Staff Reporter

Foreign nationals seeking to live or visit the United States may now face denial of their visa or green card applications if they suffer from a wide range of chronic health conditions, including obesity, diabetes, and heart disease, according to new, sweeping guidance issued by the U.S. State Department under the Trump administration.

The directive, which has been sent as a cable to embassies and consular offices worldwide, drastically expands the criteria for defining an applicant as a potential public charge, an individual deemed likely to become reliant on government assistance.

While health screenings have long been a part of the visa process, experts say this move shifts the focus from communicable diseases to the projection of long-term medical costs.

The new guidance instructs visa officers to consider applicants whose chronic medical conditions could require hundreds of thousands of dollars’ worth of care.

Conditions now being flagged include cardiovascular diseases, respiratory illnesses, cancers, diabetes, metabolic and neurological diseases and mental health conditions.

The memo specifically references obesity as a condition for concern, noting its association with secondary ailments like asthma, sleep apnea, and high blood pressure, all of which require expensive, long-term care.

The core of the policy is a new financial test for self-sufficiency.

Visa officers are now tasked with assessing, “does the applicant have adequate financial resources to cover the costs of such care over his entire expected lifespan without seeking public cash assistance or long-term institutionalisation at government expense?”

The new directive has drawn criticism from immigration advocates, who argue that consular officers are being asked to make medical and financial projections for which they are unqualified.

Charles Wheeler, a lawyer for the non-profit Catholic Legal Immigration Network, stated that the guidance contradicts the State Department’s own Foreign Affairs Manual, which advises against denying applicants based on hypothetical what if scenarios.

“That’s troubling because they’re not medically trained, they have no experience in this area, and they shouldn’t be making projections based on their own personal knowledge or bias,” Wheeler said, cautioning that the new rules effectively establish a health-based wealth test for entry into the country.