Trump Insurance Standard Would Deny Majority Of Green Card Applicants

Report: Admin plan would cut annual immigration by 375,000

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October 10, 2019

Nearly 400,000 immigrants would be denied admission to the United States for failing to meet the Trump administration's new insurance requirements, according to an analysis from the nonpartisan Migration Policy Institute.

Using data on current immigrants, the MPI estimates that roughly 375,000 immigrants would be barred from entering the United States every year because of inadequate health insurance, which an executive order makes a precondition for admission. Green-card seekers would be particularly impacted. According to the analysis, 65 percent of recent green-card recipients lack qualifying health insurance—34 percent having no insurance and 31 percent using Medicaid or other insurance not qualified under the executive order.

The executive order issued in October is intended to limit the burden placed on the health care system by noncitizens. The administration said that immigrants play a large role in hospital deficits.

"Healthcare providers and taxpayers bear substantial costs in paying for medical expenses incurred by people who lack health insurance or the ability to pay for their healthcare," the order said. "While our healthcare system grapples with the challenges caused by uncompensated care, the United States Government is making the problem worse by admitting thousands of aliens who have not demonstrated any ability to pay for their healthcare costs."

The executive order prohibits the entry of any immigrant who cannot prove within 30 days that he or she is covered by "approved health insurance," or has "the financial resources to pay for reasonably foreseeable medical costs." The requirement excludes current visa holders, immigrants under the age of 18, asylum-seekers and refugees, and a handful of other categories.

At the same time, the MPI report shows, it would still mean excluding thousands of individuals who currently enter the United States each year without adequate health insurance. This status quo could change, however, if insurance companies begin to market products that meet the executive order's requirements to prospective immigrants.

"For example, some insurers could decide to offer skeletal products expressly designed to meet the requirements of the proclamation," the report reads. "But unless and until that happens, the 65 percent estimate for arriving immigrants represents the best estimate of those who would not meet the proclamation’s requirements."

The high rate of refusal under the new policy reflects the fact that noncitizens are substantially less likely to have health insurance than the citizen population. According to the U.S. Census Bureau, only 7 percent of native-born Americans lack insurance, compared to 19 percent of all foreign-born individuals—including naturalized citizens— and 29 percent of individuals who are not citizens. In other words, of the 25 million Americans who lack health insurance, 6 million (24 percent) are noncitizens.

The administration's new health insurance requirements are just part of a larger effort to ensure that would-be immigrants do not drain public resources. It follows the expanded implementation of the so-called public charge rule, which seeks to prohibit an individual from being admitted to the United States if he or she would draw substantially on public benefits. That rule is now the subject of a federal lawsuit ahead of its scheduled October 15 implementation date.

In its analysis of the public charge rule, MPI found that 69 percent of recent green-card recipients carry at least one "negative factor"—including being unemployed, lacking English proficiency, or having an income below 125 percent of the federal poverty line—under the administration's proposed public charge test. This reflects the widespread use of public benefits among the noncitizen population. MPI estimates that 47 percent of noncitizen households use at least one major cash or noncash taxpayer-funded benefit.