More Reasons to Deny your Visa: Being Fat, Having Diabetes, or Suffering from Cardiovascular Disease or Metabolic Disorders. New DOS Guidance Authorizes Visa Refusals Based on Obesity and Chronic Health Conditions
Posted on November 19, 2025
Just when you thought that “Trump’s Team” had exhausted its creativity for denying visas, they came up with a new “rationale.” On November 6, 2025, the Department of State Department instructed their consular officers to deny both immigrant and nonimmigrant visas based on a wide range of medical conditions, including obesity, diabetes, cardiovascular disease, metabolic disorders, and mental health conditions. The legal basis? Section 212(a)(4)(A) of the Immigration and Nationality Act, which allows a consular officer to deny a visa to anyone who after entering the United States is “likely at any time to become a public charge.”
In the past only immigrant visa applicants underwent medical examinations. And those examinations were limited in scope to the most serious of medical problems and transmissible diseases. The idea was to ensure that the immigrant visa applicant was not a danger to Americans and would not become a public charge, i.e., using taxpayer money for medical treatment. Now, nearly all visa applicants can be subjected to a comprehensive consular assessment: in light of this applicant’s health and age, is it likely that they will incur medical costs in the US? If so, in light of the applicant’s finances, education, employment prospects, English ability, age, and family situation, how will they pay for those expenses?
On the nonimmigrant side, it is difficult to see how this time-consuming, absolutely subjective medical “diagnosis” can be undertaken by untrained consular officers or why it is even warranted. For the overwhelming majority of B visa applicants, they are traveling to the US for a short period of time: to conferences, vacation, visit friends and family, attend soccer matches. For most F-1 student visa applicants attending colleges and universities, the universities require insurance. For the majority of H-1B, L-1, and O-1 applicants, usually their employers will provide health insurance. For J-1 trainee, physician, work and travel, and researcher applicants, they are already required to have medical insurance or their sponsoring organization will usually provide such insurance. But that may not stop a consular officer from demanding medical insurance from an older or obese applicant or anyone planning a longer term stay in the US, such as E-2 investor applicants. One can see how individual nonimmigrant visa applicants from poorer countries – those in countries of Africa, the Middle East, Southeast Asia, and Latin America who already experience sky-high refusal rates– could be disproportionately affected by the implementation of this mandate from the Trump Team.
On the immigrant side, the impact is much more likely to be felt. Appearance alone could trigger a visa refusal. A consular officer does not need a formal diagnosis from a doctor. The officer may simply decide that an applicant looks overweight and infer that the person may be unable to work consistently, may require future treatment, or may struggle to support dependents without relying on public benefits. The officer may then refuse the visa. One can envision heightened scrutiny of the finances and prospects of certain categories of immigrants, including the parents of US citizens (IR5), other family-based immigrants (FB-1, FB-2, FB-3, FB-4), and Diversity Lottery winners and their family members, who are not required to have a job offer in the US. Given the subjectivity of these analyses, one can envision mass denials of these immigrant visa applicants – again, particularly from poorer countries. Finally, one can imagine heart wrenching situations where, if a child, has a medical problem, the family may be confronted with a Hobson’s Choice: immigrate without the child or do not immigrate at all.
If you or a family member is concerned that you may be denied a visa based on public-charge concerns related to health or obesity, do not hesitate to contact us to review your case.