New Healthcare Requirements for US Immigrants

[Nitas_man 3,100]

4 minutes ago, marko1111 said:

It would be relevant if I asked you or anyone else about my personal visa case but I didn’t I simply asked someone else who referenced something on the internet to post a link so I can read it myself but for some reason this is a problem.

It isnt a problem.  I just don’t post what I don’t agree with (and) I was commenting to boiler who is the only one in this thread who predates us.

Edited October 6, 2019 by Nitas_man

[USS_Voyager 1,972]

48 minutes ago, Nitas_man said:

If you are living here and either have no health insurance (or) your tax returns are showing that you are enjoying subsidized premiums then you might be looking at a problem.

Which is only possible because one President Donald J Trump eliminated the individual mandate of the ACA. Oh the irony. 

 

It would be funny if the next proclamation would  be to reinstate the individual mandate. 

 

So essentially Trump (and the Republicans) are saying: We’re ok if Americans don’t have insurance, but the shoeless immigrants must have insurance. My God, we were wrong about Trump all along, he IS pro-immigrant. Who would have known?

 

Sorry, been on vacation all week, haven’t fully caught up with the news yet.

 

 

[Nitas_man 3,100]

32 minutes ago, USS_Voyager said:

Which is only possible because one President Donald J Trump eliminated the individual mandate of the ACA. Oh the irony. 

 

It would be funny if the next proclamation would  be to reinstate the individual mandate. 

 

 

That’s kinda what he did.  Established the mandate, but for immigrants.

I thought that the mandate was great for everyone.

1 hour ago, geowrian said:

Beat me to it. These are 2 separate rules. One applies to AOS. The other applies to immigrant visas. Never mix DHS and DOS rules or you will get confused.

Aint that the truth

[USS_Voyager 1,972]

1 hour ago, Nitas_man said:

That’s kinda what he did.  Established the mandate, but for immigrants.

And ain’t that a kick in the nuts of Americans? The Trump Administration is saying: we do not give a (removed) if American people have insurance or not, but those shoeless shirtless immigrants MUST have insurance? 

 

I think this proclamation makes absolutely no sense whatsoever. If you follow their logic: an immigrant is required to have insurance or the ability to pay for medical costs until he/she achieve their ultimate goal which is becoming a citizen then he/she will be allowed to not have insurance. So all of a sudden, the worry about  “public charge” just disappears? 

Edited October 6, 2019 by Unlockable

[marko1111 12]

So if you were to show around 10k usd in your savings account would that be sufficient to get a green card prior to commiting to a insurance policy or is that an inadequate amount?

[wrath224 0]

So I've called about 6 different short term healthcare insurance companies and no one has been able to give me a policy that would cover 364 days as the new mandate states.

I totally plan to get my spouse on when we move together to the states (both live in Japan right now) but that's not possible until I'm in the states first?

If catastrophic plans are under the ACA those don't count right?

Healthcare wasn't an issue for me before because I was always going to obtain it through work, but now it seems it is 😕.

[Crazy Cat 41,852]

https://www.whitehouse.gov/presidential-actions/presidential-proclamation-suspension-entry-immigrants-will-financially-burden-united-states-healthcare-system/

"

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.  Hospitals and other providers often administer care to the uninsured without any hope of receiving reimbursement from them.  The costs associated with this care are passed on to the American people in the form of higher taxes, higher premiums, and higher fees for medical services.  In total, uncompensated care costs — the overall measure of unreimbursed services that hospitals give their patients — have exceeded $35 billion in each of the last 10 years.  These costs amount to approximately $7 million on average for each hospital in the United States, and can drive hospitals into insolvency.  Beyond uncompensated care costs, the uninsured strain Federal and State government budgets through their reliance on publicly funded programs, which ultimately are financed by taxpayers.

 

Beyond imposing higher costs on hospitals and other healthcare infrastructure, uninsured individuals often use emergency rooms to seek remedies for a variety of non-emergency conditions, causing overcrowding and delays for those who truly need emergency services.  This non-emergency usage places a large burden on taxpayers, who reimburse hospitals for a portion of their uncompensated emergency care costs.

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.  Notably, data show that lawful immigrants are about three times more likely than United States citizens to lack health insurance.  Immigrants who enter this country should not further saddle our healthcare system, and subsequently American taxpayers, with higher costs.

 

The United States has a long history of welcoming immigrants who come lawfully in search of brighter futures.  We must continue that tradition while also addressing the challenges facing our healthcare system, including protecting both it and the American taxpayer from the burdens of uncompensated care.  Continuing to allow entry into the United States of certain immigrants who lack health insurance or the demonstrated ability to pay for their healthcare would be detrimental to these interests."

[jasonlzak 173]

Big Donny is always known as a fighter fighting against big corporations by lining more money into their pockets. Yes he is pro-immigrant - rich immigrant.

[Nitas_man 3,100]

48 minutes ago, USS_Voyager said:

And ain’t that a kick in the nuts of Americans? The Trump Administration is saying: we do not give a (removed) if American people have insurance or not, but those shoeless shirtless immigrants MUST have insurance? 

 

I think this proclamation makes absolutely no sense whatsoever. If you follow their logic: an immigrant is required to have insurance or the ability to pay for medical costs until he/she achieve their ultimate goal which is becoming a citizen then he/she will be allowed to not have insurance. So all of a sudden, the worry about  “public charge” just disappears? 

This is what bothers me the most about this.

I do believe sponsors should insure their beneficiaries but I also believe everyone has a stake and the rules should be applied fairly and across the board.

Since it’s healthcare?  Yes, the mandate should (as it was) apply to everyone.

Edited October 6, 2019 by Unlockable

[Nitas_man 3,100]

2 hours ago, Jorgedig said:

Yup, agreed.  And just to clarify:  the elapsed time between POE and the date that his coverage on my plan began was only 15 days.  We felt comfortable relying on that interim travel plan for the short amount of time we did, as it would have only been needed in the event of an accident or acute illness.

I’m envisioning that this might be exactly what K1 entrants would be expected to do.

 

That new self-sufficiency form that has to be filed for AOS explicitly addressed health insurance so I believe that is the step where K1 visaholders would be expected to demonstrate coverage.

Usually those short term policies cover 90 days.  Marriage opens up joint enrollment.

No matter what, K1 or CR1, it is rare to not have a SS card within 90 days.

 

 

[geowrian 22,337]

Do I believe the rule is being implemented fro the wrong reasons? Yeah. YMMV

Do I believe the rule is actually good? Also yes. Again, YMMV.

It does annoy me that USCs and existing residents are not required to have coverage while new immigrants are, but that doesn't make the latter wrong either. The former is the issue IMO. Again, YMMV.

[Cilllah 476]

Alright, just gonna add the question here.

So even though this is a little annoying for myself I am totally fine with it because the only thing this leads to is myself and my daughter being covered for medical issues in the US.

 

But anyway, I am only at the NOA1 stage so far but I would like to know if my plan seems alright.

 

Enter on K1 visa with travel insurance that covers until marriage.
My partner is still on his parents insurance but this will drop off when we get married. He had medical issues so it made sense to stay on. So he will drop off then and get it through his work but his work doesn't have great insurance.
I am just going to buy market insurance myself to cover my daughter and I and have that completed prior to AOS interview. (unless his work is cheaper but we will see)

 

Then when I get my good job - basically applying for anything once I can work and I need to change my qualifications over to teach in SD (already contacted them about it) I will apply for a teaching job which I assume comes with decent insurance and I will leave the previous one and go with this one and if it is good I will be able to add my husband to it?

 

Or by that time he will have graduated and hopefully have a good job in his position too so if his insurance is better at his work we will go through that.

 

Sorry if it is a bit long winded but I just want to make sure I am understanding the process. 

[Crazy Cat 41,852]

42 minutes ago, Nitas_man said:

That new self-sufficiency form that has to be filed for AOS explicitly addressed health insurance so I believe that is the step where K1 visaholders would be expected to demonstrate coverage.

That is my thinking as well.  I expect to see a focus on having health care coverage as well as the public benefit issue examined at the AOS interview.  

[yuna628 9,676]

Hi all:

 

I know I typically answer health insurance related questions, and this once again has been a subject that has long fascinated me. I have been on vacation for a while, so I wasn't able to address this, so I'd like to point out some facts when it comes to the law, what this proclamation 'means', what the upcoming public charge rules mean (that I'd already commented on previously), and what options are available for immigrants.

 

As we know the law states the following:

 

The federal and state exchanges are opt in programs. Based on the SCOTUS ruling from long ago, it was made very clear that the government cannot compel someone to purchase a product - in this case health insurance. Because of this there was never a forced mandate. No person, USC or LPR can be forced to purchase health insurance if they do not want it. Again it is not the government's business to prevent us from making stupid choices. So if you don't want insurance you don't have to buy it, as of this date currently. I don't even see HHS making changes in this regard, and I don't see how they can because SCOTUS said they can't.

 

Furthermore according to the law, legal immigrants are still very much eligible to purchase health insurance through the exchanges. They are also eligible to purchase them even if they should have a subsidy. The subsidy, again, according to SCOTUS is not a means tested benefit. It is not a tax or tariff or fine (huge debate about this), it is a tax credit for a subsidy and those not paying into the system pay a penalty at the tax year, which was also effectively non-enforceable via SCOTUS. The person is paying into the system and certain individuals receive a break (just like there are many different types of tax credits) and if they were not paying in by direct purchase, they were paying in via the penalty. Of course the penalty is now removed, by this current administration. They could reinstate it, if they feel with grave concern people are 'scrounging' if they so choose to. Will they? Hmm.

 

The public charge rule, which is due to take effect in mid October( ??) had originally utilized some troublesome wording that would certainly endanger the legality of the public charge rule when it came to written law of the ACA and would almost certainly also run into severe Constitutional issues, especially when it was directed on a subject SCOTUS already ruled on. There were a lot of negative comments to this effect, and I believe that lawsuits would begin in full force. To this effect, these 'changes' were removed. However the new self sufficiency forms did want to know about health insurance - that having health insurance or not would be seen as a positive factor but not necessarily grounds for denial, as well as having private insurance vs those bought on the exchange would also be seen as positive weight.  Whatever that means. No mention however of being denied for buying insurance on the exchange (state or federal) with or without subsidy seemed to be clear to me, because had that language been in there would have certainly clashed with current federal law - which is why, I believe they omitted this.

 

The new proclamation makes the following assertions:

 

The lawful immigrants are more likely to not have health insurance. I have not seen any study to that affect that proves such a wild claim. Since the ACA was put into place coverage of both USCs and LPRs have certainly gone up. And.. furthermore there is no statistical evidence that a person who chooses to go without health insurance places a greater burden on the system. As per before; USCs and LPRs who do not have coverage usually do so for a variety of reasons. One may be that it is far too expensive, they feel they are young and healthy, or as many conservative publications noted the very wealthy and even some middle class chose to go without insurance willingly. They had enough out of pocket to cover the risk apparently, and the penalty was certainly cheaper afterall if you were willing to gamble.

 

Over the years, I have tried to answer health insurance questions to many confused couples that were afraid their status would be in trouble should they try to obtain any of the legal forms of health insurance available to them. This proclamation asserts that the following are acceptable:

 

1)Employer plans.

2)an unsubsidized plan via the exchanges

3) a private plan via a family member or purchased individually.

4) Tricare

5) short term plan. (Amusing as these are NOT ACA compliant plans, worthless junk, and I don't know any that would fit under the year-long term the proclamation asserts it should).

6) catastrophic coverage plan - also not really ACA compliant

7)Medicare (well this certainly would only apply to an LPR that has been here under the terms of 5 years or 40 quarters of work) I'm not sure under which class of visa this would immediately find eligibility under.

8) visitor insurance - also pretty laughable coverage.

 

Now when we think of a K1, it is a non-immigrant visa with dual intent. It is commonly processed through the immigrant unit, and usually leads to the ability to AOS after marriage. The wording does not make clear if this will apply to such unique visas during the consular interview. As before, I felt that it would certainly apply to those AOSing under the new self sufficiency rules, and it would seem that this change would too. We also know that of course, when a K1 is AOSing they are often stuck in a limbo period of being unable to work (and with approval times increasingly slower) for a significant amount of time - so this would negate the choice of an employer plan.

 

I have frequently noted another stumbling block to couples on here, is the lack of an SSN - or encountering a great deal of difficulty at obtaining one. Those of course, who AOSed off the VWP would have another unique stumbling block to obtaining one for some time. And I have seen delays even to those who came on spousal visas. The big problem I'm suggesting here is obvious and we've seen it all the time: couple encounters significant delay to obtaining health insurance CONTRARY to federal law when they do not have an SSN because of system screw up, lack of education on the part of the SSA employee or HR employee, or other such idiocy that is not usually the couple's fault. We know you do not have to have an SSN to obtain health insurance. It states this clearly. That does not mean there are a lot of idiots in charge that think they know better. There are some coupes (K1) unaware that they can obtain an SSN before they miss the window, or they are unable to get insurance within the SQE or OE period. There are also some who end up stuck in state-backlogs to obtain their marriage certificates, thus delaying AOS, and potentially delaying valuable proofs to offer when obtaining insurance.

 

In closing: This is a problematically worded proclamation that will have some legal challenges ahead. You cannot state that it is legal for someone to obtain something by their own free will under one federal law, and then say that it is illegal to obtain under another. You furthermore cannot do something contrary to what SCOTUS already ruled - that the individual mandate is... no individual mandate at all. That the ACA and it's subsidies are not a public means tested benefit. And that you cannot force someone with equal protection under the law to purchase a product against their will. Lawsuits will begin, and I believe there is some teeth to the argument.

 

I have said this before, we who sponsor our loved ones should be self sufficient in taking care of that individual. It is our responsibility as a decent and loving human being to think about what steps need to be made and how we will care for them in a country that is new to them. It is our responsibility to obtain them health insurance, ensure they have documents in order, and help them adjust to life here. Even though I used a cosponsor, I ensured we had savings, and made sure to add my husband to my health insurance as soon as possible. But our own laws state that we are not forced to buy health insurance, and that the government is not responsible for our poor choices. That is the whole argument against 'universal health care' and government involvement in our lives. If a person chooses to use the ACA, they are doing so of their free will, and are paying into the system one way or another, even if it is subsidized. It is rather rare for a subsidy these days anyway. Millions of Americans are subsidized and millions aren't. Still others have no insurance either because of the expense or bad circumstances have befallen them, or they are rich enough not to. I hold no ill will towards them.

 

It is good that a government is perhaps making sponsors aware that they should be taking more responsibility in the care of their loved ones - but when it comes to the language regarding the ACA... they're going to have a problem. Because of confusion and fear, I believe this will lead more immigrants and their families to run away from the exchange that they have a legal right to use. It will endanger lives and place greater financial strains. And it will be challenged in court making this an even greater quandary.

Edited October 7, 2019 by yuna628

[Nitas_man 3,100]

22 minutes ago, missileman said:

That is my thinking as well.  I expect to see a focus on having health care coverage as well as the public benefit issue examined at the AOS interview.  

I believe that absent adequate proof of overcoming the public charge requirement there won’t be an interview