Overview
- The State Department cable instructs consular officers to treat chronic illnesses — including cardiovascular, respiratory and metabolic diseases, cancers, diabetes, obesity, neurological and mental health conditions — as potential grounds for denial due to long-term care costs.
- Officers are told to determine whether applicants can cover expected medical expenses over their entire lifespan without U.S. public assistance.
- The guidance directs officials to weigh the health needs of dependents and whether caregiving could limit an applicant’s ability to maintain employment.
- Although the directive applies broadly, immigration attorneys say they expect it to be used chiefly in decisions on permanent residency.
- Immigration lawyers say the approach invites speculative judgments that conflict with the Foreign Affairs Manual, and reporters note the cable was reviewed by KFF Health News with no immediate State Department comment on the change.