The administration issued on October 4 a new proclamation, to go into effect November 3, ordering consular officers to inquire of potential immigrants whether they have access to medical insurance coverage or funds sufficient to cover “reasonably foreseeable medical costs.”

The requirement enacted here is that those seeking immigrant visas at consular posts abroad will be required to prove that they will be covered by “approved” health insurance (the proclamation lists several types of approved insurance, but specifically excepts Medicare or any subsidized plan) within 30 days of the foreign national’s entry into the United States on an immigrant visa, or unless the foreign national possesses the financial resources to pay for reasonably foreseeable medical costs.

It is unclear from the proclamation how one would document access to insurance within 30 days of entering the US on an immigrant visa what medical costs might be deemed “reasonably foreseeable.” There is talk in the document of the Department of State setting forth guidelines for implementation and enforcement, but these are unlikely to be ready for the November 3, 2019 effective date.  The section on implementation notes that those who use fraud or misrepresentation to overcome this ground shall be enforcement priorities for removal – a statement apparently at odds with the administration’s move to make anyone removable an equal priority (law-abiding parent as well as violent felon).

Several classifications of immigrant visa seekers are exempted from the requirement, including asylum applicants, certain classifications of children and juveniles, those obtaining immigrant visas before the effective date (essentially “grandfathering” those applicants), and a few other types of applicants.

The new proclamation can be viewed as an extension of the newer public charge rules – those implemented abroad by the Department of State some time ago and the more recent USCIS implementation for adjudications within the US – all claiming to ensure that those coming to the US are self-supporting.

This doesn’t appear to apply to applicants for nonimmigrant visas or those who already have green cards at this point.