Overview
- A State Department cable obtained by multiple outlets instructs consular officers to factor chronic conditions—including obesity, diabetes, cancers, cardiovascular, respiratory, metabolic, neurological and mental‑health disorders—into public‑charge determinations.
- U.S. officials say the guidance applies to immigrant visa cases, with decisions made case by case rather than as an automatic bar to entry.
- Officers are directed to assess whether applicants can fund medical needs over their expected lifetimes and to review bank statements, assets and retirement accounts when self‑sufficiency is claimed.
- The directive also permits weighing the health and care needs of dependents and allows officers to gauge English proficiency as part of a totality‑of‑circumstances review.
- Legal and policy experts warn the approach asks nonmedical officers to speculate about future costs in ways that conflict with the Foreign Affairs Manual and could hit older and low‑income applicants hardest, while the department says the policy protects taxpayers.