Foreigners with health conditions such as diabetes or obesity could face denial of US visas, according to new guidance from the Trump administration, reports KFF Health News.

Foreigners applying for a US visa are required to undergo a medical exam by a physician who has been approved by a US embassy. Immigrants and nonimmigrants are also screened for communicable diseases, such as tuberculosis, and required to complete a form disclosing any relevant medical history.

Now, the Trump administration is enforcing stricter regulations for the issuance of US visas based on medical grounds.

Foreigners applying for US visas may face rejection due to specific medical conditions, such as diabetes or obesity, according to a directive issued by the Trump administration.

A cable that the State Department sent to the embassy and consular staff was reviewed by KFF Health News.

The directive instructs visa officers to declare applicants unable to enter the United States for several new grounds, such as age or the possibility that they would rely on public benefits.

According to the guidelines, these individuals may become a “public charge”—a possible burden on American resources—due to their age or health problems.

As reported by KFF Health News, the cable reads, “You must consider an applicant’s health. 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. All of these can require expensive, long-term care,”

The cable advises visa officers to take into account additional factors, such as obesity, which can lead to health issues like asthma, sleep apnea, and high blood pressure, when determining if an immigrant may become a public charge and should be denied entry to the U.S.

Visa officers were also directed to determine if applicants have the means to pay for medical treatment without help from the U.S. government.

“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 cable reads.

The guidance also directs visa officers to consider the health of family members, including children or older parents.

“Do any of the dependents have disabilities, chronic medical conditions, or other special needs and require care such that the applicant cannot maintain employment?” the cable asks.

Experts told KFF Health News that the new guidelines will significantly broaden the list of medical conditions to be taken into consideration and give visa officers more authority to make decisions about immigration based on an applicant’s health status.

The directive reflects the Trump administration’s aggressive campaign aimed at deporting unauthorized immigrants in the U.S. and discouraging further immigration. This effort has involved mass arrests, country-specific refugee bans, and plans to limit the overall number of immigrants allowed into the country.

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