Chronic illnesses like diabetes may now count against people seeking U.S. visas under new State Department guidance, according to multiple media outlets.

The shift could have significant implications in northern Mexico, where conditions like diabetes are widespread and where many families apply for work, student, and family-based visas at U.S. consulates in Monterrey, Matamoros, and Ciudad Juárez. 

Immigration attorneys told KFF Health News, the nonprofit newsroom formerly known as Kaiser Health News, that the change may affect cross-border travel, reunifications, and employment opportunities for Mexican nationals who depend on consular approvals.

NPR, KFF Health News, and the Washington Post reported Wednesday that they obtained a State Department cable instructing consular officers worldwide to factor chronic medical conditions into visa decisions.