Karen Tumlin

On October 30, 2019, Karen Tumlin and a coalition of lawyers filed a challenge to a new condition on immigrant visas. They had four days before it was scheduled to take effect. Tumlin and Esther Sung of Justice Action Center joined Stephen Manning and Nadia Dahab of Innovation Law Lab, Sidley Austin lawyers and other partners in representing families facing decisions about interviews, waivers and separation.

President Trump had issued Proclamation 9945 on October 4. Beginning at 12:01 a.m. on November 3, specified immigrant-visa applicants would have to satisfy a consular officer that approved health insurance would cover them within thirty days after entry, or that they could pay reasonably foreseeable medical costs. The proof was due before the visa could issue, although the coverage itself could begin after arrival.

John Doe #1 relied on his wife to care for him and their son. He was disabled and had undergone heart surgery. If her November 6 interview in Mexico ended in a visa denial and revocation of the provisional waiver supporting her return, he faced losing that care. On November 1, the family asked to postpone the interview.

Brenda Villarruel and Gabino Soriano Castellanos postponed his November 5 interview as well. Years of processing and separation had brought them close to a decision, but the approved insurance plans appeared unavailable or unaffordable. His family and tattoo customers were waiting for him in Chicago.

Eight Named Routes

The proclamation named eight principal forms of coverage: an employer-sponsored plan, an unsubsidized individual-market plan, short-term limited-duration insurance, catastrophic coverage, a family member’s plan, specified military coverage, qualifying visitor insurance and Medicare. It also permitted other plans the health secretary deemed adequate.

Employer coverage depended on getting a job and completing any waiting period. Juan Ramon Morales already had insurance, but his plan required a Social Security number before it could add his wife. Her immigrant visa would make that next step possible; he could obtain no guarantee that coverage would begin within thirty days. She had undergone emergency brain surgery and continued to suffer seizures, making the price and exclusions of alternative plans consequential.

The proclamation accepted an unsubsidized Affordable Care Act plan while excluding coverage purchased with premium tax credits. Congress had expressly made those credits available to lawfully present immigrants. A family could therefore qualify for assistance buying insurance that would not satisfy the new entry condition.

Short-term and visitor policies could exclude preexisting conditions or limit benefits. Some states restricted short-term coverage. Catastrophic plans generally depended on lawful presence and age; Medicare generally required age and years of United States residence. Each category brought its own eligibility rules to an interview held before admission.

Applicants with sufficient financial resources could qualify without insurance. Existing visa holders, nonimmigrant travelers, certain children and national-interest admissions were exempt; asylum, refugee status, withholding of removal and Convention Against Torture protection were outside the rule. Tumlin and her co-counsel represented applicants who remained subject to the condition and could not establish either qualifying coverage or the necessary resources.

The Care a Spouse Would Provide

For Jane Doe #3, insurance and reunion were inseparable. She was disabled and covered by Medi-Cal; her husband, an architect and teacher in Germany, had multiple sclerosis. His treatment was expensive, and neither his employment in the United States nor coverage within thirty days could be assured before he arrived. The couple could not afford to bridge that uncertainty with cash or an approved policy.

Iris Angelina Castro had left her teaching job when her son became ill. Pregnant while her husband remained in the Dominican Republic, she contacted insurers and received quotes she could not afford for plans that offered incomplete coverage. The husband awaiting admission was also the person she needed for emotional, physical and financial support.

Blake Doe, a college senior sponsoring his parents, investigated insurance with his attorney. Premium quotes were $2,500 or more a month. His father’s employer offered no insurance, and neither parent could join Blake’s student plan or his wife’s employment plan. His parents already lived in Oregon; the obstacle arose in securing immigrant visas through the consular process.

The effects also reached Latino Network, a plaintiff alongside the families. Its immigration navigator postponed intake interviews, workshops and ordinary referrals to answer questions about the proclamation. Other staff moved away from early-childhood programs, and the organization anticipated nearly $14,000 in unbudgeted research and training costs. The lawyers could show harm already occurring while the new rule was still awaiting its effective date.

A Second Test Beside Public Charge

Tumlin and her colleagues challenged the authority to impose this additional condition. Congress had organized immigrant visas around family, employment, humanitarian and diversity categories. Its public-charge inquiry required consideration of age, health, family status, assets, resources, financial status, education and skills. The plaintiffs argued that a separate insurance requirement displaced those choices, including Congress’s provision of premium tax credits.

The proclamation expressly made its review separate and independent from other statutes, regulations and proclamations. The government defended that approach under section 1182(f), which authorizes the President to suspend or restrict entry after finding that a class would be detrimental to United States interests. It relied on Trump v. Hawaii: regulating a subject Congress had addressed was insufficient to invalidate a restriction; the plaintiffs needed to establish a direct statutory contradiction.

On the government’s reading, Congress had delegated broad entry authority without expressly withdrawing it for health-insurance or healthcare-cost restrictions. Difficulty obtaining a listed plan, or disagreement with the policy’s economic premises, would not by itself defeat that authority.

For immediate protection, the plaintiffs also had to establish likely success on the merits and irreparable harm, with the equities and public interest favoring an injunction. They submitted expert evidence about immigrant healthcare use and whether the restriction addressed the costs offered to justify it. The family declarations supplied the consequences of allowing the policy to operate while those questions were litigated.

Before 12:01 A.M.

Judge Michael Simon entered a temporary restraining order on November 2, hours before the proclamation was to take effect. On November 26, he issued a nationwide preliminary injunction. His analysis found likely success in the challenge to presidential authority and separation of powers: the new condition added an admissibility test beside Congress’s public-charge framework.

The court also credited the prospect of prolonged family separation, lost waiver protection and financial or medical harm that later relief could not repair. During the litigation, consular officers would continue deciding admissibility under the ordinary visa rules, without applying the proclamation’s additional insurance condition.

The nationwide order addressed a consular instruction operating across the visa system and the need for uniform administration. The government objected to universal relief before class certification and asserted institutional and financial harm from keeping its policy on hold. For Tumlin’s team, preserving emergency protection now meant defending both the injunction and the breadth of the representation.

Two Nationwide Subclasses

The lawyers sought certification of two subclasses under Rule 23(b)(2): sponsors in the United States and otherwise eligible foreign visa applicants whose applications were subject to the proclamation. Both definitions turned on inability to demonstrate qualifying coverage or resources to the consular officer’s satisfaction.

Soriano Castellanos received his visa at a rescheduled interview on January 28, 2020. The government argued that his individual relief left the Visa Applicant Subclass without a representative. In their March 9 surreply, the plaintiffs’ lawyers invoked the exception for claims too transitory to receive class review before ending. Simon agreed: a consular interview and visa decision could resolve an individual’s claim before the court ruled on certification, while the same condition continued to confront others.

On April 7, Simon certified both nationwide subclasses. He narrowed the sponsor definition by replacing people who “will soon file” a petition with people who currently had or would have an approved or pending petition. Membership would turn on an actual petition to sponsor a family member.

The government’s objections to standing, commonality, typicality and adequacy included the contention that different financial circumstances would create conflicts. The court found a common challenge to one policy and claims typical of the people it affected. With the proclamation expected to reach tens or hundreds of thousands of immigrants, the record also supported the required showing that joining every class member individually would be impracticable.

Under Rule 23(g), the court appointed Tumlin and Sung, Manning, Dahab and Tess Hellgren, Scott Stein and Kevin Fee, and Jesse Bless as class counsel. Tumlin’s work now carried a formal responsibility to the two nationwide subclasses as well as the named families.

Two Appellate Panels

In May 2020, Chief Judge Sidney Thomas and Judge Marsha Berzon denied the government’s request to stay the injunction. They found no showing of irreparable government harm and credited the injuries to families and others. Judge Daniel Bress dissented, defending the proclamation’s legality and the Executive’s institutional interests and objecting to nationwide relief. Naomi Igra and Esther Sung argued for the plaintiffs; Tumlin continued on the appellate team.

A different panel heard the merits in September, with Tacy Fletcher Flint presenting the argument for the classes. On December 31, Judge Daniel Collins’s majority reversed the preliminary injunction. Applying Trump v. Hawaii, it concluded that section 1182(f) permitted additional entry restrictions and that overlap with public-charge law or marketplace subsidies did not establish a statutory contradiction.

The majority emphasized that applicants could establish coverage beginning within thirty days without necessarily purchasing it before entry. The financial-resources alternative, exceptions and periodic review also mattered to its assessment of the proclamation’s reach and limits.

Judge A. Wallace Tashima dissented. He viewed the insurance condition as overriding Congress’s multifactor public-charge inquiry and family protections, excluding subsidized coverage Congress had authorized, and bearing an uncertain relationship to the healthcare costs invoked to support it.

Revocation Before Finality

The plaintiffs sought rehearing en banc. While that request was pending, President Biden revoked Proclamation 9945 on May 14, 2021. His Proclamation 10209 said the restriction did not advance United States interests and rejected excluding lawful immigrants who lacked substantial financial means or insurance from a restrictive list. Agencies were directed to review the rules, guidance and policies developed under it.

The plaintiffs then sought vacatur of the appellate opinion. On July 16, the Ninth Circuit vacated its December decision, remanded with instructions to vacate the November 2019 preliminary injunction as moot, and denied rehearing en banc as moot. Revocation had ended the challenged policy; vacatur removed the merits opinion’s precedential force and required the injunction to be set aside.

The district docket was terminated in November 2021. In 2026, the Ninth Circuit clarified that vacating the merits opinion had not revived the earlier stay ruling as binding authority. The policy had ended without a surviving merits precedent resolving the judges’ competing interpretations of presidential power.

Who May Set the Conditions

Tumlin remains Founder and Director of Justice Action Center, working on immigrants’ rights, family reunification, DACA, temporary protected status and constitutional litigation. In Doe #1, she and her co-counsel brought employers’ enrollment rules and families’ medical needs into a national dispute over who could set the conditions for a family’s reunion.

Responding to a Supreme Court decision on birthright citizenship in June 2026, she made her view of presidential limits explicit: “presidents do not get to rewrite the Constitution or decide which babies count as American.”