Overview
- A State Department cable directs embassies and consulates to factor applicants’ underlying health and lifetime risk of becoming a public charge into visa decisions.
- The guidance names cardiovascular and respiratory diseases, cancers, diabetes, metabolic and neurological disorders, and mental health conditions, and it flags obesity for possible consideration because of long-term costs.
- Officers are instructed to review prior use of government assistance and weigh age, family status, assets, resources, finances, education and skills under a totality-of-circumstances approach.
- The cable asks whether applicants can cover expected medical expenses without public aid over their lifespans, with determinations made without a bright-line test as DHS acknowledged in September.
- Legal advocates warn the policy asks non-medical officials to make speculative health judgments and risks discriminatory outcomes, and it fits into broader tightening that includes a $250 Visa Integrity Fee.