US visa, Green Card rules tighten: New reason to deny visas to foreigners

Foreign nationals applying for US visas or permanent residency could be denied entry if they have certain chronic health conditions, including diabetes or obesity, according to a directive issued Thursday by the Trump administration.

The guidance, sent by the State Department to US embassies and consulates worldwide, instructs visa officers to consider a wide range of medical conditions — cardiovascular, respiratory, neurological, mental health disorders, and metabolic diseases — as potential grounds for visa ineligibility.

The directive cites the potential for applicants with costly medical conditions to become a “public charge,” possibly requiring significant US government support.

Visa officers are also instructed to assess whether applicants can cover medical expenses independently without relying on public assistance.

The guidance extends scrutiny to applicants’ family members. Officers are urged to consider whether dependents’ chronic illnesses or disabilities could affect the applicant’s ability to work and remain self-sufficient in the US.

Traditionally, US visa applicants were screened for communicable diseases, vaccination compliance, and certain mental health conditions. The new rules expand this to include chronic illnesses, giving visa officers — who are not medically trained — more discretion to make subjective judgments about applicants’ health and economic viability.

Immigration lawyers and public health experts have criticised the directive. Charles Wheeler, senior attorney at the Catholic Legal Immigration Network, said it encourages “speculation about potential medical costs based on bias or limited knowledge.” Georgetown University’s Sophia Genovese called the policy “troubling,” noting it could exclude millions worldwide with common chronic conditions, raising “serious ethical and humanitarian questions.”

Applicants must still undergo a medical examination by a US embassy-approved physician, including screening for communicable diseases, mental health, substance use, and required vaccinations. However, the new directive emphasizes chronic illnesses and long-term care costs as additional considerations.