Last week, a notice was sent to consular officers with a new directive: USCIS agents must now consider chronic conditions such as obesity and diabetes as grounds to deny visa and green card applications.
The new USCIS directive on visa eligibility for people with certain health conditions is controversial. Critics warn that the measure is discriminatory, while the government defends it by emphasizing the need for more rigorous scrutiny, stricter investigations, stronger fraud detection, and ongoing modernization efforts to improve efficiency.
Under this policy, having certain medical conditions—such as obesity, diabetes, high blood pressure, heart disease, and other chronic illnesses—may be seen as a sign that the applicant could become a “public charge.”
Visa officers have been instructed to assess whether foreign nationals, particularly those applying for permanent residency (green cards), face a higher risk of becoming a financial burden due to their health. Applicants with poorly controlled diabetes, severe obesity, or similar chronic conditions, and who lack substantial means (such as high income, private health insurance, or strong family support in the United States), face a higher likelihood of denial. This rule is part of a broader effort to tighten immigration policy and aims to restrict entry to individuals who could represent significant healthcare costs for the country.
The Health Examination
Anyone who has gone through the U.S. immigration process is familiar with the requirement for medical checkups. The “Report of Immigration Medical Examination and Vaccination Record” (Form I-693) has long been required and remains mandatory. However, with this new directive, the list of diseases under consideration has expanded, as has the discretionary power of USCIS officers to decide whether to approve an applicant’s case.
Although this order already applies to the health evaluation process, it’s likely that scrutiny for visa and green card applicants will expand even further, not just in health-related matters. There’s discussion of broadening the entire concept of what constitutes a “public charge.”
What It Means to Be a “Public Charge”
When someone is at risk of being labeled a “public charge,” it means they might rely on government-funded healthcare or services if admitted to the United States. This is already a major factor in determining eligibility for green cards under the U.S. Immigration and Nationality Act (INA). The INA states that a noncitizen may be deemed inadmissible or ineligible for certain immigration benefits if they are likely to become a public charge.
Under immigration law, some benefits considered in determining public charge status include:
- Supplemental Security Income (SSI)
- Temporary Assistance for Needy Families (TANF)
- Equivalent state or local programs
The current rule on public charge considerations (known as the 2022 Final Rule) restricts evaluations to specific factors. A visa or green card denial on public charge grounds applies only if the applicant receives cash benefits or is in long-term government-funded institutional care.
How the Rules Would Change
The document published in the Federal Register last week by the Department of Homeland Security (DHS) proposes repealing the 2022 public charge rules. It argues that the 2022 rules are not the best interpretation of the law, stating they “conflict with congressional intent, are unduly restrictive, and hinder DHS’s ability to accurately and reliably determine whether certain noncitizens are likely to become public charges at any time.”
With this repeal, DHS would have greater discretion to evaluate all relevant facts to ensure that foreign nationals in the U.S. are self-sufficient and that government benefits do not encourage immigration.
There are other benefit programs that (for now) are not considered factors for visa or green card denials, such as:
- Supplemental Nutrition Assistance Program (SNAP)
- Children’s Health Insurance Program (CHIP)
- WIC (Women, Infants, and Children)
- Medicaid
- Housing assistance
If the new proposal takes effect, these could be reconsidered as denial factors.
Who Will Be Affected
The new regulation will affect applicants for:
- Visas
- Entry into the country
- Adjustment of status
If you or your sponsor are receiving government benefits and have a pending application with USCIS, it is strongly advised to consult with an immigration attorney to evaluate your situation.
Related Resources
- The Massive Increases for H-1B Visa Workers, Explained (FindLaw's Law and Daily Life)
- The Super Bowl Halftime Show Will Include Bad Bunny … and ICE, Too? (FindLaw's Law and Daily Life)
- Lesser Crimes May Now Lead to Denaturalization (FindLaw's Law and Daily Life)
