Overview
- The directive, confirmed by the agency, lists cardiovascular and respiratory diseases, cancers, diabetes, metabolic and neurological disorders, mental health conditions, and obesity as potentially requiring costly care.
- Officers are instructed to determine whether applicants can cover treatment over their expected lifespan without U.S. cash assistance or long-term institutionalization.
- The guidance tells officers to factor in dependents’ disabilities or chronic conditions if those needs could limit an applicant’s ability to stay employed.
- Although the policy technically spans most visa categories, attorneys expect primary use in immigrant and permanent-residence cases, with its reach to student visas still unclear.
- A State Department official says adjudications remain case by case, while immigration advocates warn that non‑medical officers are being asked to speculate about future healthcare costs.