Overview
- Guidance examined by KFF Health News instructs consular officers to consider conditions such as cardiovascular and respiratory diseases, cancers, diabetes, metabolic and neurological disorders, mental-health conditions, and obesity in visa rulings.
- Officers are told to evaluate whether applicants can pay for expected medical needs over their entire lifespan without U.S. cash assistance or long‑term institutionalization at government expense.
- The directive extends scrutiny to dependents’ disabilities or chronic needs when assessing an applicant’s ability to maintain employment and avoid becoming a public charge.
- Immigration lawyers say the approach asks non‑medical officers to speculate about future health costs and outcomes, noting apparent tension with the State Department’s Foreign Affairs Manual; officials did not provide comment in initial reports.
- Although the guidance technically applies broadly, experts expect it to be used mainly in permanent-residence cases, and outlets place it within a wider Trump administration push that includes new fees and stricter public-charge enforcement.