A new directive to U.S. embassies and consulates is instructing officials to consider denying visas for people who suffer from chronic health issues.
The guidelines sent by the U.S. State Department reportedly state that "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," according to KFF Health News, which said it reviewed a copy of the cable.
It also reportedly encourages visa officers to also consider conditions such as obesity.
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"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 allegedly says.
"Self-sufficiency has been a long-standing principle of US immigration policy … and the public-charge ground of inadmissibility has been a part of our immigration law for more than 100 years," it continues.
Tommy Pigott, principal deputy spokesperson, confirmed the directive to Fox News Digital on Tuesday.
"It's no secret the Trump administration is putting the interests of the American people first," said Pigott in a statement. "This includes enforcing policies that ensure our immigration system is not a burden on the American taxpayer."
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Non-citizen immigrants are significantly more likely to be uninsured compared to U.S. citizens, according to the Kaiser Family Foundation (KFF).
In 2023, about one in five lawfully present immigrant adults were uninsured, according to KFF.
There is no federal insurance mandate for work visas such as H-1B, while coverage typically depends on the employer or individual.
The cable comes after Fox News Digital first reported the administration's visa crackdown in January on reviving the "public charge" provision of immigration law from President Donald Trump's first term.
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"The public charge determination is 'in the opinion of the consular officer,'" the cable sent in January says - placing the burden of proof entirely on the applicant.
Officers are instructed to conduct a "comprehensive and thorough vetting" of each case and to assess "the totality of the applicant's circumstances" before issuing any visa.
"There is no 'bright-line' test," the cable adds. "You must consider all aspects of the case and determine whether the applicant's circumstances… suggest that he is more likely than not to become a public charge at any time."
Lora Ries, Heritage Foundation border security and immigration center director, told Fox News Digital on Tuesday that visa applicants can be denied if they're likely to become a public charge under the current law.
"If an applicant is uninsured and unable to show they can cover potential medical costs, like those associated with a chronic condition, that can indicate a high risk of becoming a public charge and make them a strong candidate for visa refusal," said Ries.
Dr. Marc Siegel, Fox News' senior medical analyst, told Fox News Digital about the directive, "The idea behind this is that obesity is connected directly to other costly chronic health problems including type 2 diabetes, heart disease, high blood pressure, stroke, high cholesterol and mostly inflammation in the body," he said.
"This could present an unpredictable and impactful cost to the health system, which is already overburdened," added Siegel.
"The solution," he also said, "is probably not a ban but an advisory or the need for further scrutiny or documentation to avoid the excess costs."
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Siegel also said, "In other words, obesity is a signal for increased risks - it doesn't mean they are there in each case."
A medical exam is already required for all immigrants and refugees entering the country, as noted by the CDC - and it's common for visa officers to screen for contagious diseases such as tuberculosis or ask for a vaccination history.
Fox News Digital's Morgan Phillips contributed reporting.
