Immigrants with health problems may be denied visas under new Trump administration guidelines

Immigrants with health problems may be denied visas under new Trump administration guidelines

Foreign nationals applying for visas to stay in the United States could be rejected if they have certain medical conditions, including diabetes or obesity, according to a Trump administration order Thursday.

The guidance, issued in a cable the State Department sent to embassy and consular officials and reviewed by KFF Health News, directs visa officials to classify applicants as ineligible to enter the U.S. for several new reasons, including age or the likelihood that they may rely on public benefits. The guidance says such people could become a “public charge” because of their health problems or age — a potential drain on U.S. resources.

While assessing the health of potential immigrants has been part of the visa application process for years, including screening for communicable diseases such as tuberculosis and collecting vaccination history, experts say the new guidelines significantly expand the list of medical conditions to be considered and give visa officers more power to make immigration decisions based on an applicant's health.

The policy is part of the Trump administration's divisive and aggressive campaign to deport immigrants living in the U.S. without authorization and discourage others from entering the country. The White House's crusade to expel immigrants has included daily mass arrests, entry bans on refugees from certain countries and plans to sharply limit the total number of people entering the United States

The new guidelines require immigrants' health to be a focus in the application process. The guidance applies to almost all visa applicants but will likely only be applied in cases where people seek permanent residency in the U.S., said Charles Wheeler, a senior attorney at the Catholic Legal Immigration Network, a nonprofit legal aid group.

“You must take into account an applicant’s health status,” the dispatch said. “Certain medical conditions – including, but not limited to, cardiovascular disease, respiratory disease, cancer, diabetes, metabolic disease, neurological disease and mental illness – can require hundreds of thousands of dollars’ worth of treatment.”

About 10% of the world's population suffers from diabetes. Cardiovascular diseases are also common; You are the world's leading killer.

The cable also urges visa officials to consider other medical conditions such as obesity, which can cause asthma, sleep apnea and high blood pressure, when assessing whether an immigrant could be subject to a public charge and therefore denied entry to the United States

“All of this can require expensive and long-term care,” the report said. State Department spokesmen did not immediately respond to a request for comment on the cable.

Visa officials have also been directed to determine whether applicants have the means to pay for medical treatment without help from the U.S. government.

“Does the applicant have sufficient financial resources to cover the costs of such care over his or her expected lifespan without requiring public financial assistance or long-term institutionalization at state expense?” The cable reads.

The cable's wording appears to contradict the Foreign Affairs Manual, which states that visa officers cannot reject an application based on "what if" scenarios, Wheeler said.

The guidance instructs visa officers to “develop their own thinking about what could lead to a medical emergency or medical expense in the future,” he said. “This is concerning because they have no medical training, no experience in the field and should not make predictions based on their personal knowledge or bias.”

The guidance also instructs visa officers to consider the health of family members, including children or elderly parents.

“Does any of the family members have a disability, chronic illness or other special needs and require care that would prevent the applicant from maintaining employment?” asks the cable.

Immigrants already undergo a medical examination by a U.S. Embassy-approved doctor.

They are screened for communicable diseases such as tuberculosis and asked to fill out a form asking them to disclose a history of drug or alcohol use, mental illness or violence. You must also have a series of vaccinations to protect yourself from infectious diseases such as measles, polio and hepatitis B.

But the new guidelines go further and emphasize that chronic illnesses should be taken into account, said Sophia Genovese, an immigration attorney at Georgetown University. She also noted that the policy's language encourages visa officers and doctors who screen immigrants to speculate about the cost of applicants' medical care and their ability to find employment in the U.S. given their medical history.

“If you take into account a person's diabetic or heart health history, it's pretty extensive,” Genovese said. “There is already some level of assessment, but not quite as far-reaching as asking, ‘What happens if someone goes into diabetic shock?’ If that change occurs immediately, it will obviously cause a variety of problems when people go to their consular interviews.”

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