US VISA APPLICATION AND DIABETES
Dated 9.11.2025 : The recent U.S government directives have broadened the scope of ineligibility for various U.S. visas, including the H-1B, by focusing heavily on an applicant’s medical history and likelihood of becoming a “public charge “
The changes reported in the media are based on a cable (a diplomatic instruction) sent by the U.S. State Department to embassy and consular officials worldwide. While the H-1B itself is a non-immigrant work visa, the consular officer at the interview stage must determine that the applicant is not “inadmissible” to the U.S.
1. Broader Scrutiny on Medical Conditions
The new guidance dramatically expands the range of medical conditions ( including diabetes and obesity ) that a Consular Officer must consider when assessing an applicant’s admissibility.
- Expanded List of Conditions: Traditionally, medical inadmissibility focused primarily on communicable diseases of public health significance (like active Tuberculosis, Syphilis, etc.) and specific mental/physical disorders associated with harmful behavior. The new directive explicitly instructs officers to consider a much broader list of chronic, non-communicable diseases:
- Cardiovascular diseases
- Respiratory diseases
- Cancers
- Diabetes
- Metabolic diseases
- Neurological diseases
- Mental health conditions
- Obesity as a Factor: The guidance also encourages officers to consider other conditions, such as obesity, which can lead to expensive, long-term health issues like sleep apnea and high blood pressure.
- Focus on Future Cost: The central new instruction is to consider whether these medical conditions “can require hundreds of thousands of dollars’ worth of care” and if the applicant would be able to cover those costs without relying on the U.S. government.
2. Stricter “Public Charge” Determination (INA 212(a)(4))
The new medical scrutiny is tied directly to the “Public Charge” ground of inadmissibility, which determines if a person is likely to become dependent on government benefits for subsistence. The new directions strengthen this assessment by mandating that visa officers consider:
Financial Resources for Healthcare
Officers must assess if the applicant and their family have adequate financial resources to cover the costs of potential long-term medical care over their entire expected lifespan without seeking public cash assistance or long-term institutionalization at government expense.
- Health of Dependents: The guidance specifically directs officers to consider the health of an applicant’s dependents (children or older parents). The question is posed: “Do any of the dependents have disabilities, chronic medical conditions, or other special needs and require care such that the applicant cannot maintain employment?”
- Age and Other Factors: Age, which is linked to potential future health issues and employment stability, is also explicitly listed as a factor to consider alongside health
Impact on H-1B Applicants: While the “Public Charge” rule has a greater historical impact on those seeking permanent residency (Green Cards), the new, expanded guidance on medical conditions can still be a significant hurdle for H-1B applicants (who apply for an initial visa at a consulate). They must convince the consular officer that their health, and that of their family, is not likely to result in them becoming a public charge in the future.
3. Broader Discretion for Consular Officers
Immigration experts have noted that this new guidance significantly broadens the discretion of consular officers, who are not medically trained, to speculate on the future progression of an applicant’s medical condition and the potential costs. This adds an element of subjectivity and unpredictability to the visa interview process, where a finding of potential future medical reliance on the government could lead to a visa denial.
These medical-related changes come in addition to the other H-1B reforms previously discussed, such as the new $100,000 fee for new applicants from outside the U.S. and the proposed weighted lottery system favoring higher-paid workers. To know more about the enhancement of H1B Visa fee, read our article : FEE HIKE ON H1B VISAS ISSUED BY USA
USCIS – Public Charge: https://www.uscis.gov/green-card/green-card-processes-and-procedures/public-charge
U.S. Dept. of State – Visas (9 FAM): https://fam.state.gov/ (navigate to 9 FAM 302 for medical/public charge grounds)
CDC – Panel Physician Technical Instructions: https://www.cdc.gov/immigrantrefugeehealth/visas/panel-physicians.html
INA 212(a)(4) – Public Charge (Cornell LII): https://www.law.cornell.edu/uscode/text/8/1182