Overview
- KFF Health News reports the Nov. 6 cable instructs consular officers to consider chronic conditions—such as cardiovascular disease, diabetes, cancers, respiratory and neurological diseases, mental health conditions, and obesity—in public charge determinations.
- Officers are told to decide whether applicants can pay expected care over their lifetimes without public cash assistance or government-funded institutionalization.
- The directive also directs consideration of dependents’ health needs that could affect an applicant’s ability to work.
- Immigration attorneys say the expansion gives officers broad discretion and appears to conflict with the Foreign Affairs Manual’s bar on denials based on hypothetical scenarios.
- The State Department has not provided substantive comment, and experts expect the guidance to weigh most heavily on permanent-residence cases.