Foreigners seeking visas to live in the US may have their applications rejected if they present certain medical conditions, including diabetes or obesity, according to a guideline issued last week by the Trump administration.
The guidance, disclosed in a memo sent by the State Department to embassy and consulate staff and analyzed by KFF Health News, instructs immigration officers to consider applicants ineligible to enter the US for various new reasons, including age or the likelihood of relying on social benefits.
The guideline states that these people could become a “burden on the state” — a potential burden 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 records, experts say the new guidelines significantly expand the list of medical conditions to be considered and give immigration officers more power to make immigration decisions based on the applicant’s health status.
The directive is part of the Trump administration’s divisive and aggressive campaign to deport immigrants living without authorization in the US and deter others from immigrating to the country. The White House’s crusade to expel immigrants includes daily mass arrests, entry bans for refugees from certain countries, and plans to severely restrict the total number of people authorized to enter 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 only be used in cases where people seek permanent residence in the US, said Charles Wheeler, senior attorney at the Catholic Legal Immigration Network, a nonprofit legal aid organization.
“You must consider the applicant’s health,” the memo says. “Certain medical conditions — including, among others, cardiovascular diseases, respiratory diseases, cancer, diabetes, metabolic diseases, neurological diseases, and mental disorders — may require medical care that costs 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 memo also encourages immigration officers to consider other conditions, such as obesity, which, according to the document, can cause asthma, sleep apnea, and hypertension, in their assessment of whether an immigrant could become a public charge and thus have their US entry denied.
“All of these conditions may require expensive and long-term care,” the memo says. State Department representatives did not immediately respond to a request for comment on the memo.
Immigration officers were also instructed to check if applicants have the means to afford medical treatment without US government assistance.
“Does the applicant have sufficient financial resources to cover the costs of this treatment throughout their entire life expectancy, without resorting to public financial assistance or long-term hospitalization at government expense?” the memo asks.
“Does the applicant have adequate financial resources to cover the costs of this treatment throughout their entire life expectancy, without resorting to public financial aid or long-term hospitalization at government expense?” The telegram’s language appears to contradict the Foreign Affairs Manual, the State Department’s own manual, which states that immigration officers cannot reject an application based on hypothetical scenarios, said Wheeler.
The guidance instructs immigration 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 have no medical training, no experience in this area, and should not make projections based on their own knowledge or bias.”
The guidance also instructs immigration officers to consider the health of family members, including children or elderly parents.
“Does any dependent have a disability, chronic illness, or other special needs that require care preventing the applicant from maintaining employment?” the telegram asks.
Immigrants already undergo a medical exam conducted by a physician accredited by a US embassy.
They are screened for communicable diseases, such as tuberculosis, and asked to fill out a form revealing any history of drug or alcohol use, mental health problems, 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 guideline goes further, emphasizing that chronic diseases must be taken into consideration, said Sophia Genovese, immigration attorney at Georgetown University. She also noted that the guideline’s language encourages immigration officers and physicians examining people seeking to immigrate to speculate on the cost of medical treatment for applicants and their ability to obtain employment in the US, considering their medical history.
“Taking into account a person’s history of diabetes or heart health is quite broad,” Genovese said. “There is already a certain degree of evaluation, just not as broad as pondering ‘What if someone goes into diabetic shock?’ If that change happens immediately, it will obviously cause a series of problems when people go to consular interviews.”
Source: npr.org by Amanda Seitz