Speaking at the White House signing ceremony for the Ryan White HIV/AIDS bill, Mr. Obama called the original legislation, “a decision rooted in fear rather than fact” and he challenged what he called the continuing “stigma” of HIV.
Lifting the ban, he said, is “a step that will encourage people to get tested and get treatment, it’s a step that will keep families together, and it’s a step that will save lives.”
History of the ban
The travel ban, in place since 1987, barred HIV-positive foreigners from obtaining permanent immigration status or entering the United States without special waivers. The United States is one of 12 nations, including Armenia, Iraq, Libya, Saudi Arabia and Sudan, that still deny entry to HIV-infected people.
The ban’s longevity has been the result of “misinformation and AIDS-phobia,” says Rachel Tiven, executive director of Immigration Equality, a legal advocacy organization based in New York.
Public health experts have similarly argued that the ban was outdated, reflecting an era when the threat of AIDS was poorly understood. A July CDC report argued that advances in epidemiology, as well as treatment, rendered the ban unnecessary.
“We’ve learned a lot since 1987,” said CDC spokeswoman Christine Pearson.
The move to lift the restriction was initiated last year, when Congress voted to remove language from the original 1987 law singling out HIV as a threat to public health. Presidents George H.W. Bush and Bill Clinton had earlier lobbied against the language to little effect.
That change opened the door for the Centers for Disease Control and Prevention to propose lifting the ban this past July. The move elicited more than 20,000 responses from the public, many of them positive, during a mandatory 45-day comment period.
Effects on travel and immigration
Over the course of the 20-year ban, some HIV-positive visitors were allowed to enter the United States, but only after demonstrating they had medication and health coverage, and successfully petitioning for the special waiver.
“All this was unevenly applied and often resulted in last-minute rejections,” Tiven says. “That’s why no major scientific conferences on AIDS have been held in the U.S. since 1987. It’s an embarrassment.”
Heidemarie Kremer, a trained physician and researcher who contracted HIV in 1988 while working as a medical student in Germany, has been in the United States since 2001 under a temporary visa for immigrants of “extraordinary ability.” Because of her infection, however, she had to continually reapply for special waivers.
Last March, when Kremer finally applied for a green card, a U.S. Citizenship and Immigration Services official told her that, though HIV rules would likely change by the end of the year, her waiver application would still be denied under the existing rules.
“That day, my whole life changed,” she said. “I kept thinking, what will happen to my kids?” she said. “What about my home and my friends?”
For now, Kremer can remain in the country until her court date later this fall, though her pro-bono legal team worries that she could still be deported, along with her children, back to Germany, despite Mr. Obama’s announcement.
“For Dr. Kremer and others like her, there is still much work to be done,” said Cristina Velez, a staff attorney with the HIV Law Project, which recruited Kremer’s legal team.
Kremer believes that the ban has stifled medical innovation, remarking that the reputation of the United States as a medical research powerhouse suffers when highly skilled, but HIV-positive, researchers cannot obtain short-term visas.
Some support for ban remains
While fear of an AIDS epidemic has subsided over the years, proponents of the ban continue to warn that allowing HIV-positive immigrants to settle in the United States could saddle public health agencies with excessive costs. The CDC estimates that lifting the ban would likely increase immigration by 4,300 people annually.
“With rising costs of health care being a heated political issue this year, a discussion of how this policy change may increase the burden on our health care system seems necessary,” according to a statement released in July by the Washington-based Center for Immigration Studies.
Last year, the Congressional Budget Office estimated that lifting the ban might cost the federal government $83 million over the next eight years, primarily in public health expenditures.
Tiven counters that these figures do not take into account the added revenue that HIV-positive immigrants would contribute as fully employed taxpayers.
Ban’s human cost
For those personally affected by the ban, however, bureaucratic wrangling over budgets and visas elide the human impact of twenty years of uncertainty, fear and frustration.
British-born Andrew Sullivan, a prominent political blogger for The Atlantic, is both openly gay and HIV-positive. He has lived in Washington, D.C. since the mid-1980s.
Despite being legally married in Massachusetts, his American-born husband cannot sponsor him for a green card because of the Federal Defense of Marriage Act. With today’s announcement, he will finally be able to apply for papers on his own.
An outspoken critic of the president’s delay on the ban, Sullivan reacted to this morning’s announcement on his blog with enthusiasm and relief: “For me, it is the end of 16 years of profound insecurity. I will be able to see my family again in England and know that my HIV will not force me to choose between my husband and the country I have come to call my home. There is no price to be put on that.”