Overview
- A State Department cable instructs consular officers worldwide to factor applicants’ health and the risk of becoming a “public charge” into visa decisions.
- The guidance cites cardiovascular, respiratory and neurological diseases, cancers, diabetes and mental-health conditions, and flags obesity, noting potential care costs in the hundreds of thousands of dollars.
- Officers are told to evaluate whether applicants can pay for treatment over their expected lifespan without public assistance and to consider dependents’ health needs that could limit the applicant’s ability to work.
- Experts say the directive technically applies across visa categories but will most often be used in immigrant and permanent residency cases.
- Immigration lawyers warn the policy invites speculative medical judgments and may conflict with the Foreign Affairs Manual, while a department official has described case-by-case reviews as part of a wider 2025 tightening that includes a $250 Visa Integrity Fee.