Could your health cost you a U.S. visa? New State Department guidance says diabetes, other chronic conditions may weigh against applicants

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.

In simple terms, the guidance asks officers to consider whether an applicant’s illness might lead them to become a “public charge” — a term immigration officials use when they think someone may not be able to support themselves without government assistance.

The media reports do not specify which visa categories the guidance applies to. 

Public-charge evaluations are already a standard part of many immigrant visa cases, and consular officers also have discretion to review financial stability in certain temporary visa cases. 

But the cable obtained by the outlets does not list any visa categories by name, leaving the scope of the directive unclear.

KFF Health News reported that the cable lists several chronic conditions that may trigger additional review: diabetes, cancer, cardiovascular disease, respiratory illnesses, metabolic disorders, neurological conditions, and mental-health diagnoses. 

According to the outlet, the cable states that some of these illnesses “can require hundreds of thousands of dollars’ worth of care.”

The Washington Post reported that the directive instructs consular officers to determine whether applicants have enough financial resources to cover long-term medical treatment “over [their] entire expected lifespan.” 

The Post also said the guidance extends to dependents, directing officers to assess whether a child’s disability or chronic illness could affect a parent’s ability to maintain stable employment.

NPR reported that the cable broadens how consulates may apply the financial self-sufficiency standard, which historically focused on whether someone was likely to rely on cash welfare benefits or long-term institutional care.

The State Department has not released the cable publicly. 

A spokesperson told the Washington Post that the agency “will continue to implement U.S. law,” but declined to comment on the directive itself.