Comment on FR Doc # E8-23485

The CDC has indicated that this rule will not affect medical examinations of aliens in the U.S. A plain language reading of section 212(a)(1) of the Immigration and Nationality Act, and 42 C.F.R. 34.1, 34.3(a)(1), do not support this conclusion. Even so, this rule would create a dangerous precedent, perhaps one that the CDC did not intend to happen. The CDC is creating a double standard: an alien in the U.S. with a newly identified disease would not be found inadmissible but an alien overseas with the same disease would be found inadmissible. Such a conclusion does not support the intent of the immigration and public health laws. Aliens in the U.S. are no less of a danger to the public health. Rather, they are more of a danger as they are already in the U.S. This rule would, among other things, encourage aliens to avoid overseas medical examinations and to find ways to illegally enter the U.S. This rule does not address the issue of what the CDC and USCIS could or would do if an alien in the U.S. had a newly identified disease. The CDC and USCIS must be ready, able and willing to deal with such a consequence. Avoidance of the issue would threaten public health. The best approach to this issue would be to apply the same standards to medical examinations performed overseas and those in the U.S. Whether aliens are overseas or in the U.S., the threat to public health is no different. If the CDC truly intends to limit this rule to overseas medical examinations, then it should revise 42 C.F.R. 34 to clearly differentiate between overseas medical examinations and to those in the U.S. Currently, 42 C.F.R. 34.3(c) contradicts the Immigration and Nationality Act and 42 C.F.R. 34.1, 34.3(a)(1). For medical examinations in the U.S., the CDC should include an additional regulation to allow civil surgeons to discretionarily screen for newly identified diseases. If this is not feasible, then the additional regulation should provide guidance if an alien in the U.S. has a newly identified disease. While it may not be a common scenario now, it could be common in the future.