Foreign nationals seeking to immigrate to the United States could now be denied visas and green cards based on pre-existing chronic health conditions such as diabetes and heart disease, under new guidance issued by the Trump administration.
The directive, which significantly expands the criteria for who is deemed a potential “public charge,” has been sent by the State Department on to US embassies and consular offices worldwide.
A cable sent by the State Department to visa officers instructs them to flag applicants whose medical conditions could require “hundreds of thousands of dollars’ worth of care.” The list of conditions cited includes, but is not limited to cardiovascular diseases; respiratory diseases; cancers; diabetes; metabolic diseases; neurological diseases; and mental health conditions.
The guidance also specifically advises officers to consider conditions like obesity, noting that it can lead to costly complications such as asthma, sleep apnea, and high blood pressure. All these chronic illnesses are now being assessed as potential indicators that an individual might become a future financial burden on the United States.The policy shift, revealed on Thursday, is one of the most aggressive moves in the administration’s broader immigration crackdown, effectively linking an applicant’s health status to their eligibility for entry.
It was not immediately clear if the directive applies to tourist and student visas. While it technically applies to all visa applicants, including those seeking non-immigrant visas for tourism (B-1/B-2) and studies (F1), it is expected to be primarily used for those seeking to permanently reside in the US.
As things stand, tourist visa applicants are required to demonstrate they have sufficient financial means for their trip; they intend to leave the US at the end of their authorized stay; and they will not become a “public charge” during their temporary visit.
At the heart of the new guidance is a stricter interpretation of the “public charge” rule—a century-old immigration provision designed to exclude those likely to become primarily dependent on government assistance. While health screenings have always been part of the visa process, traditionally focusing on communicable diseases like tuberculosis, the new directive vastly expands the list of conditions to be considered.
Immigration advocates warn that the new rules grant consular officers, who lack medical expertise, sweeping authority to make subjective judgments about an applicant’s long-term health since no one is expected to disclose their ailments in visa applications.
Under the new framework, visa officers are explicitly instructed to determine whether applicants have the financial resources to cover the costs of such long-term medical care “over his entire expected lifespan without seeking public cash assistance or long-term institutionalization at government expense.”
Immigration experts contend that this policy will dramatically reduce legal immigration for older applicants and those with common chronic illnesses. Effectively, the policy will favor the wealthiest and healthiest applicants.
