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105th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES

 1st Session                                                    105-289
_______________________________________________________________________


 
 TO EXEMPT INTERNATIONALLY ADOPTED CHILDREN 10 YEARS OF AGE OR YOUNGER 
                   FROM THE IMMUNIZATION REQUIREMENT

_______________________________________________________________________


October 1, 1997.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

Mr. Smith of Texas, from the Committee on the Judiciary, submitted the 
                               following

                              R E P O R T

                             together with

                            ADDITIONAL VIEWS

                        [To accompany H.R. 2464]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on the Judiciary, to whom was referred the 
bill (H.R. 2464) to amend the Immigration and Nationality Act 
to exempt internationally adopted children under age 10 from 
the immunization requirement, having considered the same, 
reports favorably thereon with amendments and recommends that 
the bill as amended do pass.

                           TABLE OF CONTENTS

                                                                  

                                                                 Page
The Amendment..............................................           2
Purpose and Summary........................................           2
Background and Need for Legislation........................           2
Committee Consideration....................................           3
Vote of the Committee......................................           3
Committee Oversight Findings...............................           4
Committee on Government Reform and Oversight Findings......           4
New Budget Authority and Tax Expenditures..................           4
Congressional Budget Office Estimate.......................           4
Constitutional Authority Statement.........................           5
Section-by-Section Analysis and Discussion.................           5
Changes in Existing Law Made by the Bill, as Reported......           5
Additional Views...........................................           7

    The amendments are as follows:
    Strike out all after the enacting clause and insert in lieu 
thereof the following:

SECTION 1. EXEMPTION FOR INTERNATIONALLY ADOPTED CHILDREN 10 YEARS OF 
                    AGE OR YOUNGER FROM THE IMMUNIZATION REQUIREMENT.

    Section 212(a)(1) of the Immigration and Nationality Act (8 U.S.C. 
1182(a)(1)) is amended--
            (1) in subparagraph (A)(ii), by inserting ``except as 
        provided in subparagraph (C),'' after ``(ii)''; and
            (2) by adding at the end the following:
                    ``(C) Exception from immunization requirement for 
                adopted children 10 years of age or younger.--Clause 
                (ii) of subparagraph (A) shall not apply to a child 
                who--
                            ``(i) is 10 years of age or younger,
                            ``(ii) is described in section 
                        101(b)(1)(F), and
                            ``(iii) is seeking an immigrant visa as an 
                        immediate relative under section 201(b),
                if, prior to the admission of the child, a parent of 
                the child, who has sponsored the child for admission as 
                an immediate relative, has executed an affidavit 
                stating that the parent is aware of the provisions of 
                subparagraph (A)(ii) and will ensure that, within 30 
                days of the child's admission, or at the earliest time 
                that is medically appropriate, the child will receive 
                the vaccinations identified in such subparagraph.''.

    Amend the title so as to read:

      A bill to amend the Immigration and Nationality Act to 
exempt internationally adopted children 10 years of age or 
younger from the immunization requirement.

                          Purpose and Summary

    This legislation will exempt children age 10 years and 
under who are admitted to the United States as orphans being 
adopted (or having been adopted) by a United States citizen 
from the requirement adopted in section 341 of the Illegal 
Immigration Reform and Immigrant Responsibility Act of 1996 
(P.L. 104-208, Div. C) (IIRIRA) that immigrants, prior to 
lawful admission, have received vaccinations against specified 
communicable diseases.

                Background and Need for the Legislation

    The intent of section 341 of the IIRIRA was to protect the 
public health by ensuring that immigrants entering the United 
States receive standard vaccinations against at least the 
following communicable diseases: mumps, measles, rubella, 
polio, tetanus and diptheria toxoids, pertussis, influenza type 
B and hepatitis B, and any other vaccinations against vaccine-
preventable diseases recommended by the Advisory Committee for 
Immunization Practices.
    The case of orphan children being adopted by a United 
States citizen parent and sponsored for admission to the United 
States presents special circumstances that justify a waiver 
from this vaccination requirement. Adoptive parents of 
international orphans, who have often endured great financial 
cost and other sacrifice to become parents, can be presumed to 
be solicitous of the health needs of their children, including 
ensuring that appropriate vaccines are administered. The 
Committee also is aware that requiring vaccines to be 
administered prior to departure for the United States could 
impose genuine hardship, especially in cases where parents (or 
prospective parents in cases where the adoption is to take 
place after arrival in the United States) meet their new 
children a few days or less prior to departure. Since adoptive 
parents may be concerned regarding the quality of vaccines 
administered in certain foreign countries, these parents are 
likely to have the vaccines repeated once the child arrives in 
the United States. Finally, for very young children, existing 
vaccination requirements under State law (especially those 
connected with admission to school) will help ensure that these 
children are vaccinated.

                        Committee Consideration

    On September 17, 1997, the Committee met in open session 
and ordered reported favorably the bill H.R. 2464 with an 
amendment by voice vote, a quorum being present.

                         Vote of the Committee

                             rollcall no. 1

    Amendment in the nature of a substitute by Mr. Delahunt to 
the amendment by Mr. McCollum to modify the requirement in the 
underlying amendment that adoptive parents verify that they 
will ensure that the immigrant child receives appropriate 
vaccinations within 30 days of admission or at the earliest 
time that is medically appropriate. The amendment was defeated 
by a vote of 9-19.

        AYES                          NAYS

Mr. Conyers                         Mr. Sensenbrenner
Mr. Frank                           Mr. McCollum
Mr. Nadler                          Mr. Gekas
Mr. Scott                           Mr. Coble
Mr. Watt                            Mr. Smith
Ms. Lofgren                         Mr. Canady
Ms. Jackson Lee                     Mr. Inglis
Mr. Meehan                          Mr. Goodlatte
Mr. Delahunt                        Mr. Buyer
                                    Mr. Bono
                                    Mr. Bryant
                                    Mr. Chabot
                                    Mr. Barr
                                    Mr. Jenkins
                                    Mr. Hutchinson
                                    Mr. Pease
                                    Mr. Cannon
                                    Mr. Rothman
                                    Mr. Hyde

                      Committee Oversight Findings

    In compliance with clause 2(l)(3)(A) of rule XI of the 
Rules of the House of Representatives, the Committee reports 
that the findings and recommendations of the Committee, based 
on oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated in the 
descriptive portions of this report.

         Committee on Government Reform and Oversight Findings

    No findings or recommendations of the Committee on 
Government Reform and Oversight were received as referred to in 
clause 2(l)(3)(D) of rule XI of the Rules of the House of 
Representatives.

               New Budget Authority and Tax Expenditures

    Clause 2(l)(3)(B) of House Rule XI is inapplicable because 
this legislation does not provide new budgetary authority or 
increased tax expenditures.

               Congressional Budget Office Cost Estimate

    In compliance with clause 2(l)(3)(C) of rule XI of the 
Rules of the House of Representatives, the Committee sets 
forth, with respect to the bill, H.R. 2464, the following 
estimate and comparison prepared by the Director of the 
Congressional Budget Office under section 403 of the 
Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                Washington, DC, September 24, 1997.
Hon. Henry J. Hyde,
Chairman, Committee on the Judiciary,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 2464, a bill to 
amend the Immigration and Nationality Act to exempt 
internationally adopted children under age 10 from the 
immunization requirement.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Mark 
Grabowicz, who can be reached at 226-2860.
            Sincerely,

                                           June E. O'Neill, Director.  
    Enclosure.

H.R. 2464--Immigration and Nationality Act to exempt 
        internationally adopted children under age 10 from the 
        immunization requirement

    CBO estimates that enacting H.R. 2464 would have no 
significant impact on the federal budget. The legislation would 
make it easier for a small number of adopted children under age 
10 to obtain immigrant visas. Therefore, enacting H.R. 2464 
could affect the amount of fees collected by the Immigration 
and Naturalization Service, and pay-as-you-go procedures would 
apply. Because the number of children affected would be very 
small, however, CBO estimates that any effects on direct 
spending would not be significant.
    This legislation contains no new intergovernmental or 
private-sector mandates as defined in the Unfunded Mandates 
Reform Act of 1995 and would impose no cost on state, local, or 
tribal governments.
    The CBO staff contact for this estimate is Mark Grabowicz, 
who can be reached at 226-2860. This estimate was approved by 
Robert A. Sunshine, Deputy Assistant Director for Budget 
Analysis.

                   Constitutional Authority Statement

    Pursuant to Rule XI, clause 2(l)(4) of the Rules of the 
House of Representatives, the Committee finds the authority for 
this legislation in Article I, section 8, clause 4 of the 
Constitution.

                      Section-by-Section Analysis

    This legislation exempts a child age 10 years and under who 
is being sponsored for admission to the United States as an 
orphan being adopted (or having been adopted) by a United 
States citizen from the requirement adopted in section 341 of 
the Illegal Immigration Reform and Immigrant Responsibility Act 
of 1996 (P.L. 104-208, Div. C) (IIRIRA) that immigrants, prior 
to lawful admission, have received vaccinations against 
specified communicable diseases.
    The legislation amends section 212(a)(1) of the Immigration 
and Nationality Act (INA) by adding a new subparagraph (C) 
exempting children age 10 years and under who are described in 
section 101(b)(1)(F) of the INA from the vaccination 
requirement set forth in section 212(a)(1)(A)(ii) of the INA.

         Changes in Existing Law Made by the Bill, as Reported

    In compliance with clause 3 of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

           SECTION 212 OF THE IMMIGRATION AND NATIONALITY ACT

          * * * * * * *

 general classes of aliens ineligible to receive visas and ineligible 
               for admission; waivers of inadmissibility

      Sec. 212. (a) Classes of Aliens Ineligible for Visas or 
Admission.--Except as otherwise provided in this Act, aliens 
who are inadmissible under the following paragraphs are 
ineligible to receive visas and ineligible to be admitted to 
the United States:
            (1) Health-related grounds.--
                    (A) In general.--Any alien--
                          (i) who is determined (in accordance 
                        with regulations prescribed by the 
                        Secretary of Health and Human Services) 
                        to have a communicable disease of 
                        public health significance, which shall 
                        include infection with the etiologic 
                        agent for acquired immune deficiency 
                        syndrome,
                            (ii) except as provided in 
                        subparagraph (C), who seeks admission 
                        as an immigrant, or who seeks 
                        adjustment of status to the status of 
                        an alien lawfully admitted for 
                        permanent residence, and who has failed 
                        to present documentation of having 
                        received vaccination against vaccine-
                        preventable diseases, which shall 
                        include at least the following 
                        diseases: mumps, measles, rubella, 
                        polio, tetanus and diphtheria toxoids, 
                        pertussis, influenza type B and 
                        hepatitis B, and any other vaccinations 
                        against vaccine-preventable diseases 
                        recommended by the Advisory Committee 
                        for Immunization Practices,
          * * * * * * *
                    (C) Exception from immunization requirement 
                for adopted children 10 years of age or 
                younger.--Clause (ii) of subparagraph (A) shall 
                not apply to a child who--
                            (i) is 10 years of age or younger,
                            (ii) is described in section 
                        101(b)(1)(F), and
                            (iii) is seeking an immigrant visa 
                        as an immediate relative under section 
                        201(b),
                if, prior to the admission of the child, a 
                parent of the child, who has sponsored the 
                child for admission as an immediate relative, 
                has executed an affidavit stating that the 
                parent is aware of the provisions of 
                subparagraph (A)(ii) and will ensure that, 
                within 30 days of the child's admission, or at 
                the earliest time that is medically 
                appropriate, the child will receive the 
                vaccinations identified in such subparagraph.
          * * * * * * *
                            ADDITIONAL VIEWS

    We strongly support this corrective legislation. However, 
we wish to express our concern regarding the amendment adopted 
in committee to impose a new requirement on adoptive parents 
that is both gratuitous and unenforceable.
    Every year, American families provide loving homes to some 
12,000 orphaned and abandoned children living in countries that 
cannot care for them. These adoptive families endure 
innumerable bureaucratic obstacles and delays that frequently 
take many months or even years to overcome.
    Last year, Congress enacted a new vaccination requirement 
that had the unintended consequence of making the international 
adoption process even more expensive, cumbersome and time-
consuming for these families, while posing serious potential 
health risks to the children themselves.\1\
---------------------------------------------------------------------------
    \1\ Section 212 of the Immigration Reform and Immigrant 
Responsibility Act of 1996 (8 U.S.C. 1182) provides that immigrant 
aliens are ineligible for admission if they fail to present 
documentation of having received, prior to their admission, a series of 
vaccinations against vaccine-preventable diseases. This provision 
applies to all immigrants, including young children adopted by U.S. 
citizens. While current law allows adoptive parents to seek a medical 
waiver of the requirement, this waiver must be granted on a case-by-
case basis and is entirely within the discretion of the Attorney 
General.
---------------------------------------------------------------------------
    Prior to the enactment of this requirement, internationally 
adopted children were routinely given the necessary 
immunizations once they had arrived in the United States. The 
bill would allow a return to this practice by exempting from 
the requirement foreign-born children aged 10 and younger who 
are adopted by American families.
    We wish to emphasize that everyone wants these children to 
get the immunizations they need. The only question addressed by 
the bill is whether we will allow the adoptive parents to see 
that these medical procedures are conducted safely and in an 
orderly way.
    Like most other parents, adoptive parents want to see that 
their child receives the best possible medical care--including 
the proper immunizations--from a physician they know and trust. 
Not from a stranger in a poor, war-torn nation, where their 
child is at risk from adverse reactions, vaccines that are 
unsafe or ineffective, and unsterile needles and syringes.
    There is no evidence whatsoever that allowing the parents 
to have their children vaccinated in the United States has ever 
caused a public health problem, and there is no reason that 
this bill would do so either.
    The bill is strongly supported by the adoption community, 
parent groups and physicians with expertise in the medical 
aspects of international adoption. These groups include the 
Joint Council on International Children's Services, Adoptive 
Families of America, the National Council for Adoption, the 
American Academy of Pediatrics, and the Child Welfare League. 
We strongly agree with them, and enthusiastically support the 
bill.
    Our sole reservation concerns the amendment by Mr. McCollum 
that was adopted in committee, which adds to the bill a 
completely unnecessary requirement that the adoptive parents 
sign an affidavit that their children will be vaccinated within 
30 days following their admission to the United States, or at 
the earliest time that is medically appropriate.
    The requirement is unnecessary because that is precisely 
what the adoptive parents intend to do. Indeed, that is the 
entire purpose of the bill--to see to it that it is the parents 
who make the medical decisions for their newly adopted 
children.
    When asked to justify their double standard, the proponents 
of the amendment could not cite a single case in which adoptive 
parents have failed to have them vaccinated. On the contrary, 
the evidence indicates that parents who have been through the 
rigors of the international adoption process do all they can to 
ensure that their adopted children receive prompt and regular 
medical care. Indeed, by the time that process is completed, 
parents who would hesitate to take their child to a physician 
have long since been weeded out.
    Should the parents nevertheless fail in their 
responsibilities, the states have ample rules in place to 
ensure that these children--and their American-born 
classmates--receive the necessary immunizations before they 
enter licensed day care centers or enroll in school. The bill 
would have no effect whatsoever on these state requirements and 
is entirely consistent with them.
    It is unnecessary to require these parents to sign an 
affidavit that they will do their duty by their children. We 
might as well tell every parent that they have an obligation to 
immunize their child against these childhood diseases. We might 
add that they should be sure their child is given three healthy 
meals a day and clean and safe surroundings.
    The requirement is also unenforceable. Unless we mean to 
establish a massive new federal bureaucracy to track compliance 
with this new parental mandate, we will continue to rely on the 
parents themselves to do that which they would have done in the 
absence of the requirement.
    We do agree with the majority that we should do all we can 
to see that parents are given the most up-to-date information 
regarding the immunizations their child should receive.
    At the markup, Mr. Delahunt offered an amendment to the 
McCollum amendment, which would have ensured that adoptive 
parents be given information as to the immunizations their 
child should receive, and that they be required to acknowledge 
their receipt of this information. Unfortunately, the Delahunt 
amendment was defeated on a party-line vote.
    While we take strong exception to this portion of the bill, 
we are very supportive of the legislation as a whole and urge 
its prompt enactment.

                                   John Conyers, Jr.
                                   Zoe Lofgren.
                                   Maxine Waters.
                                   William D. Delahunt.
                                   Barney Frank.
                                   Jerrold Nadler.
                                   Melvin L. Watt.
                                   Sheila Jackson Lee.
                                   Martin T. Meehan.