The Trump administration ordered the State Department to deny visas to foreigners for reasons including age and pre-existing conditions such as diabetes and obesity. According to Washington, these applicants have a high probability of becoming a “public charge” due to their health problems. In recent months, plans to discourage more foreigners from coming to the country have included, among other measures, bonds of up to $15,000 for travelers from certain countries, a $100,000 fee for workers on H-1B visas, and denial of requests based on findings of “anti-American views.”
The new guidance, which will be implemented starting in January 2026, was published in a cable sent by the State Department to officials at embassies and consulates around the world in early November. The new rules require that the immigrant’s health and certain medical conditions – including cardiovascular and respiratory diseases, cancer, diabetes, metabolic and neurological diseases, and mental disorders – be taken into consideration, as they could require medical care worth hundreds of thousands of dollars.
Immigrants applying for a visa to live permanently in the United States must undergo a medical examination conducted by a government-approved healthcare provider. All applicants are tested for infectious diseases, such as tuberculosis, and must fill out a form declaring any history of drug or alcohol use, mental health problems or violence. They must also indicate whether they have received vaccinations against infectious diseases such as measles, polio and hepatitis B.
The new directive not only significantly expands the list of medical conditions to consider, but also grants immigration officials greater powers to accept or deny visas based solely on the applicant’s health status and ability to afford medical treatment without government assistance. “Does the applicant have adequate financial resources to cover the costs of such care throughout his or her expected lifespan without seeking public cash assistance or long-term institutionalization at government expense?” asks the cable.
Officials will draw their own conclusions about what could potentially lead to medical emergencies or health care expenses in the future. In this regard, a report by KFF Health News says Washington’s directive contradicts the State Department’s Foreign Affairs Manual, which says staff cannot reject a request based on hypothetical scenarios. Charles Wheeler, senior attorney at the Catholic Legal Immigration Network (CLINIC), warns in the same report that this change is “concerning because they have no medical training, no experience in this area, and should not be making projections based on their personal knowledge or bias.”
The directive also calls on officials to take into consideration the health of the applicant’s family, including children or elderly parents. “Do any of your dependents have disabilities, chronic medical conditions or other special needs and require care such that the applicant cannot maintain employment?” is another question included in the cable.
Another point of contention is that both visa officials and doctors examining potential immigrants may speculate on the cost of treating the applicant’s medical conditions and their ability to obtain a job in the United States that would allow them to purchase health insurance that covers any medical treatments.
Approximately 10% of the world’s population suffers from diabetes and cardiovascular disease is the leading cause of death globally. In this context, Washington’s measure will block the arrival of further immigrants in the United States.
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