Trump Administration Orders Embassies to Weigh Applicants’ Health, Including Obesity, in Visa Decisions

The Trump administration has issued a sweeping new directive requiring U.S. embassies and consulates around the world to consider applicants’ health conditions — including obesity and other chronic illnesses — when determining whether to grant visas, with the goal of preventing future public costs from immigrants who may need long-term medical care.

The State Department memo directs consular officers to examine an applicant’s “financial status, health, and likelihood of requiring extended medical treatment” before making a decision. It explicitly lists cardiovascular diseases, diabetes, cancer, metabolic and neurological disorders, mental-health conditions, obesity, sleep apnea, high blood pressure, and asthma among the factors that could influence visa outcomes.

“Does the applicant have adequate financial resources to cover the costs of such care over his entire expected lifespan without seeking public cash assistance or long-term institutionalization at government expense?” the directive asks.

Applicants of retirement age must also show that they can sustain themselves without relying on employment income, and officers are instructed to consider the high costs of long-term care, such as nursing homes, which can exceed hundreds of thousands of dollars per year.

The new guidance builds on President Donald Trump’s February executive order titled “Ending Taxpayer Subsidization of Open Borders,” which sought to reinstate stricter “public charge” rules. Those policies, first implemented during Trump’s first term, allowed the government to deny green cards to immigrants who had received public benefits for more than 12 months within a three-year period.

“Self-sufficiency has been a long-standing principle of U.S. immigration policy,” the directive reads. “And the public-charge ground of inadmissibility has been a part of our immigration law for more than 100 years.”

The Biden administration rescinded those rules in 2021, but Trump’s latest move signals a full restoration — and expansion — of the policy to include health-based considerations for all visa categories, including temporary visitors.

Immigration advocates condemned the directive, warning it could lead to discriminatory denials based on weight, chronic illness, or mental-health conditions.

“It’s yet another example of the way in which this administration is trying to make it much harder to come here, either temporarily or to remain here, by targeting public-health issues,” said Erin Corcoran, a professor of immigration law and policy at the University of Notre Dame.

“They’re not medical experts,” she added.

Globally, around 16 percent of people are obese, compared with 40 percent in the United States, according to the World Health Organization. While the United States already requires medical screenings for certain infectious diseases like tuberculosis, the new rules significantly broaden the range of conditions that could trigger a denial.

The State Department has not yet clarified how embassy officials will assess medical data for visa applicants or what documentation will be required.

Still, the Trump administration maintains the goal is simple: ensuring that those admitted to the United States “will not become a burden on the American taxpayer.”

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