The U.S. State Department has introduced a new directive permitting consular officers to deny immigrant visas to applicants with certain medical conditions if they are likely to rely on public assistance due to the anticipated cost of their healthcare. This policy broadens the health-related criteria previously applied by visa officers, who must now evaluate both the applicant’s medical condition and their financial means to cover costly medical treatments without government aid or long-term institutional care.
Conditions listed in this directive include cardiovascular diseases, respiratory illnesses, cancers, diabetes, metabolic and neurological disorders, mental health issues, and obesity, which can contribute to secondary problems like asthma and high blood pressure. These ailments are estimated to incur healthcare expenses reaching hundreds of thousands of dollars over a person’s expected lifetime.
This guidance effectively revives parts of the “public charge” rule from the earlier Trump administration, which aimed to restrict green cards for immigrants receiving public benefits such as Medicaid, nutrition assistance, welfare, or housing vouchers for more than 12 months within any three-year period. Officers are also advised to consider the health of applicants’ family members who may require care, potentially impacting the applicant’s ability to maintain employment.
While visa officers lack formal medical training, they are tasked with assessing a range of factors, including an applicant’s finances, criminal background, and probability of returning to their home country. The decision to deny a visa due to medical conditions is not automatic but made on a case-by-case basis. For instance, a diabetic will not be rejected solely for needing insulin but could face denial if it appears public programs like Medicaid would be necessary to cover treatment costs.
The directive comes amid ongoing efforts by the Trump administration to tighten immigration controls and ensure that the immigration system minimizes financial burdens on federal resources. Although the Biden administration had rolled back expansive public charge restrictions in 2022 to avoid discouraging eligible citizens from seeking coverage, this new approach signifies a renewed focus on applicants’ health-related financial risks.
