The State Department Introduces New Visa Policy Targeting Applicants With High Medical Costs
By Jim Mishler | Friday, 07 November 2025 06:26 PM EST
The State Department has introduced a directive enabling consular officers to deny immigrant visas to applicants with medical conditions that could result in significant public financial burdens. The policy instructs officers to assess whether an applicant’s health might increase the likelihood of reliance on government-funded care or long-term assistance after entering the United States.
An internal cable distributed to department personnel outlines guidelines for evaluating an applicant’s overall health and financial situation before visa approval. While much of the process is not new, the State Department maintains a public list of medical conditions that could affect visa eligibility. These include cardiovascular diseases, respiratory ailments, cancers, diabetes, metabolic disorders, neurological conditions, and mental health issues, which can require extensive treatment costs.
Officers are tasked with determining whether applicants can afford necessary care “over their entire expected lifespan without seeking public cash assistance or long-term institutionalization at government expense.” The guidance mirrors aspects of the “public charge” rule from the Trump administration, which restricted green cards for immigrants utilizing benefits like Medicaid, food stamps, or housing aid.
A State Department official emphasized that officers retain discretion in each case, stating no one will be automatically rejected based solely on a medical diagnosis. Instead, decisions will focus on whether applicants can cover treatment costs without public aid. For instance, a diabetic would not be denied for needing insulin but could face rejection if reliant on Medicaid for it.
Officials argue the policy protects public resources while ensuring the immigration system supports self-sufficient individuals. Jim Mishler, a seasoned reporter with decades of experience in crime, politics, and environmental coverage, contributed this report.
