New Trump Administration Policy Allows Visa Denials for Diabetes, Obesity, and Other Chronic Conditions
Foreigners applying for a visa to live in the United States could be denied entry if they have certain medical conditions including diabetes or obesity under a new policy from the Trump administration released on Thursday.
The directive, sent in a cable from the U.S. State Department to embassies and consulates and obtained by KFF Health News, instructs visa officers to deem applicants ineligible for several new reasons including age or the likelihood that they may rely on public benefits. According to the guidance, such individuals could become a "public charge", meaning a potential burden on U.S. resources due to their health conditions or age.
While health assessments have always been part of the visa application process including tests for communicable diseases like tuberculosis and verification of vaccination records -experts say the new rules significantly expand the list of medical conditions to be considered and give visa officers broader discretion to deny applications based on health. The directive explicitly requires officials to place greater emphasis on applicants' health status.
The order applies to nearly all visa applications but is expected to most directly affect those seeking permanent residence in the U.S., explained Charles Wheeler, senior attorney at the Catholic Legal Immigration Network, a nonprofit legal services organization.
"You must consider the applicant's health status", the cable states. "Certain medical conditions including, but not limited to, cardiovascular disease, respiratory disorders, cancer, diabetes, metabolic disorders, neurological diseases, and mental health issues may require medical care costing hundreds of thousands of dollars".
Roughly 10% of the world's population has diabetes. Cardiovascular diseases are the leading cause of death worldwide.
The cable also instructs visa officers to consider other conditions such as obesity, which, according to the document, can lead to asthma, sleep apnea, and hypertension. These conditions may also require expensive, long-term treatment.
Spokespersons for the U.S. State Department did not immediately respond to requests for comment.
Additionally, visa officers are directed to determine whether applicants have sufficient financial resources to cover their medical expenses without government assistance.
"Does the applicant have sufficient financial resources to pay for such care throughout their expected lifetime without relying on public financial support or long-term institutional care at government expense?" the cable asks.
The language of the cable appears to contradict the Foreign Affairs Manual, the State Department's own internal guide which states that visa officers may not deny applications based on hypothetical "what-if" scenarios, Wheeler noted.
"The directive asks officers to make their own judgments about what could lead to a medical emergency or future medical costs", he said. "That's problematic because they have no medical training, no experience in the field, and shouldn't be making decisions based on personal assumptions or biases".
The directive also instructs visa officers to take into account the health status of family members, including children or elderly parents.
"Do the dependents have disabilities, chronic illnesses, or other special needs requiring care that could prevent the applicant from maintaining employment?" the cable asks.
Immigrants are already required to undergo a medical examination by a physician authorized by the U.S. State Department. This includes screening for infectious diseases such as tuberculosis and completing a form about past drug or alcohol use, mental illness, or violent behavior. Applicants must also show proof of vaccinations against diseases such as measles, polio, and hepatitis B.
However, the new directive goes much further by emphasizing the consideration of chronic conditions, said Sophia Genovese, an immigration attorney at Georgetown University. She noted that the language of the guidance encourages visa officers and examining physicians to speculate about the potential cost of treatment and the applicant's ability to work in the U.S. given their medical history.
"The inclusion of diabetes or cardiovascular history is extremely broad", Genovese said. "There has always been some level of medical evaluation, but not to this extent speculating, for example, 'What if someone suffers a diabetic shock?' If these changes take effect immediately, they will clearly create numerous problems during consular interviews".
The policy is part of the Trump administration's controversial and aggressive immigration agenda, which seeks to remove undocumented individuals from the U.S. and discourage others from immigrating. The White House's approach includes daily mass arrests, refugee bans for certain countries, and plans to drastically reduce the total number of admitted immigrants.
