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State Department Memo Expands Visa Medical Scrutiny to Chronic Illnesses

A leaked cable tells consular posts to treat certain chronic illnesses as potential “public charge” risks for immigrant and long‑stay cases.

Overview

  • Reports say the internal guidance, now circulating to embassies and consulates, directs officers to assess health beyond communicable diseases when deciding visa eligibility.
  • Diabetes and obesity are explicitly cited as conditions that could weigh against applicants if judged likely to generate ongoing, high medical costs.
  • The change is aimed at immigrant and long‑duration visa categories and extends to the health profiles of dependents when evaluating possible financial burden.
  • The directive was not issued through Federal Register rulemaking, leaving unclear how applicants can demonstrate they will not be a public charge or whether private insurance or documented solvency will suffice.
  • Consular denials carry no routine appeal, and immigration attorneys warn of broad officer discretion and potential federal lawsuits challenging arbitrary criteria.