Trump's new rule may ban hundreds of thousands of green card applicants from entering the United States

On Friday evening, October 18, US Presidential Administration Donald Trump issued a presidential statement stating that new immigrants will be denied entry to the United States if they do not prove that they can receive health insurance for 30 days after arrival or have sufficient resources to pay for medical care. It is estimated that this could reduce legal migration by two-thirds.

According to a new assessment by the Institute for Migration Policy (MPI), the new rule could completely block two-thirds of those applying for permanent legal residence in the United States and have an equally significant impact on statistics of future legal immigration, writes Migration Policy Institute.

MPI estimates that the new health insurance requirement could deny entry to approximately 375 immigrants per year. These are mainly family immigrants - the majority of those who receive green cards from abroad. As the Trump administration pushes to reduce family-based immigration, which has long been a cornerstone of the U.S. immigration system, the new rule could help achieve the changes sought by the White House without requiring action from Congress.

Impact assessment

This declaration will apply to future lawful permanent residents arriving from overseas, and not to immigrants already in the United States who are switching to receiving a green card from a different status. Refugees and other persons with humanitarian assistance are excluded from the policy, which is due to enter into force on November 3.

To assess the impact this could have on future immigration, MPI considered the most accessible group: recent immigrants. To determine the health insurance status of adult green card holders in the United States in less than 2 years, the researchers analyzed data from a survey by the American Community (ACS) of the 2014-2016 Census Bureau using a unique MPI methodology that allows you to assign immigration status non-citizens.

These analyzes show that 65% of recent green card recipients do not have health insurance that is subject to the Trump rule, including 34% who do not have health insurance and 31% who have Medicaid or subsidized insurance that will not be considered in the policy.

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The effect may change over time if the market adjusts to it. For example, some insurers may decide to offer products specifically designed to meet their requirements. But if and until this happens, about 65% of arriving immigrants will not meet the requirements.

MPI ratings are for adults, not children. Minors are exempt from having to prove insurance coverage if they are the main applicants for a green card, as in the case of adoption or reunion with one of the parents in the United States after living with the other parent abroad. But children who come to the United States with their parents will be tested. Unlike adults, children can take the new test, demonstrating that they will be eligible for Medicaid in their intended state of residence (in most, but not all states, Medicaid is offered to children with green cards who have been in the United States for the first 5 years).

Rule Implementation Issues

The new rule was released with little warning and detail that would be hard to come by for a policy scheduled to be implemented in just a month. So it remains to be seen how future legal permanent residents will prove that they can find coverage within 30 days of arrival—a very short window given the complexity of health insurance options in the United States. It remains to be seen how much the rule will reduce overall immigration relative to changes in the mix of immigrant arrivals, given the backlog of nearly 4 million green card applications.

It may be easier for some: those who arrive on the basis of a job offer, which includes medical insurance; those joining a spouse whose private, unsubsidized health insurance plan will cover their needs; children or young people who are reunited with their parents whose unsubsidized plan will cover their needs.

For others, this insurance test may be more difficult. The easiest way for State Department officials to implement the new policy is a direct income test. Those with high enough incomes will be able to afford unsubsidized private insurance or pay predictable medical expenses; the same cannot be said for people with lower incomes.

Green card holders are eligible to purchase health insurance through the health insurance market under the Affordable Health Care Act (ACA) and are eligible for subsidies or tax benefits to cover insurance costs if their income is below 400% of the federal poverty line (below 49 960 dollars per person; 67 640 dollars per family of 2 people or 103 000 dollars per family of 4 people). But those who expect to receive subsidies or tax benefits will not meet the requirements of the new health insurance test.

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One strategy to overcome the new requirement is for immigrants to quickly purchase time-limited, individual health insurance plans that are available outside the ACA market and can last up to one year. Such plans, permitted under the rule, have become more accessible under the Trump administration. These plans have a lower premium, but often exclude pre-existing conditions or charge more, cover only part of the cost of medical care for subscribers. As a result, 12 states have restricted or banned these plans. Others have limited their duration to 3 or 6 months, which is too short to fit the requirements of the rule. In addition, it is not clear what level of income applicants will need to convince State Department consular officers that new immigrants can afford one of these plans.

Restrictions on restrictions

Trump's rule goes hand in hand with the new public charge rule and will result in denials for many immigrants who are able to meet these requirements. Under the Public Welfare Rule, which will govern green card applications filed on or after October 15, access to unsubsidized private health insurance coverage will be one of many factors considered in determining whether a person can become a "a burden on society" in the future. Other factors include age, income, assets, English language proficiency, education level, health status and past use of public benefits.

The new health insurance requirement creates an even stricter criterion, since it takes into account only one factor: the ability to quickly find insurance. It seems very likely that someone can pass the state exam, having demonstrated a relatively high level of education, good knowledge of the English language, age and other factors, and he will be denied access to the green card due to the new rule.

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Decree Immigration Management

Trump's rule will undoubtedly run into legal problems, since there are already 8 lawsuits filed against the government-secured persons rule, which have undergone much more discussion and a formal rule-making process than the new statement.

As with the “burden on public” rule, the new announcement represents an important step in the administration's efforts to limit family-based immigration and favor those entering the country with higher incomes. As with the Public Welfare Rule, the administration is seeking to fundamentally change the legal immigration system through executive orders rather than congressional action.

It seems that the new rule, issued without warning, clarity regarding implementation, early planning or consultation with key stakeholders, is a recipe for even more chaos in the already chaotic US immigration system, the publication notes.

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