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1. George Washington University Study 2. K-1 Fiancee and K-3 Visas (Update Regularly!) |
| GWU STUDY FINDS THAT WELFARE AND IMMIGRATION REFORM LAWS IMPAIR IMMIGRANTS' LEGITIMATE USE OF MEDICAID AND HEALTH CARE SERVICES George Washington University Researchers Say Study Results Point to the Need for Better Training of INS Hearing Officers on the Issue of Medicaid and Public Charge The ability and willingness of immigrants to access Medicaid and health care services have been adversely affected by the enactment of the 1996 welfare and immigration reform laws according to the results of a study released today by the Center for Health Services Research and Policy (CHSRP) at The George Washington University Medical Center (GWUMC) School of Public Health and Health Services (SPHHS). "It is clear from our research that immigrants too often are either excluded from benefits they desperately need or don't access benefits for which they are eligible out of fear that it will adversely impact their immigration status," noted Kathleen A. Maloy, JD, PhD, the study's principal investigator and Associate Research Professor at GWUMC SPHHS. One significant barrier identified by the study is the fear that an immigrant's legitimate use of Medicaid will jeopardize that immigrant's ability to become a legal permanent resident or US citizen. The Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) of 1996, one of the two laws whose impact the researchers examined, established certain procedures for determining the admissibility of immigrants and the INS later issued a clarification related to the issue of Medicaid use and public charge. "Despite the federal clarification about public charge-which stated that any use of Medicaid (except long-term care) and CHIP would not by itself subject an immigrant to the risk of being labeled a public charge-we frequently heard reports in our research that immigration lawyers are advising their clients not to use Medicaid in order to avoid any risk of problems," noted Dr. Maloy. "There is a clear sense among both immigrants and immigration attorneys that the INS' own staff, especially hearing officers, are not aware of or are not following this policy and instead punishing immigrants for using Medicaid." "These findings highlight the critical need for a major initiative by immigration advocates and lawyers to push the INS to better communicate its policy internally and to better train hearing officers so that immigrants' rightful use of Medicaid is no longer a threat to residency or citizenship status," said Maloy. Maloy and other researchers talked with 225 immigrants in four major cities who reported numerous barriers to accessing Medicaid and frequent need to delay or forego care. The researchers found two general categories of barriers to access: 1. barriers related to immigrant status and the 1996 laws, including fear of the INS, concerns about public charge, and changed eligibility criteria; and 2. barriers related to their vulnerable and low-income population status, including culture and language, inaccessible locations for applying, complex application procedures, and inability to pay for health care services. The study, entitled "Effect of the 1996 Welfare and Immigration Reform Laws on Immigrants' Ability and Willingness to Access Medicaid and Health Care Services, was designed to investigate concerns that the combined effects of IIRIRA and the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) would reduce immigrants' legitimate use of Medicaid and health care. The study was conducted at four sites in: Chicago, IL; Metropolitan Washington, DC; San Diego, CA; and Brownsville, TX. "We concluded that the implementation of the 1996 laws increased the uninsured population, exacerbated demands on the safety net, and heightened fears about using Medicaid," commented Sara Rosenbaum, JD, Director of the CHSRP and Harold and Jane Hirsh Professor of Health Law and Policy. PRWORA established new, complex eligibility rules for public benefits for legal immigrants and made several categories of previously eligible legal immigrants ineligible for most federal public benefits. The law created more uninsured US residents by denying Medicaid access to previously eligible post-enactment legal permanent residents. The result has been additional strains on the provider safety net, making access to care more difficult for all groups of the uninsured-citizens and immigrants alike. The researchers recommendations for how federal and state officials and policymakers can address the health care access problems faced by immigrants include: 1. improve outreach and education efforts to clarify scope of public charge, and include a particular focus on INS staff at all levels and immigration attorneys; 2. simplify Medicaid application procedures; 3. improve and establish systematic outreach and education efforts about who is eligible for Medicaid; 4. address the cultural and linguistic barriers to accessing Medicaid and health care services; 5. provide more support and financial assistance to safety net providers; 6. provide more support for public health outreach and education to vulnerable populations; and 7. expand Medicaid out-stationed and alternative enrollment locations. "It is noteworthy," stated Dr. Maloy, "that most of the recommendations are not unique to immigrants but would be part of strategies to improve Medicaid enrollment and/or expand access to health care for citizens and noncitizens alike." The study was funded by The Robert Wood Johnson Foundation as part of the Foundation's commitment to funding research examining the impact of welfare reform on access to Medicaid and health care services. The study is available on-line at www.gwu.edu/~chsrp under "What's New" or can be ordered by calling the Center for Health Services and Policy, The George Washington University Medical Center School of Public Health and Health Services at 202-530-2337. Founded in 1824, The George Washington University Medical Center is a nationally recognized, interdisciplinary academic health care center comprising the University Hospital, the GW Medical Faculty Associates, the School of Medicine and Health Sciences, the School of Public Health and Health Services, and the GW Health Plan. To learn more about the GW Medical Center, visit www.gwu.edu . The GWUMC School of Public Health and Health Services (SPHHS) is the only School of Public Health in the nation's capital and the first school to formally combine public health and health services. SPHHS offers dynamic research, education, and service programs through five departments: Environmental-Occupational Health, Epidemiology-Biostatistics, Health Services Management and Policy, International Public Health, and Prevention and Community Health. The SPHHS' Center for Health Services Research and Policy conducts sponsored research and policy analysis on complex health policy issues. Capitalizing on the unique resources and environment created by its location in Washington, DC, the Center identifies, monitors, and analyzes emerging issues in federal health law and policy and evaluates the impact of changing federal policies on states, communities, and the health care system. Back to Top |
| State Department Cable on V and K Visa Processing(January 30, 2001) K3 Visas 1. The LIFE Act expands the criteria for "K" visas beyond status for fiances of U.S. citizens. Under LIFE, a new K3 status is created for spouses of U.S. citizens. According to a joint memorandum from the Senate Subcommittee on Immigration, the K3 visa is not intended to be a prerequisite for the admission of U.S. citizens' spouses. It is meant to be a speedy mechanism for the spouse of a U.S. citizen to join that U.S. citizen spouse and obtain the immigrant visa/status in the United States, rather than wait for long periods of time outside the United States. 2. The LIFE Act stipulates that K3 visas may be issued to those who are able to demonstrate that they have concluded a valid marriage with a U.S. citizen and who are the beneficiaries of an I-130 petition filed with INS. The K3 visa allows these spouses to enter the United States to await INS approval of the I-130 petition. 3. K3 issuance may further depend on INS approval of some type of petition for non-immigrant status filed in the United States by the U.S. citizen petitioner, the exact nature of which has not yet been determined by INS. 4. For those couples married outside the United States, the non-immigrant K3 visa must be "issued by a consular officer in the foreign state in which the marriage was concluded," according to the LIFE Act. This means that K3 visa processing must be available in all countries. For those regions where IV processing for several countries is centralized in one of the countries, it will be necessary to make an exception for K3 applicants and process them locally. In these circumstances, some NIV sections which do not normally process IV cases will be required to add K3 processing to their workload. For those countries where IV processing is centralized in one of the posts within the country, it will be left to the posts to determine if all posts will process K3 applicants or whether the K3 applicants will be centralized in the designated IV-issuing post in the country. 5. An unmarried child of a K3 applicant only needs to demonstrate that he/she is the child of an alien entitled to K3 status in order to obtain a K4 visa. No petition filed on the child's behalf is required. 6. Unlike the V visa classification, the K3 visa is a permanent addition to the list of NIV categories. Under the LIFE Act, an alien spouse of a U.S. citizen who is the beneficiary of a classification petition filed under section 204 of the INA before, on, or after the date of enactment of the LIFE Act is eligible for K3 classification. Documentary Requirements 7. Applicants for both V and K3 visas will be processed with similar documentary requirements as those for K1 fiance visa applications. They will need to undergo the standard IV medical examination by a panel physician. An NCIC namecheck will be done by NVC for each applicant. The applicants will need to present local police certificates. At the time of interview, applicants will be expected to present evidence of family relationship to the petitioner. 8. In addition, applicants are subject to Section 212(a)(4) and must demonstrate to the satisfaction of the consular officer an ability to overcome public charge considerations. Evidence might be a letter from the petitioner's employer, a job offer for the applicant, or evidence that the applicant will be self-supporting in the United States, or anything else. The I-864 cannot be required. The I-134 affidavit of support may be required when the consular officer deems it useful. NVC Sends Information on V Visa Availability to ELIGIBLE Applicants 9. Because the NVC stores files for F2A cases that are not yet current for processing, NVC can confirm an applicant's eligibility for V processing for those applicants whose files are at NVC. In mid February, NVC will begin sending an information/instruction sheet to those applicants with INS-approved F2A petitions in storage at NVC. The goal of this mailing is to provide the means for applicants to identify themselves to posts as eligible for V visa application. The letter will briefly outline the documentary requirements for the V visa and instruct the applicant to contact the post. Applicants will be directed to posts' websites for telephone numbers and addresses. This will be the only mailing to V applicants from NVC; no Packet 3s or 4s will be sent by NVC. 10. It will be left to posts' discretion to determine how to proceed with scheduling and processing applicants, whether by the usual Packet system, the so-called Packet 3.5, or through some other means created by post to meet the needs of these applicants and balance the equities among post's clients. 11. In contrast to the usual IV procedures, NVC will send neither an electronic file nor the paper file to posts. All files will remain at NVC. Successful V applicants will enter the United States and remain in non-immigrant status until an immigrant number is available, however long this might take. They will then be eligible to adjust status with INS in the United States, and at that time, INS may need to retrieve the file from NVC. As V classification is not meant to be the final legal status in the United States, it is preferable to leave the files at NVC until the applicant contacts INS to adjust status rather than ship files to post for V processing only to have posts return them intact after issuance. Confirming Eligibility for V and K3 Status 12. For V visa processing, CA/EX/CSD is working on a method using CLASS to verify that a non-current F2A petition case file is at NVC. Names of eligible dependents from the original I-130 petition will be included. An independent database for use by offsite scheduling contractors is also under consideration. 13. The list of verified applicants will include only those applicants for whom INS has approved and forwarded the petition to NVC. These are the only cases for which the Department can provide verification that a petition was filed with INS. VO is working with INS to come up with procedures for posts to verify petition filings for any case not yet approved by INS. There is no estimate of how many cases this might entail. 14. For K3 visa applicants, INS holds the original I-130 petitions. The Department and INS are trying to work out an arrangement for posts to verify these petition filings and meet the intent of Congress. Until such an arrangement is worked out, posts cannot begin processing K3 cases. Place of Application 15. V visas will be processed only at current IV-issuing posts. Where IV processing is currently centralized, those IV-issuing posts will be responsible for all V visa matters for all countries for which they process IVs. V applicants must apply at the consular post designated as the processing post in the underlying I-130 petition. Posts will process only those V applicants who are resident in their consular districts or for IV centralized regions, for those resident in their region. For example, non-resident TCN applicants will not be able to apply for V visas at the border posts. 16. According to the language in the LIFE Act, K3 applicants will apply at the visa-issuing post in the country where they were married. Aging Out Cases 17. F2A applicants who aged out prior to the enactment of the LIFE Act are not eligible for V issuance. The V visa provision of the LIFE Act refers only to those who are beneficiaries of petitions to accord status under Section 203(a)(2)(A) of the INA. Eligibility for V status requires that the petition be filed on or before December 21, 2000, but also that three years have elapsed since the filing of the petition and that an immigrant visa is not immediately available because of a waiting list of applicants for visas under INA Section 203(a)(2)(A). 18. Applicants whose petitions were filed before December 21, 2000 but who age out while waiting for the mandatory three years waiting period since petition filing date, do not qualify for V visa issuance. Their cases will automatically revert to F2B status under INA Section 203(a)(2)(B). 19. All applicants for both V2 and K4 visas who are children will be required to sign a form apprising them that entering into a marriage prior to admission into the United States or prior to obtaining adjustment of status will render them ineligible for adjustment as an F2A immigrant visa applicant. Validity and Fee for V and K3 Visas 20. There is no additional processing fee for V or K3 visa application or issuance. Both will pay only the standard $45.00 MRV fee. There are no separate reciprocity fees involved with these visas. 21. Unless constrained by security clearance requirements or other waivers which are valid for a year or less, the validity of V1 and K3 visas will be ten years for all applicants from all countries, multiple entries. However, unmarried children of V1 and K3 applicants may receive multiple entry visas valid only until they reach the age of 21 years. V visas should be annotated with the priority date to aid INS inspectors at POE in determining in the future whether V status continues to be appropriate. Processing Priorities 22. The underlying purpose of the LIFE Act is to reunite families that have been or could be subject to long separation during the process of immigrating to the United States. Those who might benefit from the LIFE Act are those spouses and children for whom an immigrant visa is not immediately available, whether due to processing delays or lack of availability of a visa number, despite the petition having been filed. 23. Following this, when posts eventually begin handling this new caseload, it will be important that posts process these cases as quickly as possible without further adding to the delays that prompted Congress to legislate the provisions of the LIFE Act in the first place. Posts should first handle IV cases that are current for processing and for which visa numbers are available. The second priority should be V1 and K3 applicants and their children. The Department realizes that this will probably constrain non-immigrant visa processing which will be relegated to a third place priority. CA has informally advised congressional staffers that other NIV applicants may be disadvantaged as poAts accommodate V and K3 applicants because there is no surge capacity to enhance visa operations overseas in the short term. 24. Posts can not rpt not issue a V or K3 visa until authorized to do so by the Department in septel. Department is presently asking conoffs to begin planning for V and K3 visa issuance along the lines noted above. We will provide further details on datashare, INS plans, and other issues as they become available.Back to Top |
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