President Biden Reverses Trump Rule Requiring Immigrant Health Insurance
President Biden has struck down a Trump-era rule requiring immigrants to prove that they would have health insurance shortly after entering the United States. The reversal has removed a barrier to entry for as many as two-thirds of potential immigrants to this country.
In 2019, the Trump administration announced a rule mandating that adults immigrating to the United States must have health insurance in place within 30 days of their arrival in the country (or be able to afford to cover all of their own medical bills). Exceptions to this requirement were few and narrow. Eligible policies could be employer-based or individual or family plans.
However, the Trump rule specified that individual health insurance plans be unsubsidized. That meant that most immigrants who purchased insurance policies through health insurance marketplaces using subsidies would not meet the requirements of the administration’s rule. In fact, the Migration Policy Institute estimated the year the rule was imposed that 65% of new lawful permanent residents (green card holders) would have failed to meet the new requirement if it was in place when they immigrated.
Arguments for and Against Immigrant Health Insurance Requirement
The Trump administration claimed that the health insurance requirement for immigrants would reduce the burden on the U.S. healthcare system — a system which has since become even more heavily strained by the COVID-19 pandemic. Those in favor of the rule pointed out that uninsured people often seek treatment in the emergency room when a medical condition has gotten so severe that they can no longer avoid the need for care.
Experts agree that emergency care is far more costly and less efficient than preventive care or treating a condition in its early stages. Furthermore, many patients who receive emergency room treatment are unable to pay the resulting bills. Those costs are passed on to taxpayers and to other consumers in the form of higher costs for treatment.
However, opponents of the rule believed that it was put in place for a much less honorable purpose: to severely limit immigration, especially by foreign nationals of more limited means. Essentially, the requirement that immigrants have unsubsidized health insurance would function as a “wealth test.” It would keep the majority of prospective immigrants out of the country, even if they would otherwise qualify for entry.
The ban on uninsured immigrants relied on 8 U.S.C. § 1182(f), which gives the president the authority to bar foreign nationals from entering the country if they would be “detrimental to the interests of the United States.”
Legal Challenges to Health Insurance Requirement for Immigrants
Trump issued the presidential proclamation regarding the health insurance requirement for immigrants on October 4, 2019. It was intended to take effect on November 3, 2019. It would have affected immigrant spouses of U.S. citizens and lawful permanent residents, along with their children, parents, and siblings in many cases. The rule would also have impacted those with employment-based immigrant visas, diversity visas, and certain visas for religious work.
A federal judge blocked the uninsured ban from taking effect on November 2, 2019. However, the Ninth Circuit Court of Appeals overturned the block on December 31, 2020, saying that the proclamation was within the president’s authority under the Immigration and Nationality Act (INA). When the block of the uninsured ban was reversed, President Biden had already been elected, but not yet inaugurated. The Ninth Circuit’s decision gave President Biden the opportunity to act on his stated intention to reverse many Trump-era policies regarding immigrants.
President Biden’s Position on Immigration and Health Insurance
In May 2021, President Biden honored his promise to overturn Trump-era immigration policies by striking down the uninsured ban. In so doing, he stated, “My administration is committed to expanding access to quality, affordable healthcare...We can achieve that objective, however, without barring the entry of noncitizens who seek to immigrate lawfully to this country but who lack significant financial means or have not purchased health insurance coverage from a restrictive list of qualifying plans.”
The Biden policy is good news for immigrants and their families. It recognizes that the contributions of immigrants to this country extend far beyond the wealth they bring with them. If you have questions about immigration requirements, please contact our law office to schedule a consultation.