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State Department Tells Visa Officers to Weigh Lifetime Medical Costs in Eligibility Decisions

The agency says determinations will be case by case, prompting warnings from immigration lawyers about speculative judgments.

Overview

  • An internal cable instructs consular officers to consider applicants’ health and projected care expenses, citing chronic conditions such as diabetes, cardiovascular and respiratory diseases, cancers, metabolic and neurological disorders, mental health conditions, and obesity.
  • Officers are directed to assess whether applicants can cover expected medical costs over their lifespan without relying on public benefits, reviving a broader public-charge rationale.
  • The guidance extends to dependents’ health needs, including whether care for children or elderly parents could prevent an applicant from maintaining employment.
  • A State Department official told The Hill that a medical condition alone is not an automatic disqualifier, with decisions made individually and based on the applicant’s ability to self-fund necessary care.
  • Experts say the policy will most often be applied to those seeking permanent residence, and they warn that officers’ lack of medical training could lead to inconsistent outcomes; KFF Health News first reported and reviewed the cable.