In a significant policy shakeup, the US government has announced new visa guidelines that place chronic health conditions—including diabetes, heart disease, and obesity—under scrutiny as potential reasons for denying long-term visas. This move marks a definitive expansion of existing health screenings in the visa process and is seen as part of a broader drive to emphasize self-sufficiency among would-be immigrants.​

The newly issued directive instructs diplomatic and consular officers worldwide to consider whether visa applicants with such health issues might rely on public health resources in the US. Traditionally, assessments focused on communicable diseases like tuberculosis or on ensuring vaccinations were up to date. Now, however, officers are empowered to evaluate a much wider range of chronic and costly conditions—asking not just about the applicant, but also any dependents who might require extensive care.​

Officials say the updated guidance aims to prevent applicants from becoming a “public charge”—someone dependent on government assistance or whose healthcare needs may place a heavy financial burden on US resources. The State Department’s cable specifically lists cardiovascular, respiratory, metabolic, and neurological diseases, along with mental health conditions, as areas of concern. Obesity also draws attention, as it can lead to complications like high blood pressure, asthma, and sleep apnea, all of which are linked to higher long-term healthcare costs.​

For potential immigrants, this effectively raises the bar for entry—particularly for applicants from countries with high rates of non-communicable diseases. Experts argue that the directive gives officers considerable discretion, requiring applicants to demonstrate ample financial resources to cover future medical care and avoid “public charge” classification. As a result, families with affordable private health insurance or demonstrable wealth might be better positioned under the new regime.​

While supporters laud the policy as a measure to protect overstretched healthcare systems, critics worry it could unfairly penalize people for circumstances beyond their control, placing the American Dream further out of reach for many. What is clear is that, moving forward, health will play a more prominent role in the US immigration process—transforming how consulates assess risk, eligibility, and the long-term viability of would-be residents.