply to nonimmigrant visas or to applicants for adjustment of status to lawful permanent residence within the United States.

In a Department of State (DOS) information collection request notice published in the Federal Register to implement PP 9945 [84 FR 58199 (October 30, 2019)], DOS describes how it will elicit the information required to make a determination under the proclamation, while it pursues longer-term authorization from OMB to collect the information. Comments on that DOS notice are due on October 31, 2019, the day after the notice was published.

On November 2, 2019, however, the United States District Court for the District of Oregon issued a temporary restraining order (TRO) that blocks implementation of the proclamation for 28 days. See Litigation below.

Insurance acceptable under PP 9945

"Approved health insurance" under the proclamation 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.

For persons over the age of 18, approved health insurance does not include coverage under the Medicaid program.

According to the DOS information collection request notice,

"Consular officers will verbally ask immigrant visa applicants covered by PP 9945 whether they will be covered by health insurance in the United States within 30 days of entry to the United States and, if so, for details relating to such insurance... If applicants answer affirmatively, consular officers will ask for applicants to identify the specific health insurance plan, the date coverage will begin, and such other information Start related to the insurance plan as the consular officer deems necessary."

Alternative showing of financial resources

In lieu of showing "approved health insurance" coverage under PP 9945, an applicant for an immigrant visa can establish that they possess "the financial resources to pay for reasonably foreseeable medical costs."

According to the DOS information collection request notice,

"PP 9945 does not suspend or limit the entry of applicants if they do not have coverage, but possess financial resources to pay for reasonably foreseeable medical expenses. Reasonably foreseeable medical expenses are those expenses related to existing medical conditions, relating to health issues existing at the time of visa adjudication."

Litigation

Litigation impacts the implementation of this proclamation.

  • On 10/30/2019 the Justice Action Center (JAC), the American Immigration Lawyers Association (AILA), and the Innovation Law Lab, with Sidley Austin LLP providing pro bono assistance, filed a complaint in the United States District Court for the District of Oregon. Doe et al v. Trump et al, 3:19-cv-01743. Read the press release on AILA's website (AILA Doc No. 19103006). Read the complaint, posted on the AILA website (AILA Doc No. 19103090). On November 2, 2019 the Court issued a temporary restraining order (TRO) that blocks implementation of the proclamation for 28 days. The Court also set a November 22, 2019 hearing date to determine whether a longer-term preliminary injunction should be issued. Read the Court's November 2, 2019 order on the AILA website (AILA Doc No. 19110290).