Trump issued a proclamation, effective Nov. 3, ordering consular officers to bar immigrants seeking to live in the United States unless they “will be covered by approved health insurance” or can prove that they have “the financial resources to pay for reasonably foreseeable medical costs.”

In the proclamation, Trump justified the move by saying that legal immigrants are far more likely than U.S. citizens to lack health insurance, making them a burden on hospitals and taxpayers in the United States.

“The United States government is making the problem worse by admitting thousands of aliens who have not demonstrated any ability to pay for their health care costs,” he wrote, adding, “immigrants who enter this country should not further saddle our health care system, and subsequently American taxpayers, with higher costs.”

The surprise order is the latest step in a long effort by Stephen Miller, the president’s top immigration adviser, and others in the administration, to limit what they consider the financial burdens of allowing immigrants into the United States.

After years of effort by Miller, the administration issued a regulation in August that would allow officials to deny permanent legal status to immigrants who are poor. The regulation, which imposes an aggressive wealth test on legal immigrants, has been delayed because of several legal challenges.

Under that policy, known as the “public charge” rule, immigrants seeking to live permanently in the United States could be denied if officials deem it is likely they will be a burden on society by, for example, being unable to pay for health care or seeking food and housing assistance.

Under the new proclamation, which was earlier reported by The Wall Street Journal, officials are directed to use a similar approach in determining whether to grant immigrant visas to people seeking to live in the United States.

Immigration advocates were taken aback by the proclamation, noting there are already several steps applicants for a green card must take to qualify, including passing background checks and health examinations.

“This president is grasping for straws on how to reduce legal immigration,” said Elizabeth Jamae, an immigration lawyer at Pearl Law Group in San Francisco. “These policies are not stifling illegal immigration. They are stifling legal immigration of workers who contribute to the economy.”

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