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Friday, February 5, 2010

Immigration Policies and Issues on Health-Related Grounds for Exclusion

Chad C. Haddal
Analyst in Immigration Policy

Ruth Ellen Wasem
Specialist in Immigration Policy

Under current law, foreign nationals not already legally residing in the United States who wish to come to the United States generally must obtain a visa and submit to an inspection to be admitted. They must first meet a set of criteria specified in the Immigration and Nationality Act (INA) that determine whether they are eligible for admission. Moreover, they must also not be deemed inadmissible according to specified grounds in the INA. One of the reasons why a foreign national might be deemed inadmissible is on health-related grounds. The diseases that trigger inadmissibility in the INA are those communicable diseases of public health significance as determined by the Secretary of Health and Human Services (HHS). 

The outbreak of the 2009 H1N1 virus (commonly called "Swine Flu") has generated attention in Congress and the media, particularly with its relationship to foreign travel. With Mexico also suffering high infection rates of this strain of influenza, questions have been raised on travel restrictions to the United States, particularly in regard to foreign nationals. Potential issues for Congress are three-fold: (1) are current health-related grounds for exclusion sufficient to ensure public safety in regards to contagious diseases; (2) would increased restrictions on foreign travel (even temporarily) inflict more economic harm than benefit; and (3) are the resources provided for frontline agencies charged with screening foreign travelers sufficient to identify potentially infected travelers? 

From an immigration standpoint, infectious disease outbreaks place the greatest procedural and resource pressures on Customs and Border Protection (CBP), an agency within the Department of Homeland Security (DHS). CBP is charged with screening admissions of all travelers at land, sea, and air ports of entry (POE), and CBP Officers screened approximately 409 million individuals in FY2008 for admissions into the United States. CBP works in conjunction with the Centers for Disease Control and Prevention (CDC) to monitor travelers and attempt to contain any diseases that may be spread by travelers coming from abroad. CDC, in conjunction with CBP, operates 20 quarantine stations and has health officials on call for all ports of entry. DHS has established its role in case of a pandemic outbreak through a memorandum of understanding with other agencies and in The National Strategy for Pandemic Influenza. 

Various federal statutes and legal questions may arise should a response to an influenza pandemic require limiting the use of transportation-related infrastructure, which includes, but is not limited to airports, seaports, and land ports of entry. Constitutional concerns, especially those related to the "right to travel" may also be implicated by decisions impacting transportation-related infrastructure. 

In recent years health-related grounds for exclusion has also been a congressional concern for other contagious diseases. In addition to the H1N1 outbreak, these diseases have included tuberculosis (TB). This report will be updated as circumstances warrant.


Date of Report: January 29, 2010
Number of Pages: 19
Order Number: R40570
Price: $29.95

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