The U.S. Department of State has issued guidance to embassy and consular officials concerning criteria for visa applicant ineligibility, as detailed in a cable examined by KFF Health News. This directive broadens the scope of conditions under which foreign nationals seeking U.S. visas, particularly for permanent residency, may be denied entry.
Eligibility Criteria Expansion
The guidance instructs visa officers to consider applicants ineligible for several reasons, including age or the likelihood of becoming a "public charge." This "public charge" determination may be based on an applicant's health issues or age, implying a potential reliance on U.S. public benefits.
Medical Conditions for Consideration
The cable specifies that various medical conditions can necessitate extensive and costly care, thereby impacting an applicant's eligibility. These conditions include, but are not limited to:
- Cardiovascular diseases
- Respiratory diseases
- Cancers
- Diabetes
- Metabolic diseases
- Neurological diseases
- Mental health conditions
Additionally, the guidance encourages officers to consider conditions such as obesity, noting its potential to contribute to other health issues like asthma, sleep apnea, and high blood pressure, which may also require long-term care.
Financial and Family Assessments
Visa officers are also directed to assess an applicant's financial capacity. This includes determining if applicants possess sufficient resources to cover potential medical treatment costs over their expected lifespan without utilizing public cash assistance or long-term institutionalization at government expense.
The guidance further extends the assessment to family members, asking officers to consider if any dependents have disabilities, chronic medical conditions, or other special needs that could impede the applicant's ability to maintain employment.
Context and Expert Observations
Previously, the visa application process included health assessments focusing on communicable diseases like tuberculosis and vaccination history. This new guidance expands the list of medical conditions under consideration and grants visa officers increased discretion in evaluating an applicant's health status.
Legal experts have noted that the cable's language appears inconsistent with the Foreign Affairs Manual, which advises against rejecting applications based on speculative "what if" scenarios. Charles Wheeler, a senior attorney for the Catholic Legal Immigration Network, stated concerns regarding non-medically trained officers making projections based on personal knowledge or bias. Sophia Genovese, an immigration lawyer at Georgetown University, highlighted the directive's expansive nature regarding chronic diseases and the encouragement for officers and examining doctors to speculate on future medical costs and employment capabilities.
The directive applies broadly to visa applicants but is primarily anticipated for cases involving individuals seeking to reside permanently in the U.S.