[Congressional Record Volume 145, Number 128 (Tuesday, September 28, 1999)]
[Extensions of Remarks]
[Page E1983]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page E1983]]
                      INTERNATIONAL PATIENTS' CARE

                                 ______
                                 

                            HON. KEN BENTSEN

                                of texas

                    in the house of representatives

                      Tuesday, September 28, 1999

  Mr. BENTSEN. Mr. Speaker, today I am introducing legislation to 
address the time limitation placed on international patients and 
attending family members who remain in the United States while 
receiving medical treatment. I am grateful for the Texas Medical Center 
in Houston for bringing this important issue to my attention.
  Many international patients who obtain pre-arranged care in the 
United States require long-term medical treatment and lengthy hospital 
stays. However, a provision in the 1996 Immigration Reform Act 
instituted a time limit on ``voluntary departure'' status that has 
restricted health care facilities from providing sufficient care to 
some patients.
  Each year, hospitals and health care facilities across the United 
States provide prearranged treatment and health care assistance to more 
than 250,000 international patients, who come from many nations around 
the world. At the Texas Medical Center in Houston, more than 25,000 
international patients are seen each year. These patients come to the 
United States because of the high quality health care that is the best 
in the world.
  Since the 1996 immigration reforms were enacted, many medical patient 
visitors have entered the United States under the Visa Waiver Pilot 
Program, which allows a maximum 90-day stay. After 90 days, these 
patients and their attending family members are eligible to apply for 
voluntary departure, which allows an additional stay of 120 days. Upon 
completion of the 120 days, these individuals must request ``deferred 
action'' status, which allows them to stay in the United States for an 
extended period, but places them under illegal status. Consequently, 
these patients--whose lives are often dependent on return visits to the 
United States for further medical treatment--are barred from entering 
the United States from between 3 and 10 years.
  After I brought this issue to the attention of the INS and the 
Department of State, each agency has worked to strengthen their staff 
knowledge of medical patients, and to better screen prospective 
international patients at U.S. embassies and during inspections. 
However, due to the relaxed rules governing participation in the Visa 
Waiver program, many patients have continued to come to this country 
unaware of its strict length-of-stay restrictions.
  Mr. Speaker, I was a strong proponent of the immigration reforms 
passed by Congress and signed by the President in 1996. Overall, I 
believe these were tough, but needed reforms that cracked down on 
illegal immigration. I have worked closely with law enforcement 
authorities in my district to clamp down on illegal immigration, and I 
have supported legislative effors to provide the INS with the resources 
to safeguard the integrity of our borders while also holding the agency 
to high professional standards of law enforcement. In this case, 
though, I believe it is entirely appropriate to make a concession to 
the small number of itnernational patients who travel to the United 
States for life-saving treatment.
  The bill I am offering today would authorize a 3-year pilot program 
allowing the Attorney General to waive the voluntary departure 120-day 
cap for a very limited number of international patients and attending 
family members who enter the United States under the Visa Waiver 
program. It would implement a tough, restrictive process for these 
patients, to ensure that only those truly in need of long-term medical 
care could obtain such a waiver. This legislation would require these 
patients to provide comprehensive statements from attending physicians 
detailing the treatment sought and their anticipated length of stay in 
the United States. In addition, the patients would be required to 
provide proof of ability to pay for their treatment and the daily 
expenses of attending family members. This legislation would strictly 
limit the number of allowable family members and limit the total number 
of waivers to 300 annually. To safeguard against fraud and abuse, this 
legislation would require the INS to provide Congress with an annual 
status report detailing the number of international patients waivers 
allowed each fiscal year. Should the INS fail to release this data, 
Congress would be authorized to discontinue these waivers.
  In drafting this legislation, I consulted with the Texas Medical 
Center to determine an accurate, workable number of annual waivers for 
this legislation. After contacting a number of medical institutions 
throughout the United States, the Texas Medical Center estimated that 
approximately 1000 annual waivers will be needed to meet the total 
number of international patients who fall out of legal immigration 
status due to long-term health care needs. Despite this estimate, I 
believe 300 annual waivers will provide an adequate starting point to 
address this situation, while providing an appropriate safeguard 
against fraud and abuse.
  Mr. Speaker, I realize that there are many members who are hesitant 
to make changes to the immigration law Congress adopted in 1996. I know 
that I am loath to do anything more than a surgical fix to the 
underlying statutory scheme. However, I am convinced that the reforms 
enacted in 1996 were not intended to target nonimmigrant visitors who 
enter this country to receive preapproved, life-saving medical 
treatment. I believe we have an obligation to protect the status of 
legal, international patients who owe their lives to the high-quality 
medical care they receive in the United States. Working together, in a 
bi-partisan manner, we have taken great strides in strengthening our 
immigration laws. We should not allow our hard work to be diminished by 
the unintentional consequences of otherwise highly effective 
immigration reforms.
  I urge my colleagues to join me in supporting this important effort.

                          ____________________