Overview
- An internal cable instructs consular officers to consider chronic conditions—cardiovascular or respiratory diseases, cancers, diabetes, metabolic, neurological, and mental‑health disorders—and to factor obesity into assessments.
- Officers must evaluate whether applicants can cover expected care over their entire lifespan without U.S. cash assistance or long‑term institutionalization, and they are told to review dependents’ health needs that could affect self‑sufficiency.
- The administration defended the shift as protecting taxpayers, while a State Department official stressed case‑by‑case decisions and gave an example distinguishing privately funded insulin from reliance on Medicaid.
- Immigration attorneys and advocates warn the guidance grants broad discretion to non‑medical officers and may conflict with the Foreign Affairs Manual’s warning against speculative “what if” denials.
- The change broadens longstanding communicable‑disease screening, was first reported by KFF Health News, and is expected to be applied most in immigrant and permanent‑residence cases.