Overview
- The State Department cable instructs consular staff to weigh chronic conditions—including cardiovascular and respiratory diseases, cancers, diabetes, metabolic, neurological and mental health issues—and obesity as potential grounds under the public‑charge standard.
- Officers are told to assess whether applicants can cover anticipated medical costs over their entire expected lifespan without relying on cash public assistance or long‑term institutional care.
- The directive extends the review to dependents’ health and asks whether caregiving needs could prevent an applicant from maintaining employment.
- Legal experts say the approach greatly broadens health‑based denials and appears at odds with the Foreign Affairs Manual’s warning against speculative “what if” decisions by nonmedical personnel.
- The department has not commented on enforcement, and international students and skilled workers—particularly in India—report worry about how common conditions such as diabetes or obesity could affect visa outcomes.