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September 26, 2017

New Trump 'travel ban' eases restrictions on health providers—but concerns remain, AAMC says

Daily Briefing

    President Trump on Sunday issued a proclamation that extends and expands his recently expired "travel ban," but eases restrictions for individuals from affected countries who hold visas commonly used for medical education.

    Trump's previous travel ban, which expired Sunday, sought to ban the issuance of new visas for 90 days to individuals—with no exception for health care providers—from Iran, Libya, Somalia, Sudan, Syria, and Yemen, and to suspend refugee entry from all countries for 120 days. 

    The ban faced multiple lawsuits and is currently before the Supreme Court, which was asked to consider whether Trump's order violated federal law. The 4th U.S. Circuit Court of Appeals had ruled the travel ban violated the First Amendment's ban on government establishment of religion, and the 9th U.S. Circuit Court of Appeals had ruled that the order exceeded the authority Congress had granted the executive office regarding immigration law.

    Supreme Court arguments on the matter were scheduled to begin next month, but the high court postponed arguments following Trump's proclamation.

    Details of the new travel ban

    Trump's proclamation revised and expanded the number of countries that face travel restrictions for the United States from six to eight:

    • Chad;
    • Iran;
    • Libya;
    • North Korea;
    • Somalia;
    • Syria;
    • Venezuela; and
    • Yemen.

    The restrictions vary by country, the Washington Post reports. For instance, the ban completely bars travelers—including health care providers and potential medical students—from North Korea and Syria, but the restrictions for individuals from Venezuela apply only to certain government officials and their families. The White House said the proclamation takes into account the "unique conditions and deficiencies" in the affected countries' vetting processes and "tailor[s]" the restrictions accordingly.

    The new restrictions will take effect Oct. 18 and last indefinitely. A senior administration official said the new policy is not intended to be in place forever, describing it as "necessary and conditions-based, not time-based."

    Individuals from the affected countries who already have visas or who are lawful permanent residents of the United States are exempted from the proclamation. The proclamation also includes a list of potential case-by-case exceptions to the new restrictions, including individuals in need of "urgent medical care."

    Possible effects on health care industry

    While earlier versions of the travel ban led to concern from health care industry stakeholders that medical students and providers would be prohibited from entering the United States, the revised ban partially addresses those concerns, experts said.

    Educational Commission for Foreign Medical Graduates (ECFMG) Assistant Vice President Elizabeth Ingraham in March told the Daily Briefing that the J-1 or H-1B visas are the two most common visa classifications used by foreign national physicians who wish to enter U.S. residency training.

    The latest proclamation excludes individuals travelling under those visas from six of the eight affected countries—Iran, Libya, Somalia, Venezuela, and Yemen—meaning such individuals will be able to enter the United States, according to Inside Higher Ed. However, those from Iran and Somalia will be subject to heightened screening.

    Association of American Medical Colleges President and CEO Darrell Kirch in a statement Monday although the proclamation "eases restrictions on individuals from most of the previously affected countries who hold visas commonly used for medical education and training, and includes education, professional training and urgent medical need as potential grounds for waivers … highly qualified aspiring and practicing physicians and scientists may still face barriers to entry, including potentially inconsistent waiver decisions."

    Kirch continued, "To address this concern, medical schools and teaching hospitals urge the administration to make categorical exceptions for medical students, medical residents, physicians, and scientists as well as those attending medical and scientific conferences in the United States."

    SCOTUS cancels arguments

    According to the Times, Trump's new proclamation essentially renders moot the cases challenging Trump's earlier executive order. As such, the Supreme Court justices on Monday canceled upcoming arguments on the matter and asked lawyers representing all involved parties to submit briefs by Oct. 5 on how the high court should proceed.

    According to the Times, immigration law experts are split on whether the proclamation is legal. Some experts said the proclamation has a greater chance of being upheld in court because it takes into account the affected countries' security and vetting procedures. Leon Fresco, who worked in the Department of Justice's Office of Immigration Litigation under former President Barack Obama, said, "It's very likely that the court will hold that the new measure contains the type of rigorous analysis and measured policy choices necessary to pass constitutional muster."

    In contrast, others said the proclamation is more vulnerable to legal challenges than Trump's original order. Peter Margulies, a law professor at Roger Williams Law School in Rhode Island, said the new policy "undermines the structure and purpose" of federal immigration law.

    Justin Cox, a staff attorney at the National Immigration Law Center, said the new proclamation "continue[s] to injure" some of the plaintiffs in cases currently challenging the ban.

    According to the Post, some advocates have vowed to continue challenging the restrictions (Savage/Tanfani, Los Angeles Times, 9/25; Barnes/Barrett, Washington Post, 9/25; Chappell, "The Two-Way," NPR, 9/25; Zapotosky et al., Washington Post, 9/25; Redden, Inside Higher Ed, 9/26).

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