On Friday, October 4, President Trump issued an unexpected proclamation ordering consular officials to bar immigrants seeking to live in the United States unless they "will be covered by approved health insurance" or can evidence they have the financial resources to pay for "reasonably foreseeable medical costs," expected to take effect on November 3.

The president's proclamation further stated that legal immigrants are three times as likely as U.S. citizens to lack health insurance, therefore creating a burden to taxpayers and hospitals in the United States. The proclamation relied on a Kaiser Family Foundation study, which found that 23 percent of legal immigrants were likely to be uninsured, compared with about 8 percent of American citizens.

The proclamation hails back to the RAISE Act, covered in our prior immigration alert, which proposed changes that could reduce annual legal immigration by 50 percent. While the RAISE Act did not gain traction, it appears that the Presidential Proclamation has taken care of this issue with reference to the administration's concern about immigrants entering the United States without assurance that they will be covered with their own health insurance. If immigrants attending consular appointments abroad cannot evidence that they intend to be covered by health insurance within 30 days of arriving in the United States, which can include health care through a job or coverage under a relative's insurance, their immigrant visas will be denied and entry to the United States as an immigrant will be foreclosed.

This proclamation parallels the recently enacted "public charge" rule, which covers applicants for adjustment of status and permanent residence in the United States. Adjustment of status applicants conferred with residence in the United States will also be required to demonstrate their ability to maintain themselves economically through a detailed demonstration of self-sufficiency documentation. This requirement, unless delayed by court order, is scheduled to take effect on October 15.

For immigrant visa applicants who are employer-sponsored, it is likely that insurance will be provided through their employer, but many adults immigrating to the United States sponsored by family members are likely to be denied green cards under the proposed executive order.

There are already preliminary steps in place to assure that those immigrating to the United States through consular processing have already undergone medical examinations, security checks and are beneficiaries of affidavits of support from appropriate U.S. sponsors.

It is expected that the proclamation will be challenged in the courts, as have many prior presidential proclamations including the asylum ban and security ban earlier in the administration's tenure.