On Oct. 4, President Donald Trump signed a new “Presidential Proclamation on the Suspension of Entry of Immigrants Who Will Financially Burden the United States Healthcare System,” which goes into effect Nov. 3 and affects most immigrant visa applicants. This Presidential Proclamation is separate from the Public Charge Rule, which is on hold in the U.S. due to a court injunction, and its implementation at U.S. Consulates has been delayed by the Department of State.

According to the new Presidential Proclamation, with very small exceptions including refugees and asylees, applicants for immigrant visas will need to present evidence to the consular office “to the consular officer’s satisfaction” at the time of their immigrant visa interview that they will be covered by approved health insurance within 30 days of entering the U.S. or that they have enough financial means to pay for “reasonably foreseeable medical costs.” The Presidential Proclamation asserts that “lawful immigrants are about three times more likely than United States citizens to lack health insurance.

The DOS has updated its website with instructions on how they will be implementing the new rules for all immigrant visa applicants with interviews on or after Nov. 3 (See https://travel.state.gov/healthcare). The Department of State has advised that inability to meet this requirement will result in the denial of the visa application and further indicated on its website that “Officers will review the medical and financial documentation that is already part of the applicant’s case file and may request additional information or documentation as needed.” Therefore, prior to the visa interview, applicants may wish to review costs and eligibility requirements for approved health insurance plans or consider how they would pay for the reasonably foreseeable medical costs of any current medical condition they may have.

Approved health insurance, as indicated in the Presidential Proclamation, includes employer-sponsored health plans, including retiree plans; unsubsidized health plans offered in the individual market within a State; short-term, limited duration health plans effective for a minimum of 364 days or until the beginning of planned, extended travel outside the United States; catastrophic plans; coverage by a family member’s health plan; U.S. military health plans, including TRICARE; visitor health insurance plans with adequate medical coverage for a minimum of 364 days or until the beginning of planned, extended travel outside the United States; medical plans under the Medicare program; any other health plan with adequate coverage as determined by the Secretary of Health and Human Services. For individuals over the age of 18, approved health insurance does not include coverage under the Medicaid program.

According to Law360, two Senate Democrats have urged President Trump to stop this proclamation from going into effect. Like the Public Charge Rule, the Presidential Proclamation may become the subject of litigation. However, as of the publication of this blog post, the Presidential Proclamation is still scheduled to go into effect on Nov. 3, and applicants should be prepared to bring to the interview evidence that they will be covered by approved health insurance upon arrival in the U.S. or that they have enough means to pay for “reasonably foreseeable medical costs.” As such, applicants may seriously consider carrying a copy of their recent bank statements showing enough income to cover medical costs in the U.S. or a copy of their health insurance card and information about their health insurance policy confirming that their plan provides adequate coverage.

As we are still unsure how consular offices will be handling the new rule, and it is solely at the U.S. Consular Officer’s discretion to determine if the applicant has enough financial means to pay for any “reasonably foreseeable medical costs” or that the applicant will in fact be covered by a health insurance within 30 days of arriving in the U.S., immigrant visa applicants are well-advised to consider carrying evidence of coverage with them, even if they think they might be exempt from this rule.