Foreigners applying for U.S. visas may now face denial if they suffer from chronic health conditions such as diabetes or obesity, under a new directive issued by the Trump administration. The policy, communicated through a cable from the State Department to U.S. embassies and consulates and reviewed by KFF Health News, expands the scope of medical scrutiny in visa decisions. Applicants deemed likely to become a “public charge” — relying on U.S. resources due to age or illness — could be rejected, CBS reported.
“You must consider an applicant’s health,” the cable states. “Certain medical conditions, including but not limited to cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental health conditions — can require hundreds of thousands of dollars’ worth of care.”
The directive also highlights obesity, noting it can lead to complications such as asthma, sleep apnea, and high blood pressure — all cited as potential grounds for visa denial. Consular officers are instructed to assess whether applicants have sufficient financial resources to cover long-term medical expenses without relying on government aid. The cable asks: “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 institutionalization at government expense?”
Experts say the guidance represents a significant expansion of existing medical assessments, which traditionally focused on communicable diseases like tuberculosis or vaccination records. Sophia Genovese, an immigration lawyer at Georgetown University, noted, “Taking into consideration one’s diabetic history or heart health history — that’s quite expansive. There is a degree of assessment already, just not this broad.”
Critics argue the directive gives excessive discretion to visa officers, who lack medical training and may rely on subjective judgment or personal bias. Charles Wheeler, senior attorney at the Catholic Legal Immigration Network, said, “The guidance directs visa officers to speculate about potential medical emergencies or costs in the future. They are not medically trained and should not make such projections based on personal knowledge or bias.”
The Trump administration’s move aligns with its broader push to tighten immigration policies, including refugee bans and reductions in legal migration.
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