Foreigners seeking visas to live in the US may be rejected if they have certain medical conditions, including diabetes or obesity, according to a guideline issued last week by the Trump administration.
The guidance, issued in a cable sent by the State Department to embassy and consulate officials and reviewed by KFF Health News, instructs visa officers to consider applicants ineligible to enter the US for several new reasons, including age or the likelihood that they will rely on public benefits.
The guidance states that such people could become a “public charge” — a potential drain on US resources — due to their health problems or age.
Although assessing the health of potential immigrants has been part of the visa application process for years, including screening for communicable diseases like tuberculosis and obtaining vaccination histories, experts say the new guidelines broadly expand the list of medical conditions to be considered and give visa officers more power to make immigration decisions based on the applicant’s health status.
The guideline is part of the Trump administration’s divisive and aggressive campaign to deport immigrants living without authorization in the US and discourage others from immigrating to the country. The White House’s crusade to expel immigrants has included daily mass arrests, bans on refugees from certain countries, and plans to severely restrict the total number allowed in the US.
The new guidelines make immigrants’ health a focus in the application process. The guidance applies to nearly all visa applicants but will likely be used only in cases where people seek to reside permanently in the US, said Charles Wheeler, senior attorney at the Catholic Legal Immigration Network, a nonprofit legal assistance group.
“You must consider the applicant’s health,” the cable says. “Certain medical conditions — including, but not limited to, cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental health conditions — may require care costing hundreds of thousands of dollars.”
About 10% of the world’s population has diabetes. Cardiovascular diseases are also common; they are the leading cause of death worldwide.
The cable also encourages visa officers to consider other conditions, such as obesity, which it says can cause asthma, sleep apnea, and high blood pressure, in assessing whether an immigrant could become a public charge and thus be denied entry to the US.
“All of these can require expensive and long-term care,” the cable says. State Department spokespeople did not immediately respond to a request for comment on the cable.
Visa officers were also instructed to determine whether applicants have the means to pay for medical treatment without US government assistance.
“Does the applicant have sufficient financial resources to cover the costs of such care for their entire life expectancy without seeking public cash assistance or long-term institutionalization at government expense?” the cable says.
The cable’s language appears to contradict the Foreign Affairs Manual, the State Department’s own manual, which states that visa officers cannot reject an application based on “what if” scenarios, Wheeler said.
The guidance instructs visa officers to develop “their own ideas about what could lead to some kind of medical emergency or medical costs in the future,” he said. “This is concerning because they are not medically trained, have no experience in this area, and should not make projections based on their own personal knowledge or bias.”
The guidance also instructs visa officers to consider the health of family members, including children or elderly parents.
“Does any dependent have disabilities, chronic medical conditions, or other special needs that require care to such an extent that the applicant cannot maintain employment?” the cable asks.
Immigrants already undergo a medical exam conducted by a doctor approved by a US embassy.
They are screened for communicable diseases like tuberculosis and asked to fill out a form disclosing any history of drug or alcohol use, mental health conditions, or violence. They are also required to have a series of vaccines to protect against infectious diseases like measles, polio, and hepatitis B.
But the new guidance goes further, emphasizing that chronic diseases must be considered, said Sophia Genovese, immigration attorney at Georgetown University. She also noted that the guideline’s language encourages visa officers and doctors examining people seeking to immigrate to speculate on the cost of applicants’ medical care and their ability to obtain employment in the US, considering their medical history.
“Considering someone’s diabetic or cardiac health history — that’s quite broad,” Genovese said. “There is already some degree of this evaluation, just not as broad as opining on ‘What if someone goes into diabetic shock?’. If this change is implemented immediately, it will obviously cause a myriad of problems when people go to their consular interviews.”
Source: npr.org by Amanda Seitz