According to a directive issued Thursday, Nov. 6, by the Trump administration, foreigners applying for visas to live in the United States may be denied if they have certain medical conditions, such as obesity or diabetes.
The directive, included in a cable sent by the State Department to embassy and consulate officials (and reviewed by KFF Health News), instructs visa officers to declare applicants “ineligible” for entry into the United States for new reasons, including age or the likelihood of becoming dependent on government benefits.
It also says these people could become a “burden on society”, meaning they could represent a possible drain on the country's resources due to health problems or age.
While health assessments of potential immigrants have been part of the visa application process for years, including testing for infectious diseases such as tuberculosis and checking vaccination history, experts said the new guidelines significantly expand the list of medical conditions that need to be considered. And they give officials more authority to make immigration decisions based on an applicant's health status.
The directive is part of the Trump administration's divisive and aggressive campaign to deport people living in the country without documents and discourage others from immigrating.
The government's offensive to restrict immigration included daily mass arrests, bans on refugees from some countries and plans to sharply limit the amount Total immigrants allowed in the country.
The new rules require immigrants' health to be a central issue in the application process.
While they apply to almost all visa applicants, they are likely to be used primarily for people who want to reside in the country permanently, he explained. Charles Wheelersenior attorney for the Catholic Legal Immigration Network, a nonprofit organization offering legal assistance.
“The health of the applicant must be taken into account,” the cable said. “Certain diseases, including but not limited to cardiovascular and respiratory diseases, cancer, diabetes, metabolic diseases, neurological diseases and mental health disorders, may require medical care that costs hundreds of thousands of dollars.”
Next to 10% of the world's population lives with diabetes. Cardiovascular diseases are also common and leading cause of death Nivel Global.
The cable also urges visa officers to consider other conditions such as obesity, which it notes can cause asthma, sleep apnea and hypertension, when assessing whether a person may become a public charge. If it is determined that this may have occurred, you may be denied entry into the United States.
“All these [afecciones] “They may require expensive and long-term medical care,” the cable said. State Department officials did not immediately respond to requests for comment.
Officials must also determine whether applicants have sufficient financial resources to cover health care costs without U.S. government assistance.
“Does the applicant have sufficient financial resources to cover these expenses throughout his or her lifetime without resorting to government financial assistance or requiring long-term institutionalization at government expense?” says the cable.
The language in the cable contradicts the State Department's own Foreign Affairs Manual, which states that officials cannot deny a request based on hypothetical scenarios, Wheeler said.
The directive directs officers to “develop their own judgment about what may result in a medical emergency or future medical expenses,” he said. “This is concerning because they have no medical training, no experience in the field, and they should not make predictions based on their personal knowledge or bias.”
The guidelines also ask officers to consider the health status of the applicant's family members, including children or elderly parents.
“Do any dependents have a disability, chronic illness, or other special need that requires attention to such an extent that it prevents the applicant from maintaining employment?” says one question over the cable.
Currently, immigrants are already required to undergo a medical examination by a doctor approved by the US Embassy.
They are tested for infectious diseases such as tuberculosis and interviewed fill out the form where they report whether they have a history of drug or alcohol use, mental disorders or episodes of violence. They also need to receive a series of vaccinations. against infectious diseases such as measles, polio and hepatitis B.
But this new directive goes further, emphasizing that chronic illnesses need to be taken into account, explained Sofia Genovese, an immigration lawyer at Georgetown University. He also noted that the directive's language encourages officials and doctors tasked with examining applicants to consider the cost of their health care and their ability to obtain employment in the United States given their health status.
“Taking into account a history of diabetes or cardiovascular disease, this is quite broad,” Genovese said. “There's already some degree of assessment, but not so extensive as to give an opinion on, for example, the question: 'What happens if someone goes into diabetic shock?' “If this change is implemented immediately, it will obviously cause a lot of problems when people come for consular interviews.”
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