The United States may now deny visa applications from individuals with common health conditions such as diabetes, heart disease, or obesity under a new directive from President Donald Trump’s administration, which broadens the grounds for medical ineligibility.
According to a cable issued Thursday by the State Department and obtained by KFF Health News, consular officers have been instructed to assess a wide range of chronic or high-cost medical conditions — including cardiovascular, respiratory, neurological, and mental health disorders — when determining visa eligibility.
The document says the aim is to prevent applicants who could become a “public charge,” or financial burden on the government, from entering the country. Officers are directed to assess whether applicants possess sufficient financial resources to cover medical expenses “over their entire expected lifespan” without relying on public aid.
This policy marks a sharp shift from previous standards. Health screenings traditionally focused on infectious diseases such as tuberculosis and ensuring vaccination compliance, but the new directive extends well beyond that scope. Experts told CBS the change grants significant discretion to visa officers — most of whom lack medical training — to make subjective judgments about applicants’ health and financial stability.
Charles Wheeler, senior attorney at the Catholic Legal Immigration Network, told CBS that the policy “encourages consular officers to speculate about potential medical costs based on bias or limited knowledge.” He said the directive contradicts the State Department’s own Foreign Affairs Manual, which bars visa denials based on speculative “what if” scenarios.
The cable also instructs officials to assess applicants’ dependents, taking into account whether family members’ disabilities or chronic illnesses could affect the applicant’s ability to remain financially independent.
Immigration and health experts have criticised the move as part of the Trump administration’s wider effort to restrict immigration, citing policies such as mass deportations, refugee limits, and visa reforms aimed at favouring wealthier, healthier applicants.
Sophia Genovese, an immigration lawyer at Georgetown University, told CBS that the guidance “goes well beyond the traditional medical exam” and effectively allows visa officers to deny applications based on “speculative medical costs or conditions that are extremely common worldwide.”
Globally, around one in ten people live with diabetes, while cardiovascular diseases are the world’s leading cause of death. Genovese warned the policy could disqualify millions of would-be applicants: “If the US begins treating chronic illness as disqualifying, it raises serious ethical and humanitarian questions about who deserves entry.”