,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #dfce  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ba1         
#bjbj,mr4 ,m55dez 7= himself & ,mr4     
,rubio7 introduc$ ! foll[+ bill2 :i* 0  
read twice & ref]r$ to ! ,committee on !
 ,judici>y  ,a ,,bill  ,to respond to   
int]national traffick+ ( ,cuban m$ical  
pr(essionals by ! ,gov]nm5t ( ,cuba1 & =
 o!r purposes4  #a4 ,%ort title2 table (
 cont5ts  7a7 ,%ort title ,?is ,act may 
be cit$ z ! ,combat+ ,traffick+ ( ,cuban
 ,doctors ,act ( #bjbj4  7b7 ,table (   
cont5ts ,! table ( cont5ts = ?is ,act is
 z foll[s3 ,sec4 #a4 ,%ort title2 table 
( cont5ts4,sec4 #b4 ,f9d+s4,sec4 #c4    
,s5se ( ,congress4,sec4 #d4 ,annual     
report & det]m9ation on int]national    
traffick+ ( ,cuban m$ical p]sonnel4,sec4
 #e4 ,ree/abli%+ ! ,cuban ,m$ical       
,pr(essionals ,p>ole program4,sec4 #f4  
,role ( ! ,pan ,am]ican ,heal?          
,organization4  #b4 ,f9d+s ,congress    
makes ! foll[+ f9d+s3 7#a7 ,9 #bjai1 !  
,gov]nm5t ( ,cuba ma9ta9$ an e/imat$    

#cd1jjj to #ej1jjj m$ical p]sonnel 9 m  
?an #fj c\ntries "u conditions t        
repres5t =c$ labor1 accord+ to !        
,dep>tm5t ( ,/ate4  7#b7 ,s9ce !        
outbreak ( ! ,,covid-#ai p&emic 9 e>ly  
#bjbj1 ! ,gov]nm5t ( ,cuba has deploy$  
approximately #a1ejj m$ical p]sonnel to 
at lea/ #bj c\ntries4  7#c7 ,! ,dep>tm5t
 ( ,/ate's #bjbj ,traffick+ 9 ,p]sons   
report rank$ ,cuba 9 ,ti] #c & includ$  
evid5ce reg>d+ ,cuba's =eign m$ical     
missions & ! ,gov]nm5t ( ,cuba's long/&+
 failure to crim9alize mo/ =ms ( =c$    
labor1 specifically not+ allegations t  
,cuban au?orities co]c$ p>ticipants to  
rema9 9 =eign m$ical missions by-- 7,a7 
)hold+ _! passports & m$ical cr$5tials2 
7,b7 us+ m9d]s to conduct surveillance (
 p>ticipants outside ( "w2  7,c7        
re/rict+ _! movem5t2  7,d7 retaliat+    
aga9/ _! family memb]s 9 ,cuba if       
p>ticipants leave ! program2 or  7,e7   
impos+ crim9al p5alties1 exile1 & family
 sep>ation if p>ticipants d n return to 
,cuba z direct$ by gov]nm5t sup]visors4 

7#d7 ,on ,july #bf1 #bjai1 ! ,unit$     
,/ates impos$ visa re/rictions "u       
section #bab7;a77#c77;,c7 ( !           
,immigration & ,nationality ,act 7#h    
,u4,s4,c4 #aahb7;a77#c77;,c77 aga9/     
c]ta9 ,cuban (ficials & o!r individuals 
responsible = ! co]cive labor practices 
( ,cuba's ov]seas m$ical missions4  7#e7
 ,! ,unit$ ,nations ,special ,rapporteur
 on contempor>y =ms ( slav]y & ! ,unit$ 
,nations ,special ,rapporteur on        
traffick+ 9 p]sons1 especially wom5 &   
*ildr51 9 _! lett] to ! ,gov]nm5t (     
,cuba on ,novemb] #f1 #bjai-- 7,a7 not$ 
reports ( co]cive labor practices ?r\gh 
! ,gov]nm5t ( ,cuba's =eign m$ical      
missions2  7,b7 highlight$ reports by   
,cuban m$ical pr(essionals t !y receiv$ 
regul> ?reats f ,cuban (ficials :ile    
work+ ov]seas1 includ+ sexual h>assm5t (
 wom52 &  7,c7 express$ conc]n t !      
practices ref]r$ to 9 subp>agraphs 7,a7 
& 7,b7 con/itute slav]y & traffick+ 9   
p]sons4  7#f7 ,9 ,july #bjac1 ! ,cuban  
,m9i/ry ( ,heal? sign$ an agreem5t ) !  

,brazilian ,m9i/ry ( ,heal? to =malize  
an arrangem5t = ,cuban doctors to       
provide m$ical s]vices 9 ,brazil t--    
7,a7 requir$ ! adm9i/ration ( =m]       
,brazilian ,presid5t ,dilma ,r\sseff to 
transmit a mon?ly paym5t ?r\gh ! ,pan   
,am]ican ,heal? ,organization 7ref]r$ to
 9 ?is section z ,,paho7 to ! ,cuban    
,m9i/ry ( ,heal? = ! m$ical s]vices     
provid$ by ea* ,cuban doctor s]v+ 9     
,brazil2 &  7,b7 prev5t$ p>ticipat+     
,cuban doctors f seek+ employm5t 9      
,brazil outside ( ! =mal /ructure ( !   
agreem5t4  7#g7 ,9 implem5t+ ! agreem5t 
describ$ 9 p>agraph 7#f71 ! ,cuban      
,m9i/ry ( ,heal? act$ ?r\gh ! =-pr(it   
,cuban ,m$ical ,s]vices ,trad+          
,corporation 7ref]r$ to 9 ?is section z 
,,cms7-- 7,a7 to pay ea* ,cuban doctor  
approximately #be p]c5t 7av]ag+ #gij7 ( 
! mon?ly paym5t receiv$ f ,,paho 7av]ag+
 #c1aeh72 &  7,b7 to reta9 approximately
 #ge p]c5t ( ! mon?ly paym5t = ea*      
doctor receiv$ f ,,paho4  7#h7 ,betwe5  
#bjac & #bjai1 accord+ to ! digital     

plat=m ,di>io de ,cuba1 ! ,gov]nm5t (   
,cuba-- 7,a7 g>ni%$ ! sal>ies ( m ?an   
#bj1jjj ,cuban m$ical pr(essionals :o   
s]v$ 9 ,brazil "u ! ,mais ,mdicos       
program2  7,b7 frequ5tly confiscat$ _!  
passports2 &  7,c7 prohibit$ family     
memb]s f accompany+ !m4  7#i7 ,cuban    
doctors 7 ! only m$ical pr(essionals    
p>ticipat+ 9 ! ,mais ,mdicos program to 
h _! sal>ies directly g>ni%$ by _!      
gov]nm5t1 :ile doctors ( o!r            
nationalities s]v+ 9 ,brazil receiv$ !  
full am\nt ( ! paym5ts made = _! m$ical 
s]vices "u ! program4  7#aj7 ,!         
,gov]nm5t ( ,cuba /at$ t ,cuban doctors 
unwill+ to return to ! c\ntry aft] _!   
p>ticipation 9 =eign m$ical missions    
w\ld n be p]mitt$ to return to _! homel&
 = #h ye>s4  7#aa7 ,9 ,febru>y #bjai1   
,brazil's ,m9i/ry ( ,heal? ann\nc$ !    
t]m9ation ( ! ,mais ,mdicos program4    
7#ab7 ,! ,gov]nm5t ( ,cuba realiz$      
pr(its 9 excess ( #f1cjj1jjj1jjj dur+   
#bjah f export+ ! s]vices ( ,cuban      
pr(essionals1 ( :i* =eign m$ical        

missions repres5t ! majority ( ! s]vices
 & income4  7#ac7 ,c\ntries 9 :i* simil>
 abuses to ^? suff]$ by ,cuban m$ical   
pr(essionals 9 ,brazil h be5 report$ to 
h occurr$ include ,angola1 ,guatemala1  
,mexico1 ,qat>1 & ,v5ezuela4  7#ad7 ,9  
,v5ezuela1 a gr\p ( ,cuban doctors      
report$ 9 #bjai t !y _h be5 direct$1 &  
(t5 co]c$1 to use _! m$ical s]vices to  
influ5ce votes 9 favor ( ! ,maduro      
regime1 includ+-- 7,a7 by d5y+ m$ical   
treatm5t to opposition support]s2 &     
7,b7 by giv+ precise vot+ in/ructions to
 eld]ly pati5ts4  7#ae7 ,! t]m sev]e =ms
 ( traffick+ 9 p]sons is def9$ "u       
section #ajc7aa77;,b7 ( ! ,traffick+    
,victims ,protection ,act ( #bjjj 7#bb  
,u4,s4,c4 #gajb7aa77;,b77 z !           
recruitm5t1 h>bor+1 transportation1     
provision1 or obta9+ ( a p]son = labor  
or s]vices1 ?r\gh ! use ( =ce1 fraud1 or
 co]cion = ! purpose ( subjection to    
involunt>y s]vitude1 peonage1 debt      
bondage1 or slav]y4  #c4 ,s5se (        
,congress ,x is ! s5se ( ,congress t--  

7#a7 ! ,gov]nm5t ( ,cuba subjects ,cuban
 doctors & o!r m$ical pr(essionals to   
/ate-sponsor$ human traffick+2  7#b7 !  
,gov]nm5t ( ,cuba %\ld fully comp5sate  
,cuban m$ical pr(essionals :o h         
p>ticipat$ 91 or :o are curr5tly        
p>ticipat+ 9 =eign m$ical mission       
programs 9 o!r c\ntries1 includ+        
,brazil's ,mais ,mdicos program1 = !    
full am\nt ( wages paid to ! ,gov]nm5t (
 ,cuba2  7#c7 ! ,gov]nm5t ( ,cuba %\ld  
imm$iately & transp>5tly respond to     
reque/s = in=mation f ! ,unit$ ,nations 
,special ,rapporteur on contempor>y =ms 
( slav]y & ! ,unit$ ,nations ,special   
,rapporteur on traffick+ 9 p]sons1      
especially wom5 & *ildr52 &  7#d7 =eign 
gov]nm5ts t sign agreem5ts ) ! ,gov]nm5t
 ( ,cuba or ! =-pr(it ,cuban ,m$ical    
,s]vices ,trad+ ,corporation or o!r     
companies affiliat$ ) ! ,gov]nm5t (     
,cuba to procure ! s]vices ( ,cuban     
m$ical pr(essionals directly assume     
legal risks relat$ to _! p>ticipation 9 
=c$ labor arrangem5ts4  #d4 ,annual     

report & det]m9ation on int]national    
traffick+ ( ,cuban m$ical p]sonnel  7a7 
,annual report ,n lat] ?an #ahj days    
aft] ! date ( ! enactm5t ( ?is ,act &   
annually !reaft] until ! date specifi$ 9
 subsection 7c71 ! ,secret>y ( ,/ate    
%all submit a report to ! ,committee on 
,=eign ,relations ( ! ,s5ate & !        
,committee on ,=eign ,affairs ( ! ,h\se 
( ,repres5tatives t-- 7#a7 id5tifies !  
c\ntries t are ho/+ ,cuban m$ical       
p]sonnel :o are p>ticipat+ 9 =eign      
m$ical missions = ! ,gov]nm5t ( ,cuba2  
7#b7 to ! ext5t feasible1 includes an   
e/imate (-- 7,a7 ! numb] ( ,cuban m$ical
 p]sonnel 9 ea* c\ntry2 &  7,b7 ! value 
( ! f9ancial arrangem5t betwe5 !        
,gov]nm5t ( ,cuba & ! ho/ c\ntry        
gov]nm5t2 &  7#c7 describes ! conditions
 9 ea* c\ntry "u :i* ,cuban m$ical      
p]sonnel live & "w4  7b7 ,det]m9ation on
 human traffick+ ,9 ea* report submitt$ 
pursuant to subsection 7a71 ! ,secret>y 
( ,/ate %all det]m9e :e!r-- 7#a7 !      
,cuban m$ical p]sonnel 9 ea* c\ntry     

id5tifi$ 9 ! report are subject$ to     
conditions t qualify z sev]e =ms (      
traffick+ 9 p]sons 7z def9$ 9 section   
#ajc7aa7 ( ! ,traffick+ ,victims        
,protection ,act ( #bjjj 7#bb ,u4,s4,c4 
#gajb7aa7772 &  7#b7 ,cuba's =eign      
m$ical missions program con/itutes pro( 
( failure to make significant ef=ts to  
br+ ! ,gov]nm5t ( ,cuba into compliance 
) ! m9imum /&>ds = ! elim9ation (       
traffick+ 9 p]sons 7z det]m9$ "u section
 #ajh ( ! ,traffick+ ,victims           
,protection ,act ( #bjjj 7#bb ,u4,s4,c4 
#gajf774  7c7 ,sunset ,! ,secret>y (    
,/ate is n requir$ to submit ! report   
o!rwise requir$ "u subsection 7a7 aft] !
 date on :i* ! ,secret>y submits a      
second consecutive annual report "u su* 
subsection t includes a det]m9ation "u  
subsection 7b7 t ,cuban m$ical p]sonnel 
are no long] subject$ to traffick+ 9    
p]sons4  #e4 ,ree/abli%+ ! ,cuban       
,m$ical ,pr(essional ,p>ole program  7a7
 ,9 g5]al ,! ,secret>y ( ,homel&        
,security1 9 coord9ation ) ! ,secret>y (

 ,/ate1 %all re9/ate ! ,cuban ,m$ical   
,pr(essional ,p>ole program to au?orize 
! admission into ! ,unit$ ,/ates (      
,cuban m$ical p]sonnel conscript$ to    
/udy or "w 9 a ?ird c\ntry "u !         
direction ( ! ,gov]nm5t ( ,cuba4  7b7   
,au?ority ,! ,director ( ,u4,s4         
,citiz5%ip & ,immigration ,s]vices may  
ex]cise its discretion>y p>ole au?ority 
"u section #bab7;d77#e77;,a7 ( !        
,immigration & ,nationality ,act 7#h    
,u4,s4,c4 #aahb7;d77#e77;,a77 &         
subsections 7c7 & 7d7 ( section #bab4e (
 title #h1 ,code ( ,f$]al ,regulations1 
to p]mit eligible ,cuban nationals to   
come to ! ,unit$ ,/ates1 includ+ = urg5t
 humanit>ian reasons or significant     
public b5efit4  7c7 ,eligibility crit]ia
  7#a7 ,9 g5]al ,a ,cuban m$ical        
pr(essional is eligible = consid]ation (
 p>ole "u ! ,cuban ,m$ical ,pr(essional 
,program if he or %e-- 7,a7 is a ,cuban 
national1 citiz51 or p]son habitually   
resid+ 9 ,cuba2  7,b7 is a m$ical       
pr(essional :o1 at ! "t he or %e seeks  

su* p>ole1 is conscript$ by ! ,gov]nm5t 
( ,cuba to /udy or "w 9 a ?ird c\ntry2 &
  7,c7 is n inadmissible "u section     
#bab7;a7 ( ! ,immigration & ,nationality
 ,act 7#h ,u4,s4,c4 #aahb7;a774  7#b7   
,admission ( family memb]s  7,a7 ,9     
g5]al ,! sp\se & unm>ri$ *ildr5         
accompany+ ! prim>y applicant 9 ! ?ird  
c\ntry ref]r$ to 9 p>agraph 7#a77;,b7   
%all be eligible = p>ole "u ! ,cuban    
,m$ical ,pr(essional ,program 9         
conjunction ) an application f an       
individual describ$ 9 p>agraph 7#a74    
7,b7 ,applications ,a ,cuban m$ical     
pr(essional grant$ discretion>y p>ole "u
 section #bab7;d77#e77;,a7 ( !          
,immigration & ,nationality ,act 7#h    
,u4,s4,c4 #aahb7;d77#e77;,a77 pursuant  
to ?is section may submit an application
 to ,u4,s4 ,citiz5%ip & ,immigration    
,s]vices seek+ admission to ! ,unit$    
,/ates ( 8 or h] sp\se & unm>ri$ *ildr54
  #f4 ,role ( ! ,pan ,am]ican ,heal?    
,organization  7a7 ,f9d+s ,congress f9ds
 t ! ,pan ,am]ican ,heal? ,organization 

7ref]r$ to 9 ?is section z ,,paho7--    
7#a7 has contribut$ to ! heal? &        
well-be+ ( ! p 9 ! ,we/]n ,hemisph]e =  
long] ?an a c5tury1 ) ! ,unit$ ,/ates   
s]v+ z a memb] /ate s9ce #aibe2  7#b7   
engages 9 te*nical coop]ation ) its     
memb] c\ntries-- 7,a7 to fight          
communicable & noncommunicable diseases 
& _! causes2  7,b7 to /r5g!n heal?      
sy/ems2 &  7,c7 to respond to em]g5cies 
& disa/]s2  7#c7 z ( ,augu/ #bd1 #bjbj1 
_h assi/$ doz5s ( c\ntries 9 ! ,we/]n   
,hemisph]e region ) _! response to !    
,,covid-#ai p&emic1 includ+-- 7,a7 !    
provision ( #f1bjj1jjj ,,covid-#ai te/s 
to #cf c\ntries & t]ritories2  7,b7 #hd 
%ipm5ts ( p]sonal protective equipm5t to
 #bi c\ntries2 &  7,c7 o!r te*nical     
support & tra9+ to its memb] /ates2     
7#d7 has commission$ a ?ird p>ty review 
( its role 9 ! ,mais ,mdicos program2 & 
7#e7 has committ$ to und]take re=ms to  
/r5g!n its int]nal ov]sight & risk      
managem5t = all future programs4  7b7   
,s5se ( ,congress ,x is ! s5se (        

,congress t-- 7#a7 ,,paho is ! preem95t 
multilat]al organization d$icat$ to     
public heal? issues 9 ! ,am]icas2  7#b7 
,,paho-- 7,a7 has play$ a vital role 9  
/r5g!n+ heal? sy/ems 9 ,lat9 ,am]ica to 
address ! ,,covid-#ai p&emic2 &  7,b7   
cont9ues to provide ess5tial heal?      
assi/ance to meet ! ne$s ( ,v5ezuelans  
affect$ by ! ongo+ humanit>ian crisis 9 
_! c\ntry & displac$ individuals 9 o!r  
c\ntries 9 ! region2  7#c7 ! ,unit$     
,/ates %\ld cont9ue to support ,,paho1  
includ+ ?r\gh paym5t ( assess$          
contributions 79 full & on "t7 &        
volunt>y contributions1 to ensure       
,,paho's cont9u$ op]ations2  7#d7       
,,paho's role 9 ! ,mais ,mdicos program1
 z describ$ 9 section #b1 0 deeply      
conc]n+2 &  7#e7 ,,paho %\ld provide    
great] transp>5cy ab\t its role 9 !     
,mais ,mdicos program & /r5g!n its      
int]nal ov]sight & risk managem5t4  7c7 
,report ,n lat] ?an #ij days aft] ! date
 ( ! enactm5t ( ?is ,act1 ! ,secret>y ( 
,/ate & ! ,secret>y ( ,heal? & ,human   

,s]vices %all submit a report to !      
,committee on ,=eign ,relations ( !     
,s5ate & ! ,committee on ,=eign ,affairs
 ( ! ,h\se ( ,repres5tatives t          
includes-- 7#a7 a review ( & f9d+s on   
,,paho's role 9 ! ,mais ,mdicos program 
betwe5 #bjac & #bjai2  7#b7 a summ>y (  
corrective actions to be tak5 by ,,paho2
 &  7#c7 recomm5dations = fur!r         
corrective actions1 z necess>y4  7d7    
,acc\ntability measures ,! ,secret>y (  
,/ate & ! ,secret>y ( ,heal? & ,human   
,s]vices %all jo9tly-- 7#a7 take all    
necess>y /eps to ensure t ,,paho        
und]takes gov]nance re=ms t /r5g!n      
int]nal ov]sight & risk managem5t = all 
future programs2 &  7#b7 n lat] ?an #cj 
days aft] ! receipt ( ! results ( !     
indep5d5t1 ?ird-p>ty review ( ,,paho's  
role 9 ! ,mais ,mdicos program1 provide 
a brief+ to ! ,committee on ,=eign      
,relations ( ! ,s5ate & ! ,committee on 
,=eign ,affairs ( ! ,h\se (             
,repres5tatives t includes a detail$    
summ>y ( su* results & ! progress made 9

 ,,paho's ef=ts to /r5g!n int]nal       
ov]sight & risk managem5t4