The Trump administration issued a new directive Thursday allowing US embassies to deny visas or permanent residency to applicants with certain chronic health conditions, including diabetes, obesity, cardiovascular, respiratory, neurological, mental health, and metabolic disorders.
The guidance instructs visa officers to assess whether applicants can cover medical expenses independently, citing concerns that costly health conditions could make them a "public charge" reliant on government support.
Officers are also advised to consider the health of applicants' family members, evaluating whether dependents' illnesses could affect self-sufficiency in the US.
Previously, visa screenings focused on communicable diseases, vaccinations, and select mental health conditions.
The new rules broaden this scope, giving officers more discretion to judge applicants' health and economic viability -- despite not being medically trained.
Immigration lawyers and public health experts have criticized the policy. Charles Wheeler of the Catholic Legal Immigration Network warned it could lead to biased assumptions about medical costs, while Georgetown's Sophia Genovese called it "troubling," potentially excluding millions with common chronic conditions.
Medical exams by US embassy-approved physicians remain mandatory, covering communicable diseases, mental health, substance use, and vaccinations, but chronic illnesses and long-term care costs are now central to visa eligibility.