In a major policy shift, the Trump administration has expanded visa and green card denial grounds to include certain health conditions such as diabetes, obesity, and heart disease.
According to a new directive from the US State Department, visa officers worldwide can now consider these medical conditions when deciding if an applicant may become a “public charge” — someone likely to depend on government support for medical care or living expenses.
Health now key to visa decisions
The guidance lists a range of conditions — including cardiovascular and respiratory diseases, cancers, metabolic and neurological disorders, and mental health issues — as potential grounds for ineligibility.
Obesity is highlighted as a concern due to its links with long-term illnesses like sleep apnea and high blood pressure, which could lead to expensive, ongoing treatment. Applicants must now prove they can afford their healthcare costs without government aid.
Family health also under scrutiny
For the first time, consular officers can review the health of an applicant’s dependents. If family members have disabilities or chronic conditions that could limit the applicant’s ability to work, this may count against them.
Broader “Public Charge” rule
Previously, US visa health screenings focused mainly on communicable diseases such as tuberculosis. This expanded rule now brings chronic, non-communicable diseases under the same lens, giving visa officers wide discretion to deny applications based on health and financial risk.
Possible impact
Experts warn that the new rule could deter older immigrants and those with long-term medical conditions from applying. It is expected to affect all visa types — including tourist, student, and work visas — and may reduce overall legal immigration.
Critics have called it one of the most sweeping expansions of US immigration policy in decades, arguing it unfairly penalizes people for common health conditions and could lead to subjective, non-medical judgments.
Key points:
- Chronic illnesses like diabetes and obesity can now lead to visa denial.
- Family members’ health will be factored into visa decisions.
- Expands the “public charge” rule beyond infectious diseases.
- Could limit legal immigration, especially for older or unwell applicants.

