President Donald Trump has ordered U.S. embassies and consulates to treat obesity and age as legitimate grounds for denying visas, marking a significant escalation in his hardline immigration agenda. Newly issued State Department guidelines instruct visa officers to scrutinize applicants’ health conditions, including obesity and diabetes, and reject those who may require public benefits. The move dramatically tightens the longstanding “public charge” rule, which already permits denying entry to individuals likely to rely on taxpayer-funded aid. The administration has defended the policy shift as a measure “putting Americans first,” even as critics highlight Trump’s own history with obesity.
New Health-Based Criteria
According to KFF Health News, the administration directed U.S. diplomatic missions worldwide to expand the reasons for rejecting visa applicants. The new instructions place considerable weight on applicants’ current and potential health needs. Officers are urged to consider whether individuals could incur significant medical costs, especially if their conditions might later qualify them for publicly funded care. This represents one of the most sweeping reinterpretations of health-based visa restrictions in recent years.
Rubio’s Directive Explained
In a cable dated 6 November, Secretary of State Marco Rubio wrote, “You must consider an applicant’s health.” He added that “certain medical conditions, including but not limited to cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental health conditions, can require hundreds of thousands of dollars’ worth of care.” The directive frames these conditions as possible future burdens on U.S. taxpayers, thereby justifying visa denial under expanded public charge evaluations.
Public Charge Rule Tightened
The public charge rule has long permitted the government to deny visas to applicants likely to become financially dependent on state resources. Under Trump’s new interpretation, health conditions and age are now central considerations in determining whether an applicant might ultimately rely on government assistance. The administration’s sharply more restrictive stance aligns with Trump’s broader immigration goals, which include mass deportations and reductions in legal entry pathways.
Global and U.S. Health Context
Health data cited in the reporting notes that roughly 10 percent of the world’s population has diabetes, while one in eight people globally was living with obesity in 2022. In the United States, more than 40 percent of adults meet the BMI threshold for obesity. The article also recalls that Trump himself fell into the obesity category in 2020 with a BMI of 30.5 at 244 pounds. However, at his most recent physical in April, he weighed 224 pounds, placing him in the overweight category instead.
Trump’s Immigration Crackdown
The new visa criteria come as Trump advances an aggressive effort to restrict both legal and illegal immigration. His administration recently reduced the annual refugee admissions ceiling from 125,000 to 7,500, one of the lowest levels in modern history. These decisions underscore his pledge to sharply limit entry into the country while heightening scrutiny on those seeking admission.
Administration Defends Policy
Responding to questions about the guidelines, State Department Principal Deputy Spokesperson Tommy Pigott told the Daily Beast, “It’s no secret the Trump Administration is putting the interests of the American people first. This includes enforcing policies that ensure our immigration system is not a burden on the American taxpayer.” White House Deputy Press Secretary Anna Kelly added that for a century, State Department policy has allowed visa denials for applicants posing financial strain, saying the administration is “finally fully enforcing this policy, and putting Americans first.”
Ongoing Political Tensions
The policy shift has further intensified the already heated immigration debate. While supporters argue that stricter vetting protects U.S. taxpayers, critics accuse the administration of weaponizing health conditions and age in a discriminatory manner. The move fits into a broader pattern of sweeping immigration restrictions that have reshaped the entry process for millions seeking to come to the United States.