President Trump signed a proclamation late Friday barring legal immigrants who cannot prove they will have health care coverage or the means to pay for it within 30 days of their arrival to the United States.
Trump said uninsured individuals are a burden on the health care industry and U.S. taxpayers.
"Immigrants who enter this country should not further saddle our health care system, and subsequently American taxpayers, with higher costs," Trump declared.
Beginning Nov. 3, only immigrants covered by approved health insurance or those who can show they can pay for "reasonably foreseeable medical costs" will be allowed entry into the U.S.
The announcement affects immigrants applying for visas from overseas. It doesn't apply to non-citizen children of U.S. citizens. Refugees and asylum-seekers are also exempt.
However, it would apply to the spouses and parents of U.S. citizens and the immediate family members of lawful permanent residents.
"This new attempt at an immigration ban is as shameless as it is stunning," tweeted Doug Rand, a former Obama administration official who is the co-founder of Boundless Immigration. "It will be chaotic to implement and guaranteed to separate U.S. citizens from their legal immigrant spouses and other close relatives."
The proclamation is the latest effort by the Trump administration to limit the number of low-income immigrants coming to the United States. The administration also plans to make it harder for immigrants to get green cards if they use a wide range of public benefits. That new rule is set to take effect this month, although it is facing legal challenges.
Under the proclamation signed Friday, the required insurance can be purchased individually or provided by an employer, and it can be short-term coverage or catastrophic.
Medicaid doesn't count. And an immigrant will not be able to obtain a visa if using the Affordable Care Act's subsidies when buying insurance. Those subsidies are paid for by the federal government.
"While lawful immigrants qualify for ACA subsidies, they'll be stuck in a catch-22 because subsidized coverage does not qualify as insurance under the proclamation," tweeted Larry Leavitt, executive vice president for health policy at Kaiser Family Foundation, a health care policy think tank.
The White House said in a statement that too many non-citizens were taking advantage of the country's "generous public health programs," and said immigrants contribute to the problem of "uncompensated health care costs."
According to the Migration Policy Institute, a nonpartisan immigration think tank, 57 percent of U.S. immigrants had private health insurance in 2017, compared with 69 percent of U.S.-born, and 30 percent had public health insurance coverage, compared with 36 percent of native-born.
The uninsured rate for immigrants dropped from 32 percent to 20 percent from 2013 to 2017, since the implementation of the Affordable Care Act, according to Migration Policy.
The new proclamation is expected to face legal challenges.
"If this policy survives the inevitable court challenges and is implemented, it will create a new and arbitrary hurdle for some half a million green card applicants each year," Rand, the former Obama administration official, told NPR. "Consular officers will deny the parents of U.S. citizens based on a snap judgment about their apparent health. U.S. citizens will be separated from their husbands and wives abroad based on a failure to demonstrate health insurance coverage or a subjective level of wealth."
NPR and the Associated Press contributed to this report.
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