The U.S. Department of State (DOS) has issued new guidance that significantly expands the list of health-conditions consular officers can consider when deciding whether to approve a visa. Previously, health-related inadmissibility focused mainly on communicable disease (think: tuberculosis) and vaccine compliance. The new guidance goes further: chronic conditions such as diabetes, obesity, cardiovascular disease, respiratory disease, neurological or mental-health disorders may now trigger additional scrutiny under the “public charge” concept.

According to one summary of the internal memo:

“Certain medical conditions — including, but not limited to, cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental-health conditions — can require hundreds of thousands of dollars’ worth of care.”

The memo even mentions obesity because it can lead to asthma, sleep-apnea, high blood pressure.

If you or a dependent have a chronic health condition, your visa or immigrant application may now face greater risk of denial unless proactively addressed.

Why Is This Happening?

The rationale: the new guidance leverages the long-standing “public charge” ground of inadmissibility, the idea that someone is likely to become dependent on U.S. government resources and therefore inadmissible. The DOS cable directs consular officers to ask: “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 focus is on the likelihood of future reliance on public benefits due to medical costs or inability to work, and whether dependents have chronic conditions that may hamper employment or increase care costs.

In short: new policy = health + financial capacity + dependents + future risk = visa risk.

Who Is Likely to Be Affected By These Visa Rules?

While the guidance technically applies to all visa applicants, certain categories will feel it most intensely:

• Immigrant visas (green-card applicants abroad): since they intend to live permanently in the U.S., the “public charge” test has more weight.
• Family-based or employment-based green-card applicants with chronic health issues (or whose dependents do) such as diabetes, obesity, heart disease, sleep apnea, mental-health conditions.
• Applicants with dependents who have special needs/chronic conditions that could impact the applicant’s employment capacity or result in care-cost liabilities. The memo explicitly includes dependents’ health.
• Applicants lacking strong financial or insurance resources to cover anticipated lifelong medical costs without relying on government support.

Conversely, short-term nonimmigrant visas (student, tourist, temporary work) may be less impacted, though risk is not zero. Several reports suggest the impact for nonimmigrant categories is likely lower.

What Can You Do About Visa Health Restrictions?

Here’s what you should do if this change applies to you (or your clients/employees):

1. Full Health Disclosure and Documentation

Be transparent about any chronic health conditions in your application and medical exam. Hide nothing, the changes mean health is now a material factor.

Collect all medical records, treatment plans, prognosis, insurance coverage, and cost estimates.

2. Demonstrate Financial Capacity / Self-Sufficiency

Because officers will ask whether you can cover future care costs:

• Show insurance policies that cover the condition(s) in the U.S.
• Show savings/assets/income sufficient to cover medical costs.
• If employer-sponsored health care will apply, document it clearly.
• Address potential long-term care issues, especially if you or a dependent have a condition that may require institutionalization or heavy ongoing treatment.

3. Address Dependents’ Conditions

If you have dependents (spouse, children, aging parent) with chronic/serious conditions, you must show how you will provide for them and still maintain employment. Otherwise, the officer may view you as a risk of becoming a “public charge”.

4. Make the Case That You Will Contribute

Beyond just avoiding being a burden, show that your presence is a net benefit; employment, community ties, assets, health stability, etc. A positive narrative helps mitigate concerns.

5. Work With Immigration Counsel

These decisions are subjective and the stakes are high. At Berardi Immigration Law, we routinely advise on “public charge” issues and medical-condition risks in visa applications. As Managing Partner, Rosanna Berardi, Esq., puts it:

“A successful visa outcome no longer relies solely on the health exam. Now, we must build the full ‘health + financial’ story around the applicant so consular officers see self-sufficiency instead of risk.”

What Remains Unchanged About Visa Health Requirements

Applicants will continue to undergo the standard immigrant visa medical exam (for permanent-residence cases), which focuses on communicable disease, vaccine compliance and general physical fitness. The new guidance adds layers, but doesn’t replace the core medical exam process.

There is no automatic bar simply because someone has diabetes or heart disease. The guidance states officers must assess the totality of circumstances.

Attorneys may still challenge adverse decisions, especially if they believe the consular officer misinterpreted the policy or relied on speculation.

Visa Health Conditions FAQs

If I have obesity or diabetes, does that mean my visa will automatically be denied?
No. These conditions may trigger closer scrutiny, but denial is not automatic. What matters is your overall health situation plus your ability to cover future costs, employment prospects, and dependents’ needs.

What if my dependent has a chronic condition?
It could elevate your risk of denial, because consular officers will consider whether you can maintain employment and support that dependent without government assistance. You must show your financial and insurance backing and how you’ll address that dependent’s ongoing care.

Going Forward With New Visa Health Rules

This is one of the most significant shifts we’ve seen in visa-adjudication policy in years. Chronic health conditions that once might have mattered only minimally during the standard medical exam are now front and center under the “public charge” evaluation.

If you or a dependent have a health condition, it’s time to get proactive. Gather medical records, assets, insurance details, and build your case for self-sufficiency and contribution. At Berardi Immigration Law, we can help you navigate the added complexity and put you in the best possible position before you submit your application. Because in today’s world? It’s more than “Are you healthy?”, it’s “Can you pay your bills, and will you be self-sufficient?”

Let’s make sure your U.S. immigration path doesn’t get derailed by what used to be routine. Book your consultation with Berardi Immigration Law online today.