Washington, D.C.: In a controversial new immigration directive, the United States government has authorized visa and green card denials for foreign nationals with chronic health conditions such as diabetes, cancer, or heart disease — marking a major expansion of its “public charge” policy.

The guidance, issued under former President Donald Trump’s administration, empowers visa officers to flag applicants whose medical conditions could lead to significant healthcare costs, potentially amounting to “hundreds of thousands of dollars.” The order, circulated by the US Department of State to embassies worldwide, instructs officials to weigh whether an applicant might become financially dependent on public resources for long-term care.

According to the internal cable, officers must assess a wide range of medical issues — including cardiovascular and respiratory diseases, cancers, metabolic and neurological disorders, and mental health conditions — when determining eligibility. Applicants or their dependents are also required to prove they have sufficient financial resources to meet lifelong treatment costs without resorting to government-funded programs.

“Visa officers must evaluate whether the applicant can afford medical care over their expected lifespan without seeking public cash assistance,” the directive reportedly states.

Immigration rights groups have sharply criticized the move, warning it could unfairly discriminate against people with chronic but manageable illnesses, while giving consular officials sweeping discretion in medical decision-making.

“This policy risks excluding individuals simply because they have a common health condition like diabetes or hypertension,” said an immigration attorney quoted by KFF Health News.

Although the guidance applies broadly to visa categories, experts believe it will primarily impact those applying for permanent residency in the US. The directive also extends scrutiny to family members — including children and elderly dependents — whose healthcare needs could influence the applicant’s employability and self-sufficiency.

Critics say the new rule blurs the line between legitimate health assessments and discriminatory gatekeeping, potentially leading to inconsistent and biased outcomes across consulates worldwide.

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