[Congressional Record Volume 146, Number 93 (Tuesday, July 18, 2000)]
[House]
[Pages H6377-H6380]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   INTERNATIONAL PATIENT ACT OF 2000

  Mr. SMITH of Texas. Mr. Speaker, I move to suspend the rules and pass 
the bill (H.R. 2961) to amend the Immigration and Nationality Act to 
authorize a 3-year pilot program under which the Attorney General may 
extend the period for voluntary departure in the case of certain 
nonimmigrant aliens who require medical treatment in the United States 
and were admitted under the visa waiver pilot program, and for other 
purposes, as amended.
  The Clerk read as follows:

                               H.R. 2961

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``International Patient Act of 
     2000''.

     SEC. 2. THREE-YEAR PILOT PROGRAM TO EXTEND VOLUNTARY 
                   DEPARTURE PERIOD FOR CERTAIN NONIMMIGRANT 
                   ALIENS REQUIRING MEDICAL TREATMENT WHO WERE 
                   ADMITTED UNDER VISA WAIVER PILOT PROGRAM.

       Section 240B(a)(2) of the Immigration and Nationality Act 
     (8 U.S.C. 1229c(a)(2)) is amended to read as follows:
       ``(2) Period.--
       ``(A) In general.--Subject to subparagraph (B), permission 
     to depart voluntarily under this subsection shall not be 
     valid for a period exceeding 120 days.
       ``(B) 3-year pilot program waiver.--During the period 
     October 1, 2000, through September 30, 2003, and subject to 
     subparagraphs (C) and (D)(ii), the Attorney General may, in 
     the discretion of the Attorney General for humanitarian 
     purposes, waive application of subparagraph (A) in the case 
     of an alien--
       ``(i) who was admitted to the United States as a 
     nonimmigrant visitor (described in section 101(a)(15)(B)) 
     under the provisions of the visa waiver pilot program 
     established pursuant to section 217, seeks the waiver for the 
     purpose of continuing to receive medical treatment in the 
     United States from a physician associated with a health care 
     facility, and submits to the Attorney General--

       ``(I) a detailed diagnosis statement from the physician, 
     which includes the treatment being sought and the expected 
     time period the alien will be required to remain in the 
     United States;
       ``(II) a statement from the health care facility containing 
     an assurance that the alien's treatment is not being paid 
     through any Federal or State public health assistance, that 
     the alien's account has no outstanding balance, and that such 
     facility will notify the Service when the alien is released 
     or treatment is terminated; and
       ``(III) evidence of financial ability to support the 
     alien's day-to-day expenses while in the United States 
     (including the expenses of any family member described in 
     clause (ii))

[[Page H6378]]

     and evidence that any such alien or family member is not 
     receiving any form of public assistance; or

       ``(ii) who--

       ``(I) is a spouse, parent, brother, sister, son, daughter, 
     or other family member of a principal alien described in 
     clause (i); and
       ``(II) entered the United States accompanying, and with the 
     same status as, such principal alien.

       ``(C) Waiver limitations.--
       ``(i) Waivers under subparagraph (B) may be granted only 
     upon a request submitted by a Service district office to 
     Service headquarters.
       ``(ii) Not more than 300 waivers may be granted for any 
     fiscal year for a principal alien under subparagraph (B)(i).
       ``(iii)(I) Except as provided in subclause (II), in the 
     case of each principal alien described in subparagraph (B)(i) 
     not more than 1 adult may be granted a waiver under 
     subparagraph (B)(ii).
       ``(II) Not more than 2 adults may be granted a waiver under 
     subparagraph (B)(ii) in a case in which--

       ``(aa) the principal alien described in subparagraph (B)(i) 
     is a dependent under the age of 18; or
       ``(bb) 1 such adult is age 55 or older or is physically 
     handicapped.

       ``(D) Report to congress; suspension of waiver authority.--
       ``(i) Not later than March 30 of each year, the 
     Commissioner shall submit to the Congress an annual report 
     regarding all waivers granted under subparagraph (B) during 
     the preceding fiscal year.
       ``(ii) Notwithstanding any other provision of law, the 
     authority of the Attorney General under subparagraph (B) 
     shall be suspended during any period in which an annual 
     report under clause (i) is past due and has not been 
     submitted.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Smith) and the gentlewoman from Texas (Ms. Jackson-Lee) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Texas (Mr. Smith).


                             General Leave

  Mr. SMITH of Texas. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks and to include extraneous material on H.R. 2961.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. SMITH of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I am pleased to bring to the floor H.R. 2961, the 
International Patient Act of 2000, a bill introduced by our colleague, 
the gentleman from Texas (Mr. Bentsen).
  Aliens who seek to visit the United States temporarily for business 
or pleasure are admitted to the United States under ``B'' visas. B-1 
business visas are initially valid for up to 1 year and can be extended 
in increments of not more than 6 months each. B-2 visas are initially 
valid for up to 1 year and can also be extended in increments of not 
more than 6 months.
  The visa waiver program allows aliens traveling from certain 
countries to come to the United States as temporary visitors for 
business or pleasure without having to obtain ``B'' visas. However, a 
visit cannot exceed 90 days and no extensions are available.
  The Attorney General can authorize an alien admitted under the visa 
waiver program who faces an emergency situation to remain in the United 
States for 120 days beyond the initial 90-day admission under voluntary 
departure. While the 210-day period provided by the initial 90-day 
admission and the 120 days under voluntary departure is adequate to 
deal with most emergency situations, it does not meet the need of a 
relatively few aliens who are admitted to the United States under the 
visa waiver program and are receiving long-term medical treatment.
  H.R. 2961 would address this problem by establishing a 3-year pilot 
program authorizing the Attorney General to waive the 120-day cap on 
voluntary departure for a limited number of patients and attending 
family members who enter the U.S. under the visa waiver program.
  The legislation contains safeguards to ensure only those truly in 
need of long-term medical care can obtain such a waiver.
  An alien seeking a waiver would be required to provide a 
comprehensive statement from their physician detailing the treatment 
sought and the alien's anticipated length of stay in the United States.
  In addition, the alien and attending family members would be required 
to provide proof of their ability to pay for the treatment and their 
living expenses.
  The bill caps the total number of waivers at 300 annually and limits 
the number of family members who can enjoy the benefits of a waiver.
  The bill also requires the INS to provide Congress with an annual 
report detailing the number of waivers granted each fiscal year and 
provides for the suspension of the Attorney General's authority if an 
annual report is past due.
  The only change made to the bill from the version reported by the 
Committee on the Judiciary is that the starting date of the 3-year 
pilot program is advanced to October 1, 2000.
  H.R. 2961 is drafted to meet the compelling needs of international 
medical patients without creating any undue risk or abuse.
  I urge my colleagues to support this bill.
  Mr. Speaker, I reserve the balance of my time.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I want to thank the chairman for moving this legislative 
initiative along and, as well, the chief sponsor of this legislation, 
my colleague, the gentleman from Texas (Mr. Bentsen), for his 
insightful leadership on this very, very important issue.
  This bill is an excellent compromise for a very harsh provision that 
the INS had in place that really did damage to those individuals who 
needed important and urgent medical help. And so this particular 
legislation allows for the discretion of the Attorney General to extend 
the stay of many who are securing important medical health or other 
urgent matters. It allows this country to be a nation of laws as well 
as a nation with humanity.
  So again, Mr. Speaker, I thank you and I thank my colleague because 
this particular legislation would create a 3-year pilot program under 
which the Attorney General would have the discretionary authority to 
waive the 120-day limit on grant of voluntary departure. I think that 
this, as I said earlier, is a good idea. Aliens entering the United 
States temporarily for prearranged, personally financed medical 
treatment generally are admitted as nonimmigrant visas.
  If eligible, they may do this under the visa waiver pilot program. 
This program allows aliens traveling from certain designated countries 
to come to the United States as temporary visitors without having the 
immigration documentation normally required to enter the United States.
  In many instances, these particular visitors are coming on emergency, 
needing a heart transplant or needing an organ transplant or having a 
devastating disease.
  Visitors entering under the visa waiver program are admitted for 90 
days, after which they become deportable. What a crisis if they happen 
to be in the midst of their recuperation or their physician has 
indicated that they cannot travel or they need to be under the medical 
facility.
  The Illegal Immigration Reform and Immigrant Responsibility Act of 
1996 created the 120-day limit on voluntary departure grants. It is 
harsh and unreasonable to have a limit on this privilege that operates 
without regard to the circumstances of the alien's situation.
  This bill would correct this problem with respect to aliens who are 
in the United States under the visa waiver program and need additional 
voluntary departure time for medical treatment.
  An infinite number of unexpected problems can occur, particularly 
during a visit to a foreign country. For instance, the alien may have 
to stay beyond the additional 120-day period while waiting for 
assistance from his consulate office on a legal matter, such as dealing 
with a car accident and determining the time that they should leave or 
that all legal matters have been handled.
  This bill is needed to prevent people from being departed who have 
serious medical conditions.
  Coming from a community that has in it one of the most outstanding 
medical centers in the Nation housed in the 25th Congressional 
District, that of my colleague and sponsor of this bill, the

[[Page H6379]]

gentleman from Texas (Mr. Bentsen), we are aware of the international 
responsibilities that our medical center has taken on in providing care 
for so many of those who have come to seek help to extend their lives 
and to then live quality healthy lives.
  It is aptly named the International Patient Act because it allows 
visitors from around the world to temporarily remain in the United 
States to seek medical treatment. It really puts the United States in 
the context of which we want to be known, that of a world leader, that 
of a country of laws, as I indicated, but a country that is a great 
humanitarian or views humanity in the sense of being sensitive to their 
need.
  Therefore, Mr. Speaker, I do support this legislation and would hope 
that we would be able to have our colleagues pass this legislation to 
ensure that others may be protected.
  Mr. Speaker, the bill proposed by my colleague from Texas, 
Congressman Bentsen, would create a three-year pilot program under 
which the Attorney General would have discretionary authority to waive 
the 120-day limit on grants of voluntary departure. I think this is a 
good idea.
  Aliens entering the United States temporarily for prearranged, 
personally financed medical treatment generally are admitted as 
nonimmigrant visitors. If eligible, they may do this under the Visa 
Waiver Pilot Program. This program allows aliens traveling from certain 
designated countries to come to the United States as temporary visitors 
without having the immigration documents normally required to enter the 
United States. Visitors entering under the visa waiver program are 
admitted for 90 days, after which they become deportable.
  The Illegal Immigration Reform and Immigrant Responsibility Act of 
1996 (``IIRIRA'') created the 120-day limit on voluntary departure 
grants. It is harsh and unreasonable to have a limit on this privilege 
that operates without regard to the circumstances of the alien's 
situation.
  The bill would correct this problem with respect to aliens who are in 
the United States under the visa waiver program and need additional 
voluntary departure time for medical treatment.
  An infinite number of unexpected problems can occur, particularly 
during a visit to a foreign country. For instance, the alien might have 
to stay beyond the additional 120-day period while waiting for 
assistance from his consulate office on a legal matter such as dealing 
with a car accident.
  This bill is needed to prevent people from being deported who have 
serious medical conditions. It is aptly named the International Patient 
Act because it allows visitors from around the world to temporarily 
remain in the United States to seek medical treatment. I support this 
legislation.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1100

  Mr. SMITH of Texas. Mr. Speaker, I reserve the balance of my time.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I yield such time as he may 
consume to the gentleman from Texas (Mr. Bentsen).
  (Mr. BENTSEN asked and was given permission to revise and extend his 
remarks.)
  Mr. BENTSEN. I thank the gentlewoman for yielding me this time.
  Mr. Speaker, today the House considers H.R. 2961, the International 
Patient Act, bipartisan legislation which I introduced at the request 
of several of the institutions of the Texas Medical Center in my 
congressional district 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 to the 
Texas Medical Center in Houston for bringing this important issue to my 
attention. I am also grateful to the gentleman from Texas (Mr. Smith) 
and the gentlewoman from Texas (Ms. Jackson-Lee) for their assistance 
in putting this legislation together and bringing it to the House 
floor.
  Many international patients who obtain prearranged care in the United 
States require long-term medical treatment and lengthy hospital stays. 
However, a provision in the 1996 Illegal Immigration Reform and 
Immigrant Responsibility 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 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, Texas, 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 U.S. under the visa waiver 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, quote, ``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 to 10 years.
  After I brought this issue to the attention of the Immigration and 
Naturalization Service 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 the 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 efforts 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 international patients who travel to the United 
States for lifesaving treatment.
  The bill I am offering today would authorize a 3-year pilot program 
allowing the U.S. 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 U.S. under the visa waiver 
program. It would implement a tough, restrictive process to 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 
persons 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 and a number of its member institutions to determine an 
accurate, workable number of waivers for the bill. After contacting a 
number of medical institutions throughout the United States, the Texas 
Medical Center estimated that approximately 1,000 annual waivers would 
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 the 300 annual waivers provided for in 
this bill will provide an adequate starting point to address this 
situation and provide an appropriate safeguard against fraud and abuse, 
and additionally will give us the information necessary should this 
have to be reviewed in the future.
  Mr. Speaker, I realize there are many Members who are hesitant to 
make

[[Page H6380]]

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 the 
country to receive preapproved, lifesaving 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 bipartisan manner, we have taken great strides 
in strengthening our immigration laws. We should not allow our hard 
work to be diminished by the unintended consequences of otherwise 
highly effective immigration reforms.
  I urge my colleagues to join me in supporting this important effort. 
Once again I want to thank the gentleman from Texas (Mr. Smith) and the 
gentlewoman from Texas (Ms. Jackson-Lee) for their assistance on this 
bill.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  I would like to again congratulate my colleague from Texas. He has 
worked very hard on this legislation. I would only offer to say that we 
hope that the visa waiver program that is intimately connected to this 
legislation can be passed by the United States Senate so that we can 
move this legislation along. Additionally, I think it is very important 
that as we look at the provisions in this legislation that there are 
300 allowances, that we have the opportunity to review it and maybe 
move the numbers up to cover the great need for people to receive 
medical care.
  Ultimately, I think we will have to come to this floor and fix many 
elements of the 1996 immigration reform law to prevent mandatory 
detention and other problems that have been with that legislation. I 
hope this is the first step.
  I congratulate the author of this legislation. I would ask my 
colleagues to support it.
  Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.
  Mr. SMITH of Texas. Mr. Speaker, I have no further requests for time, 
and I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Isakson). The question is on the motion 
offered by the gentleman from Texas (Mr. Smith) that the House suspend 
the rules and pass the bill, H.R. 2961, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________