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Presidential Proclamation Imposes Health Insurance Requirement on Immigrant Visa Applicants

The State Department will suspend the issuance of immigrant visas to foreign nationals who cannot demonstrate that they will obtain health insurance or otherwise pay for their healthcare expenses in the United States, according to a presidential proclamation issued Friday.

Starting November 3, 2019, foreign nationals applying for immigrant visas at U.S. consulates abroad must prove either that they will acquire approved health insurance within thirty days of their entry to the United States or that they will have the means to pay for reasonably foreseeable medical expenses while in the United States. Failure to do so will result in the denial of their visa request.

Who is subject to the new requirement

The new requirement applies to immigrant visa applicants at a U.S. consulate abroad, including employment-based, family-based and Diversity Visa applicants. However, the following immigrant visa applicants are exempt:

  • Foreign nationals holding an immigrant visa issued before 12:01 a.m., November 3, 2019, the rule’s effective date;
  • Most unmarried children of U.S. citizens who are under the age of 21, including orphaned children adopted abroad and orphaned children to be adopted in the United States;
  • Children under the age of 18 unless they are accompanying a parent who is subject to the proclamation;
  • Parents of U.S. citizens who are 21 or older, provided that the adult child can demonstrate that the parent’s healthcare needs will not pose a substantial burden on the U.S. healthcare system;
  • Returning residents;
  • Iraqi or Afghan translators and interpreters, as well as Iraqis and Afghans who worked for or on behalf of the U.S. government;
  • Foreign nationals whose entry would further U.S. law enforcement endeavors; and
  • Any foreign national whose entry would be in the national interest.

The proclamation will not apply to applicants applying to adjust status from within the United States, or foreign nationals applying abroad for nonimmigrant visas, such as B-1/B-2, H-1B, L-1A/L-1B or O-1 visas.

What health insurance plans are acceptable under the proclamation

The proclamation lists several types of health insurance plans that will be considered acceptable under the new requirement. These include:

  • An employer-sponsored health plan;
  • A family member’s plan;
  • An unsubsidized individual plan obtained on a state market;
  • Medicare;
  • A catastrophic plan;
  • A short-term or visitor plan; or
  • Any other health plan that provides adequate coverage for medical care as determined by the Secretary of Health and Human Services.

Subsidized health insurance obtained through the Affordable Care Act (ACA) exchanges will not be considered an acceptable form of health insurance.

The proclamation does not provide details about how consular officers will make a determination as to whether the intending immigrant has the means to pay for reasonable foreseeable health care costs.   

What’s next

The health insurance requirement is set take effect at 12:01 a.m. eastern daylight time on Monday, November 3, 2019. In the coming weeks, the State Department is expected to issue implementation guidelines outlining adjudication standards and identifying acceptable forms of evidence. 

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