Overview
- An internal cable dated November 6 and attributed to Secretary of State Marco Rubio expands the public‑charge review to medical factors for immigrant visas and some temporary categories, with humanitarian cases exempted.
- The guidance cites conditions such as cardiovascular and respiratory disease, metabolic and neurological disorders, cancer, diabetes, mental‑health conditions, and explicitly obesity as potential grounds for inadmissibility.
- Officers are told to determine if an applicant can fund treatment over their expected lifetime and may refuse a visa if resources or coverage appear insufficient.
- State Department spokesperson Tommy Pigott defended the move as prioritizing U.S. interests and preventing taxpayers from bearing medical costs.
- Immigration lawyers and medical commentators warn of subjective, potentially discriminatory outcomes and note reports that posts, including the U.S. Embassy in Peru, have begun implementing the directive.