US expands “public charge” rule, potentially denying visas and green cards to applicants with chronic illnesses like diabetes, heart disease, and cancer

The United States government has issued new immigration guidelines that could deny visas and green cards to foreign nationals living with chronic health conditions, including diabetes, heart disease, cancer, and other long-term illnesses.

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The directive, released under President Donald Trump’s administration, broadens the definition of a “public charge”, a term in U.S. immigration law for individuals likely to rely on government assistance.

According to a State Department cable circulated to U.S. embassies and consulates, visa officers are instructed to identify applicants whose medical conditions could result in “hundreds of thousands of dollars’ worth of care.”

The guidance specifically mentions cardiovascular and respiratory diseases, cancers, metabolic and neurological disorders, mental health conditions, and obesity, citing the latter’s association with complications such as asthma, sleep apnea, and hypertension.

Previously, medical screenings mainly focused on communicable diseases such as tuberculosis. This new directive marks a significant policy shift by placing chronic illnesses at the centre of immigration eligibility assessments.

The U.S.-based Murthy Law Firm notes that this represents an unprecedented linkage between health status and admissibility, tying an applicant’s medical history to their perceived economic value.

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It remains unclear whether the rules will also apply to nonimmigrant visas, such as tourist (B1/B2) or student (F1) visas, leaving many potential applicants uncertain about their eligibility.