State Department says visas may be denied over diabetes and obesity
Visa applicants can now be rejected for health conditions such as obesity, diabetes, cancer and other chronic illnesses under new State Department guidelines issued earlier this month, according to reports from multiple outlets. The directive adds new grounds for denying visas at a time when the Trump administration is working to restrict additional pathways to entry and residency.
State Department spokesperson Tommy Pigott confirmed the shift in an emailed statement, saying the administration is focused on preventing the U.S. immigration system from becoming “a burden on the American taxpayer.” White House spokesperson Anna Kelly echoed that rationale, noting that for decades the department has had the authority to deny visa applicants deemed likely to impose a financial burden, News.Az reports, citing Axios.
The guidance broadens the criteria consular officers must consider when evaluating visa cases. It explicitly instructs officers to factor in health conditions that could require expensive, long-term medical care — including cardiovascular and respiratory diseases, cancers, diabetes, metabolic and neurological disorders, and mental health conditions. The directive also outlines obesity as a factor in determining whether an applicant could be considered a “public charge.”
The public charge rule, which has been part of U.S. immigration policy for decades, allows officials to deny entry to individuals judged likely to become dependent on government assistance. Some groups, like refugees, are exempt. While health screenings and mandatory vaccinations have always been part of the visa process, immigration experts say the new guidance significantly expands the scrutiny applied to common medical conditions that millions of people manage every day.
Sarah Krieger, senior policy counsel at the National Immigration Law Center, said she had not yet reviewed the full internal cable but described the policy shift as “unusual and concerning” based on early reports. She noted that the State Department’s Foreign Affairs Manual still contains older public charge guidance, creating the potential for inconsistency and confusion among consular officers. “This new policy seems designed to cause chaos,” she said, adding that it could most harm vulnerable immigrants who would otherwise qualify for entry.
Consular officers have also been instructed to evaluate whether an applicant has the financial means to cover the full cost of medical care for chronic conditions over their lifetime without relying on public assistance or long-term government-funded care.
The directive follows a February executive order directing federal agencies to ensure that no taxpayer-funded benefits go to “unqualified aliens,” reinforcing the administration’s broader effort to reshape U.S. immigration policy through tighter eligibility requirements.
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