March 16, 2017

Judges block travel ban affecting foreign medical residency applicants

Daily Briefing

    Two federal judges have issued rulings that temporarily block President Trump's recent executive order that bans the issuance of new visas for 90 days to individuals from Iran, Libya, Somalia, Sudan, Syria, and Yemen.

    On Wednesday, the day before the order was set to go into effect, federal judges in three separate cases heard challenges to the order. A federal judge hearing the case in Hawaii was the first to temporarily block the order, followed early Thursday morning by a second judge in Maryland. U.S. District Judge James Robart, who heard the third challenge in Seattle, has not yet issued a ruling.

    Background: Executive order could affect medical residency applicants

    The new order, which was set to take effect at 12:01 a.m. Thursday, is different in several respects from one issue­d Jan. 27 that was later put on hold by the 9th U.S. Circuit Court of Appeals. It would not apply to anyone who already is in the United States legally or who has a valid visa, and it no longer would restrict travel from Iraq specifically. The order still would suspend refugee entry from all countries for 120 days.

    The Association of American Medical Colleges last week said about 500 people had applied for medical residency in the United States from the six nations and could be directly affected by the new order's 90-day ban.

    Educational Commission for Foreign Medical Graduates (ECFMG) Assistant VP Elizabeth Ingraham said that foreign nat­ional physicians who wish to enter U.S. residency training "must have a contract for a U.S. residency position" before they can start the visa application process. The order would have taken effect March 16, one day before Match Day, when applicants for medical residency in the United States find out whether and where they are placed in residency.

    Because most U.S. residency positioned are obtained through the National Resident Matching Program, Ingraham said, "most physicians who obtain a 2017 residency position and need an appropriate visa status cannot begin to apply for one" until March 17 at the earliest, at which point the new order is scheduled to block the issuance of visas to individuals from the six countries.

    Ruling details

    On Wednesday, U.S. District Court Judge Derrick Watson in Hawaii issued a nationwide temporary restraining order against provisions in the order that affected refugees and the issuance of new visas to individuals from the six affected countries on the grounds that it impermissibly targeted travelers on the basis of their religion.

    Watson described as "flawed" the government's defense that, as Watson summarized it, "the executive order cannot be found to have targeted Islam because it applies to all individuals in the six referenced countries." He added, "It is undisputed, using the primary source upon which the government itself relies, that these six countries have overwhelmingly Muslim populations that range from 90.7 percent to 99.8 percent."

    In a separate decision published Thursday morning, U.S. District Judge Theodore Chuang in federal court in Maryland issued a narrower preliminary injunction that blocked the order's visa provision. Chuang said the plaintiffs had "not provided a sufficient basis" for him to declare the other sections invalid.

    Chuang refuted DOJ's defense that the ban was necessary for national security, citing Trump's comments regarding Muslims during the presidential campaign.

    "These statements, which include explicit, direct statements of President Trump's animus towards Muslims and intention to impose a ban on Muslims entering the United States, present a convincing case that the First Executive Order was issued to accomplish, as nearly as possible, President Trump's promised Muslim ban," Chuang wrote. He added, "In this highly unique case, the record provides strong indications that the national security purpose is not the primary purpose for the travel ban."

    Any appeals against the rulings would need to consider each ruling separately, the Washington Post reports.

    DOJ, Trump reaction

    The Justice Department said it strongly disagreed with the ruling in the Hawaii case and that the executive order Trump issued "falls squarely within his lawful authority in seeking to protect our nation's security."

    Speaking at a rally in Nashville on Wednesday, Trump said he was prepared to take the case to the Supreme Court (Zapotosky, Washington Post, 3/16; Jarrett, CNN, 3/16; Gerstein, Politico, 3/15; Levine/Rosenberg, Reuters, 3/16; Carter, Seattle Times, 3/15).

    Navigating the first 100 days of the Trump administration

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    Since Donald Trump won the presidential election in November, health care reform has since quickly risen to the top of the GOP's policy agenda—and heath care executives are grappling with a new sense of uncertainty.

    While many unknowns will remain across the next few months and potentially even years, the first 100 days of the Trump administration will provide significant insight into the direction of reform efforts. Read our briefing to learn what five key issues you should watch.

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