Capitol Correspondence - 10.14.19

President’s Proposal to Tie Immigration to Health Insurance Concerns Employers

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Politico Pulse’s reporting on President Trump’s new proposal to make the receipt of a visa to enter the United States contingent on the ability to purchase health insurance is deeply relevant to the disability community. That is because roughly a quarter of the overall direct care workforce, which includes Direct Support Professionals (DSPs), is comprised of immigrants – reflecting a staggering workforce crisis in disability supports which is leaving many positions vacant with no local workers applying. ANCOR is working on an immigration visa proposal which might also be affected by this new Administration priority.

Politico Pulse reported:

“The president’s Friday night move to deny visas to immigrants unless they purchase health insurance or prove they can pay for health care was condemned by advocates who say the measure is hard-hearted.

Immigrants also wouldn’t be able to use government assistance — like Obamacare’s subsidies — to meet the requirement. That makes it a ‘catch-22’ for immigrants who would likely need that support in order to obtain coverage and come to America, says the Kaiser Family Foundation’s Larry Levitt.


— And it could add pressure to health care delivery. More than 2 million U.S. health workers were foreign-born in 2015, with most working as health aides, techs or in other low-wage support positions. It’s not clear how many of those workers would have qualified for visas under Trump’s proclamation, even as the need for health support workers has boomed as the U.S. population ages.”

Politico Pro supplemented this information by reporting that “Officials who oversee the nation’s health insurance markets have privately raised concerns that President Donald Trump’s recent mandate requiring visa-seekers to prove they can get health insurance may be unworkable and even illegal, according to three individuals with knowledge of the deliberations.


Officials inside the Center for Consumer Information and Insurance Oversight are confused about numerous aspects of the proclamation, such as whether implementing the new health insurance requirements would fall to them or the State Department, and have huddled in multiple meetings this week about how to address outstanding questions. Trump’s new requirements also would not be subject to the notice-and-comment process of rulemaking, which health officials believe could be illegal and would spark lawsuits.”

Readers interested in seeing the overall effects of the proposal on immigration to the U.S. might find analysis the non-partisan Migration Policy Institute shared on Twitter informative. A more easily readable version is available on ThreadReader.