“Confirmed Judges, Confirmed Fears” is a blog series documenting the harmful impact of President Trump’s judges on Americans’ rights and liberties. Cases in the series can be found by issue and by judge at this link.

With Trump judge Daniel Collins casting the deciding vote, a divided Ninth Circuit panel upheld a Trump administration immigration order that overrides the Affordable Care Act (ACA) and other federal laws. The December 2020 decision in Doe v. Trump allows the administration to exclude immigrants who might “financially burden” the U.S. health care system.

In October of 2019, President Trump issued a proclamation restricting entry of immigrant visa applicants who cannot demonstrate that they will either (1) acquire health insurance other than from a subsidized state health insurance plan within 30 days or (2) have the ability to pay for reasonably foreseeable health care expenses. A district court quickly enjoined enforcement of the order. In December 2019 and again in May 2020, a divided Ninth Circuit panel (different from the one in the new opinion) denied the administration’s motion to let the rule go into effect while the case was litigated, both times over the objection of Trump judge Daniel Bress. The result of that litigation is the new Ninth Circuit decision that Judge Collins authored and cast the deciding vote on.

The ACA makes lawfully-present immigrants eligible for subsidized insurance plans, but coverage by those plans does not count as acceptable health care coverage under the Trump proclamation. Collins wrote that the ACA provision only addresses immigrants who are “lawfully present,” while the Trump order addresses a different group: people applying for a visa so they can become lawfully present.

In dissent, Judge A. Wallace Tashima noted that the majority’s reasoning assumed that prospective immigrants would be able to satisfy the Trump proclamation’s insurance requirement without relying on the ACA, an assumption at odds with the district court’s finding, based on the evidence, that the Trump-approved plans were “unavailable” to prospective immigrants. The Trump order was “antagonistic” to “any reasonable understanding” of Congressional intent underlying the ACA. Tashima explained that the order overrides the ACA because “it strains credulity to suggest that Congress intended to authorize the President to undermine its own policy judgments.”

Similarly, Collins claimed that the Trump rule is consistent with the congressional Public Charge Rule, in which Congress specifically listed a variety of factors that must be considered in determining that an immigrant would be inadmissible as a “public charge.” His majority opinion considered the Trump proclamation as setting a new grounds for inadmissibility that was separate from the “public charge” portion of the Immigration and Naturalization Act. But Tashima’s dissent pointed out that Congress specifically told immigration officials how to determine if someone should be considered inadmissible due to their financial condition, and that the Trump proclamation “plainly overrides” that congressional policy judgment.