The United States has rolled out new visa guidance that could see applicants denied entry or green cards based on chronic health conditions such as diabetes, obesity, and heart disease.

Framed as an extension of the “public charge” rule, the directive allows consular officers to weigh an applicant’s long-term medical costs while determining eligibility. Embassies have been asked to flag individuals whose conditions could “require hundreds of thousands of dollars in care.”

The list includes cardiovascular and respiratory diseases, cancers, diabetes, neurological and metabolic disorders, and even obesity, given its association with conditions like hypertension and sleep apnea.

Previously, medical checks in visa processing focused on communicable diseases such as tuberculosis. The new rules mark a shift toward evaluating chronic, non-infectious illnesses as potential financial burdens on the US system.

While the guidance applies to all visa categories, including student (F-1) and tourist (B-1/B-2) visas, it’s primarily aimed at those seeking permanent residence.

However, experts warn that F-1 students could also face scrutiny if consular officers question whether their financial backing can cover lifelong treatment costs without public assistance.

Immigration advocates have voiced concern that the rule gives excessive discretion to consular officers, most of whom lack medical expertise. They argue that the measure could disproportionately affect older or chronically ill applicants — effectively favouring those who are “the healthiest and the wealthiest.”

For international students, the change introduces a new layer of uncertainty. Even if tuition and living costs are fully funded, health-related assessments could become an unpredictable hurdle.

As implementation unfolds, universities and applicants may need to strengthen financial and medical documentation to avoid rejection.