State Department says visas can be denied over diabetes, obesity: reports

What they're saying: "It's no secret the Trump Administration is putting the interests of the American people first," State Department spokesperson Tommy Pigott told Axios in an emailed statement.

• "This includes enforcing policies that ensure our immigration system is not a burden on the American taxpayer."
• White House spokesperson Anna Kelly echoed that sentiment in a statement provided to Axios, saying that "[f]or 100 years, State Department policy has included an authority to deny visa applicants who would pose a financial burden to taxpayers."

Driving the news: The guidance could give officers more reason to turn away applicants deemed likely to rely on public services to support themselves once in America, according to Fox News and KFF Health News, which both previously reported on new State Department guidelines Nov. 6.

• It specifically mandates that health conditions be considered in reviewing immigrants' applications.
• "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," it reads, per KFF.
• It reportedly also instructs visa officers to consider other conditions, like obesity, in assessing whether a person could be deemed a "public charge."

State of play: The "public charge" rule of inadmissibility, which allows for applications to be denied if the person will become dependent on government programs, isn't new. Certain groups, like refugees, are exempt from public charge determinations.

• The DOJ's 1999 Field Guidance on Deportability and Inadmissibility on Public Charge Grounds defined a public charge as someone who "has become ... or who is likely to become 'primarily dependent on the government for subsistence, as demonstrated by ... the receipt of public cash assistance for income maintenance or ... institutionalization for long-term care at government expense."
• Applicants' health has already long been assessed as part of the visa process, and several vaccinations are required for immigrants. But this directive seeks to broaden that screening to encourage consideration of a number of chronic and common health conditions, immigration experts have said.

What they're saying: Sarah Krieger, senior policy counsel at the National Immigration Law Center, told Axios in an email that she had yet to see the cable firsthand but described it as "an unusual and concerning move" based on reports.

• She said that the State Department's Foreign Affairs Manual still contains prior public charge policy guidance, which she said "is likely going to cause confusion for consular officers, especially because this cable guidance appears to contradict the longstanding FAM guidance."
• "This new policy seems designed to cause chaos and confusion," she said. "I expect it will harm the most vulnerable people, including those who may otherwise be eligible to come to the United States."

What's inside: Officers were also instructed to consider whether the applicant has "adequate financial resources to cover the costs of such care over his entire expected lifespan without seeking public cash assistance or long-term institutionalization at government expense."

• The directive follows a February executive order that told departments to review programs and payments so that "no taxpayer-funded benefits go to unqualified aliens."

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Editor's note: This story has been updated with a National Immigration Law Center statement.