The U.S. Department of State has issued new directives stating that foreign nationals suffering from chronic illnesses such as diabetes or obesity may be denied American visas or permanent residency (Green Cards). The guidelines, introduced under the Trump administration, have been circulated to U.S. embassies and consulates worldwide. The move marks a significant shift in how health conditions are evaluated during immigration and visa processing.
According to the new State Department guidelines, visa officers may now consider applicants’ cardiovascular, respiratory, neurological, mental health, and metabolic conditions — including diabetes — as potential grounds for visa denial. The document states that if a medical condition is likely to result in high treatment costs or make the applicant dependent on public financial assistance in the future, the visa may be refused on those grounds.
The instructions also direct visa officers to take into account the health of applicants’ family members or dependents. If a dependent has a chronic illness or disability that could affect the applicant’s financial independence or job performance in the United States, it may influence the officer’s decision. This expansion of criteria aims to assess long-term financial and healthcare burdens linked to immigration cases.
Previously, only communicable diseases, vaccination compliance, and certain mental health issues were part of the medical evaluation for U.S. visa and immigration decisions. Under the new policy, however, non-communicable but chronic conditions have also been added, giving visa officers greater discretionary powers. Critics have warned that this discretion could lead to subjective or biased decisions influenced by cultural or personal prejudice.
Immigration and public health experts in the United States have strongly criticized the new policy, calling it discriminatory and unscientific. Senior attorney Charles Wheeler said the policy could open the door to arbitrary judgments based on assumptions rather than facts. Professor Sophia Genevis of Georgetown University described the move as a serious ethical and human rights concern, warning that millions of people worldwide living with common chronic illnesses could be unfairly affected.
Despite the policy changes, medical examinations for U.S. visa applicants will remain mandatory and must still be conducted by embassy-approved physicians. The examination includes screening for infectious diseases, mental health, substance use, and vaccination status. However, under the new directives, chronic illnesses and the potential long-term financial costs of their treatment will also play a key role in determining visa eligibility.
