New State Dept Policy Allows Rejection of Visa Apps Over Common Health Issues

A new State Department policy seeks to limit immigrants from entering the United States based on whether they have certain underlying medical conditions, including common ailments like diabetes, obesity, and mental health issues.

The U.S. visa process has always allowed for denial of entry based on health concerns, but has typically focused on people with notable communicable diseases, such as tuberculosis, or who do not have a strong vaccine history. The new policy vastly expands the criteria for rejection of visas, citing purported concerns of medical costs individuals may incur while residing in the U.S.

“Certain medical conditions — including, but not limited to, cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental health conditions — can require hundreds of thousands of dollars’ worth of care,” the new Trump administration directive says.

The mandate also tasks visa officers with asking applicants if they have “adequate financial resources to cover the costs” of their health needs, not only for the duration of their visit but over their “entire expected lifespan” and without needing to seek “public cash assistance…at government expense.”

While some visa holders are eligible for government funded health programs like Medicaid, most immigrants who are lawfully present in the U.S. have health insurance — one analysis found that fewer than one in five individuals with legal resident status (18 percent) are uninsured.

The new State Department rules give visa officers much wider discretion in deciding to reject an applicant’s request to enter the U.S., a key priority for the Trump administration.

According to reporting from KFF, the directive appears to contradict the department’s own handbook, which tells visa officers to avoid rejecting applicants based on “what if” scenarios.

The guidance instead gives officers incredible leeway to develop “their own thoughts about what could lead to some sort of medical emergency or sort of medical costs in the future,” said Charles Wheeler, senior attorney for the Catholic Legal Immigration Network, speaking to KFF about the matter. “That’s troubling because they’re not medically trained, they have no experience in this area, and they shouldn’t be making projections based on their own personal knowledge or bias.”

The guidance comes as the White House has ramped up its xenophobic rhetoric, and is reportedly considering new policies that favor white immigrants over nonwhite immigrants. It also reinforces false assertions — pushed numerous times by U.S. officials throughout history — that foreign visitors or immigrants seeking permanent residence in the U.S. are somehow inherently “sickly,” claims that have been repeatedly debunked as bigoted and false.

Such sentiments were reinvigorated during the COVID-19 pandemic, when several politicians — including President Donald Trump — falsely claimed their anti-immigrant fervor was based, in part, on supposedly protecting Americans from exposure to the virus or other diseases.

There are, of course, some limited historical examples of diseases being transmitted by newcomers to a geographical location, such as when European colonizers introduced smallpox and yellow fever to Indigenous populations in North and South America. But multiple studies have found there is no link between modern migration and the importation of diseases to countries migrants are seeking to enter.

Some research, in fact, suggests that an influx of immigrants can actually make the country’s health outcomes better. In addition to having higher vaccination rates than the citizenry, a high rate of immigrants entering the U.S. end up becoming health care workers. Indeed, close to one in six health workers say they came from somewhere other than the U.S., per a study published in JAMA.