Combating Trafficking of Cuban Doctors Act of 2021

II 117TH CONGRESS 1ST SESSION S. 2138 To respond to international trafficking of Cuban medical professionals by the Government of Cuba, and for other purposes. IN THE SENATE OF THE UNITED STATES JUNE 17, 2021 Mr. MENENDEZ (for himself and Mr. RUBIO) introduced the following bill; which was read twice and referred to the Committee on the Judiciary A BILL To respond to international trafficking of Cuban medical professionals by the Government of Cuba, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Combating Trafficking of Cuban Doctors Act of 2021’’. 5 (b) TABLE OF CONTENTS.—The table of contents for 6 this Act is as follows: 7 Sec. 1. Short title; table of contents. Sec. 2. Findings. Sec. 3. Sense of Congress. Sec. 4. Annual report and determination on international trafficking of Cuban medical personnel. VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6211 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 2138 IS Sec. 5. Reestablishing the Cuban Medical Professionals Parole program. Sec. 6. Role of the Pan American Health Organization. SEC. 2. FINDINGS. 1 Congress makes the following findings: 2 (1) In 2019, the Government of Cuba main- 3 tained an estimated 34,000 to 50,000 medical per- 4 sonnel in more than 60 countries under conditions 5 that represent forced labor, according to the Depart- 6 ment of State. 7 (2) Since the outbreak of the COVID–19 pan- 8 demic in early 2020, the Government of Cuba has 9 deployed approximately 1,500 medical personnel to 10 at least 20 countries. 11 (3) The Department of State’s 2020 Traf- 12 ficking in Persons report ranked Cuba in Tier 3 and 13 included evidence regarding Cuba’s foreign medical 14 missions and the Government of Cuba’s long- 15 standing failure to criminalize most forms of forced 16 labor, specifically noting allegations that Cuban au- 17 thorities coerced participants to remain in foreign 18 medical missions by— 19 (A) ‘‘withholding their passports and med- 20 ical credentials’’; 21 (B) ‘‘using ‘minders’ to conduct surveil- 22 lance of participants outside of work’’; 23 (C) ‘‘restricting their movement’’; 24 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 2138 IS (D) ‘‘retaliat[ing] against their family 1 members in Cuba if participants leave the pro- 2 gram’’; or 3 (E) ‘‘impos[ing] criminal penalties, exile, 4 and family separation if participants do not re- 5 turn to Cuba as directed by government super- 6 visors’’. 7 (4) On July 26, 2019, the United States im- 8 posed visa restrictions under section 212(a)(3)(C) of 9 the Immigration and Nationality Act (8 U.S.C. 10 1182(a)(3)(C)) against certain Cuban officials and 11 other individuals responsible for the coercive labor 12 practices of Cuba’s overseas medical missions. 13 (5) The United Nations Special Rapporteur on 14 contemporary forms of slavery and the United Na- 15 tions Special Rapporteur on trafficking in persons, 16 especially women and children, in their letter to the 17 Government of Cuba on November 6, 2019— 18 (A) noted reports of coercive labor prac- 19 tices through the Government of Cuba’s foreign 20 medical missions; 21 (B) highlighted reports by Cuban medical 22 professionals that they received regular threats 23 from Cuban officials while working overseas, in- 24 cluding sexual harassment of women; and 25 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 2138 IS (C) expressed concern that the practices 1 referred to in subparagraphs (A) and (B) con- 2 stitute slavery and trafficking in persons. 3 (6) In July 2013, the Cuban Ministry of Health 4 signed an agreement with the Brazilian Ministry of 5 Health to formalize an arrangement for Cuban doc- 6 tors to provide medical services in Brazil that— 7 (A) required the administration of former 8 Brazilian President Dilma Rousseff to transmit 9 a monthly payment through the Pan American 10 Health Organization (referred to in this section 11 as ‘‘PAHO’’) to the Cuban Ministry of Health 12 for the medical services provided by each Cuban 13 doctor serving in Brazil; and 14 (B) prevented participating Cuban doctors 15 from seeking employment in Brazil outside of 16 the formal structure of the agreement. 17 (7) In implementing the agreement described in 18 paragraph (6), the Cuban Ministry of Health acted 19 through the for-profit Cuban Medical Services Trad- 20 ing Corporation (referred to in this section as 21 ‘‘CMS’’)— 22 (A) to pay each Cuban doctor approxi- 23 mately 5 to 25 percent of the monthly payment 24 received from PAHO; 25 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 2138 IS (B) to retain approximately 70 to 90 per- 1 cent of the monthly payment for each doctor re- 2 ceived from PAHO; and 3 (C) to permit PAHO to retain approxi- 4 mately 5 percent of such monthly payments. 5 (8) Between 2013 and 2019, according to the 6 digital platform Diario de Cuba, the Government of 7 Cuba— 8 (A) garnished the salaries of more than 9 20,000 Cuban medical professionals who served 10 in Brazil under the Mais Me´dicos program; 11 (B) frequently confiscated their passports; 12 and 13 (C) prohibited family members from ac- 14 companying them. 15 (9) Cuban doctors were the only medical profes- 16 sionals participating in the Mais Me´dicos program to 17 have their salaries directly garnished by their gov- 18 ernment, while doctors of other nationalities serving 19 in Brazil received the full amount of the payments 20 made for their medical services under the program. 21 (10) The Government of Cuba stated that 22 Cuban doctors unwilling to return to the country 23 after their participation in foreign medical missions 24 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 2138 IS would not be permitted to return to their homeland 1 for 8 years. 2 (11) In February 2019, Brazil’s Ministry of 3 Health announced reforms to the Mais Me´dicos pro- 4 gram that— 5 (A) terminated the arrangement with the 6 Government of Cuba and PAHO; and 7 (B) allowed Cuban medical personnel to re- 8 main in Brazil and be paid directly by the Bra- 9 zilian Ministry of Health. 10 (12) The Government of Cuba’s response to the 11 reforms referred to in paragraph (11) was to order 12 the Cuban medical personnel to return to Cuba, 13 rather than allowing them to be fully and directly 14 compensated. Most Cuban medical personnel re- 15 turned to Cuba, as ordered, although approximately 16 2,000 Cuban medical personnel remain in Brazil. 17 (13) The Government of Cuba realized profits 18 in excess of $6,300,000,000 during 2018 from ex- 19 porting the services of Cuban professionals, of which 20 foreign medical missions represent the majority of 21 the services and income. 22 (14) Countries in which similar abuses to those 23 suffered by Cuban medical professionals in Brazil 24 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 2138 IS have been reported to have occurred include Angola, 1 Guatemala, Mexico, Qatar, and Venezuela. 2 (15) In Venezuela, a group of Cuban doctors 3 reported in 2019 that they had been directed, and 4 often coerced, to use their medical services to influ- 5 ence votes in favor of the Maduro regime, includ- 6 ing— 7 (A) by denying medical treatment to oppo- 8 sition supporters; and 9 (B) by giving precise voting instructions to 10 elderly patients. 11 (16) The term ‘‘severe forms of trafficking in 12 persons’’ is defined under section 103(11)(B) of the 13 Trafficking Victims Protection Act of 2000 (22 14 U.S.C. 7102(11)(B)) as ‘‘the recruitment, harboring, 15 transportation, provision, or obtaining of a person 16 for labor or services, through the use of force, fraud, 17 or coercion for the purpose of subjection to involun- 18 tary servitude, peonage, debt bondage, or slavery’’. 19 SEC. 3. SENSE OF CONGRESS. 20 It is the sense of Congress that— 21 (1) the Government of Cuba subjects Cuban 22 doctors and other medical professionals to state- 23 sponsored human trafficking; 24 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 2138 IS (2) the Government of Cuba should fully com- 1 pensate Cuban medical professionals who have par- 2 ticipated in, or who are currently participating in 3 foreign medical mission programs in other countries, 4 including Brazil’s Mais Me´dicos program, for the 5 full amount of wages paid to the Government of 6 Cuba; 7 (3) the Government of Cuba should immediately 8 and transparently respond to requests for informa- 9 tion from the United Nations Special Rapporteur on 10 contemporary forms of slavery and the United Na- 11 tions Special Rapporteur on trafficking in persons, 12 especially women and children; and 13 (4) foreign governments and international orga- 14 nizations that enter into agreements with the Gov- 15 ernment of Cuba or the for-profit Cuban Medical 16 Services Trading Corporation or other companies af- 17 filiated with the Government of Cuba to procure the 18 services of Cuban medical professionals directly as- 19 sume legal risks related to their participation in 20 forced labor arrangements and human trafficking. 21 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 2138 IS SEC. 4. ANNUAL REPORT AND DETERMINATION ON INTER- 1 NATIONAL TRAFFICKING OF CUBAN MEDICAL 2 PERSONNEL. 3 (a) ANNUAL REPORT.—Not later than 180 days after 4 the date of the enactment of this Act and annually there- 5 after until the date specified in subsection (c), the Sec- 6 retary of State shall submit a report to the Committee 7 on Foreign Relations of the Senate and the Committee 8 on Foreign Affairs of the House of Representatives that— 9 (1) identifies the countries that are hosting 10 Cuban medical personnel who are participating in 11 foreign medical missions for the Government of 12 Cuba; 13 (2) to the extent feasible, includes an estimate 14 of— 15 (A) the number of Cuban medical per- 16 sonnel in each country; and 17 (B) the value of the financial arrangement 18 between the Government of Cuba and the host 19 country government; 20 (3) describes the conditions in each country 21 under which Cuban medical personnel live and work; 22 and 23 (4) describes the role of any international orga- 24 nization in each country hosting Cuban medical per- 25 sonnel. 26 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 2138 IS (b) DETERMINATION ON HUMAN TRAFFICKING.—In 1 each report submitted pursuant to subsection (a), the Sec- 2 retary of State shall determine whether— 3 (1) the Cuban medical personnel in each coun- 4 try identified in the report are subjected to condi- 5 tions that qualify as severe forms of trafficking in 6 persons (as defined in section 103(11) of the Traf- 7 ficking Victims Protection Act of 2000 (22 U.S.C. 8 7102(11))); and 9 (2) Cuba’s foreign medical missions program 10 constitutes proof of failure to make significant ef- 11 forts to bring the Government of Cuba into compli- 12 ance with the minimum standards for the elimi- 13 nation of trafficking in persons (as determined 14 under section 108 of the Trafficking Victims Protec- 15 tion Act of 2000 (22 U.S.C. 7106)). 16 (c) SUNSET.—The Secretary of State is not required 17 to submit the report otherwise required under subsection 18 (a) after the date on which the Secretary submits a second 19 consecutive annual report under such subsection that in- 20 cludes a determination under subsection (b) that Cuban 21 medical personnel are no longer subjected to trafficking 22 in persons. 23 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 11 •S 2138 IS SEC. 5. REESTABLISHING THE CUBAN MEDICAL PROFES- 1 SIONAL PAROLE PROGRAM. 2 (a) IN GENERAL.—The Secretary of Homeland Secu- 3 rity, in coordination with the Secretary of State, shall rein- 4 state the Cuban Medical Professional Parole program to 5 authorize the admission into the United States of Cuban 6 medical personnel conscripted to study or work in a third 7 country under the direction of the Government of Cuba. 8 (b) AUTHORITY.—The Director of U.S. Citizenship 9 and Immigration Services may exercise the discretionary 10 parole authority under section 212(d)(5)(A) of the Immi- 11 gration and Nationality Act (8 U.S.C. 1182(d)(5)(A)) and 12 subsections (c) and (d) of section 212.5 of title 8, Code 13 of Federal Regulations, to permit eligible Cuban nationals 14 to come to the United States, including for urgent human- 15 itarian reasons or significant public benefit. 16 (c) ELIGIBILITY CRITERIA.— 17 (1) IN GENERAL.—A Cuban medical profes- 18 sional is eligible for consideration of parole under 19 the Cuban Medical Professional Program if he or 20 she— 21 (A) is a Cuban national, citizen, or person 22 habitually residing in Cuba; 23 (B) is a medical professional who, at the 24 time he or she seeks such parole, is conscripted 25 VerDate Sep 11 2014 05:00 Jul 03, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2138.IS S2138 pbinns on DSKJLVW7X2PROD with BILLS 12 •S 2138 IS by the Government of Cuba to study or work in 1 a third country; and 2 (C) is not inadmissible under section 3 212(a) of the Immigration and Nationality Act 4 (8 U.S.C. 1182(a)). 5 (2) ADMISSION OF FAMILY MEMBERS.— 6 (A) IN GENERAL.—The spouse and unmar- 7 ried children accompanying the primary appli- 8 cant in the third country referred to in para- 9 graph (1)(B) shall be eligible for parole under 10 the Cuban Medical Professional Program in 11 conjunction with an application from an indi- 12 vidual described in paragraph (1). 13 (B) APPLICATIONS.—A Cuban medical 14 professional granted discretionary parole under 15 section 212(d)(5)(A) of the Immigration and 16 Nationality Act (8 U.S.C. 1182(d)(5)(A)) pur- 17 suant to this section may submit an application 18 to U.S. Citizenship and [Text truncated for display. 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