“Is it true they’re no longer admitting anyone with diabetes? What about my brother, I think he’s obese?” a U.S. citizen client asked during a recent consultation about filing an immigration petition for her brother.
Familiar story? I’ve heard this question repeatedly since the administration issued guidance directing consular and immigration officers to broaden how they apply medical inadmissibility rules. The guidance requires officers to consider applicants’ health during visa reviews. It applies to most visa categories but will mainly affect people seeking permanent residence in the United States.
Traditionally, officials barred applicants only for communicable diseases of public-health significance or conditions that made them likely to become a “public charge.” There are more to consider now. The new administration guidance instructs consular officers to scrutinize more health conditions when deciding admissibility.
The new approach directs officials to weigh a wider range of health conditions, including chronic, treatable, and noncommunicable illnesses such as cardiovascular and respiratory diseases, cancers, diabetes and metabolic disorders, neurological disorders, and mental health conditions. They must also consider whether those conditions might require medical treatment or use public resources in the United States. The applicant bears the burden of proof. They must show they are unlikely to become primarily dependent on government assistance for subsistence.
How it works
Consular officers review medical exams and case files when determining admissibility. Under the new guidance, they must consider whether an applicant’s condition could foreseeably burden public-health programs, emergency services, or the healthcare system. Officials may also weigh an applicant’s financial capacity and access to insurance. As a result, more applicants with disabilities, chronic conditions, or otherwise manageable illnesses could face visa denials if those conditions are judged likely to generate significant public costs.
Medical Exam
Applicants undergo a medical exam where a doctor assesses their health and notes conditions like obesity.
Consular Office Review
The officer considers the exam results, the applicant’s financial situation, and the new guidance to decide if they’re likely to need public assistance.
Potential impact
While not an automatic denial, obesity can raise red flags, prompting deeper questions about treatment costs and employment prospects, potentially affecting visa approval.
Why people are concerned
Advocates and health groups say the policy risks excluding many immigrants who pose little contagion risk and who could live, work, and obtain care in the U.S. They warn it could separate families, deter migrants from seeking preventive care, and stigmatize disability and illness. Civil-rights and immigration lawyers predict lawsuits challenging the guidance’s legal basis and its application, arguing that it expands inadmissibility beyond Congress’s intent and lacks clear standards.
What supporters say
Proponents argue the guidance protects public resources and ensures that immigration decisions account for foreseeable costs to government-funded health programs.
What public needs to watch
Because the guidance gives officers greater discretion, the public must watch how they use it. A narrow interpretation would limit denials to extreme cases. A broad one could bar many people with manageable conditions. To prevent abuse, officials should publish clear criteria, track outcomes, and implement safeguards so discretion doesn’t become a blunt instrument that harms vulnerable people.