What the Trump administration said

The US has introduced stricter visa rules under a new Trump administration directive that could deny entry to foreign nationals suffering from serious or chronic health conditions, including diabetes, obesity, and heart disease. The policy, issued through a State Department advisory, instructs visa officers to assess whether applicants could become a financial burden on public welfare systems.

The new guidance expands the criteria for identifying visa applicants who may become a public charge – a term used to describe individuals likely to rely on government-funded healthcare or social benefits, according to foreign media reports. Officials have been told to assess an applicant’s overall health, financial stability, and ability to bear long-term medical expenses independently.

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The advisory, notes that medical conditions such as cardiovascular, respiratory, metabolic, neurological, and mental health disorders could require “hundreds of thousands of dollars’ worth of care” over time. The document states: “You must consider an applicant’s health. Certain medical conditions can impose heavy costs on the system.”

This marks a major shift from earlier procedures that focused primarily on communicable diseases like tuberculosis or vaccination compliance.

The updated guidelines explicitly mention obesity as a risk factor, citing its links to conditions such as asthma, sleep apnoea, and high blood pressure. Visa officers have been instructed to consider such cases while assessing long-term health costs. The directive also highlights the need to verify whether applicants have the financial capacity to cover treatment expenses “throughout their expected lifespan” without seeking government-funded care.

The document reportedly poses a direct question for officers: “Does the applicant have adequate financial resources to cover the costs of such care without seeking public cash assistance or long-term institutionalisation at government expense?”

In addition to individual health conditions, the new directive allows visa officers to evaluate the medical status of applicants’ dependents. If a family member has a disability, chronic illness, or requires long-term care that could limit the applicant’s ability to stay employed, it may be grounds for rejection.

The advisory notes: “Do any of the dependents have disabilities, chronic medical conditions, or other special needs and require care such that the applicant cannot maintain employment?”

The new rule could affect a large number of prospective immigrants worldwide, particularly those from countries with higher rates of lifestyle diseases or limited access to advanced healthcare. Data from international health agencies show that around 10 per cent of the global population lives with diabetes, while heart-related ailments remain the leading cause of death globally.