The U.S. State Department has sent a new directive to embassies and consulates worldwide instructing officers to treat chronic illnesses such as diabetes and obesity as potential grounds for immigrant visa ineligibility under the “public charge” rule.
According to KFF Health News, which reported the memo on November 6, the guidance expands the scope of medical evaluations by directing officers to consider an applicant’s age, health condition, and likelihood of relying on public assistance as new factors for visa denial.
The cable lists several chronic diseases that may trigger visa restrictions, including cardiovascular, respiratory, cancer, diabetes, metabolic, neurological, and mental disorders. It states that these conditions could generate “hundreds of thousands of dollars” in long-term treatment expenses.
Obesity is also singled out due to its association with hypertension, sleep apnea, and asthma—conditions that could increase healthcare costs.
Currently, immigration applicants must undergo medical screenings for infectious diseases and provide documentation of mental health, substance use, and vaccination history. The new policy extends beyond communicable illnesses to require officers to evaluate non-infectious chronic conditions when assessing eligibility.
A controversial section allows consular officers to predict an applicant’s future medical expenses, directing them to determine whether the person can “cover lifetime treatment costs” and to consider the “possibility of long-term care facility admission.” Analysts warn this could disadvantage older or economically vulnerable applicants.
The memo further instructs officers to review the health of applicants’ family members. It states that if dependents have disabilities or chronic illnesses that might hinder the applicant’s ability to maintain employment, this should also be considered during review.
Kwanwoo Chun, an immigration attorney, said, “The public charge concept was designed for individuals already receiving public aid. Denying visas based on potential future illnesses dangerously expands that definition.” He added that allowing non-medical officers to forecast disease progression and treatment costs “poses serious risks” and that examining family members’ medical histories “intrudes excessively into sensitive health information.”
BY HANKIL KANG [kang.hankil@koreadaily.com]
