This is probably another new Trump Immigration policy initiative intended to make the process of getting a Green Card or a US visa more difficult. The Department of State’s recent advisory for Consular Officers is a step in this direction.
The new Visa Rule focuses on a more detailed health review as part of the public charge litmus test for applicants seeking approval.
The expanded medical review process requires consular officers to consider a much broader range of health conditions in public charge determinations. The list of certain specific health conditions that the advisory talks about is:
- Diabetes
- Asthma
- High blood pressure
- Cardiovascular diseases
- Sleep apnoea
- Cancer
- Respiratory, neurological, and metabolic diseases
- Mental health conditions
- Obesity
Under the new advisory, if you are a Green Card applicant and have tested positive for any of the ailments, and the consular officer thinks you don’t have enough financial resources to cover the medical costs during your lifetime, they might deny your application. They can base the denial on public charge findings, assuming that, because of the unavailability of financial backing, you might become dependent on the government for paying medical bills or require long-term institutionalization at the government’s expense.
Check our recent episode of Immigration Fridays as Prashanthi speaks in detail about the naunces of the new rule and how Green Card Applicants should prepare for it.
What is the Public Charge guideline?
Public charge is a key factor in visa decisions, affecting both immigrant and non-immigrant applicants. While not explicitly defined, it involves assessing whether applicants may depend on government aid due to health, age, or financial issues, which may affect their eligibility.
Looking back at history, in the case of public charge for permanent residence, the review of the visa applicant’s health was limited to screening for communicable diseases such as tuberculosis and measles, vaccination history, and history of alcohol and drug abuse. But during the first term of the Trump administration, the government issued guidelines on public-charge inadmissibility. Still, they focused on financial factors and on any broad benefits the applicant had received or was receiving. On the other hand, in the second term, with this new advisory, the public charge New Visa rule is more expansive and favours the wealthiest and healthiest. It grants consular officers, who lack medical expertise, the power to serve as judge and jury in deciding admissibility based on their subjective evaluation of your long-term medical costs.
Specific Directions under the new Visa rule
Though technically the cable is not a Visa rule change, it still provides specific directions that consular officers must adhere to, which are:
- The officer must consider not only the applicant’s health but also the health of the applicant’s dependent family members who are not themselves applicants when making a public charge finding.
- The officer now needs to consider a wide range of public benefits currently or previously received by the applicant. However, the current Visa rules don’t define public charge to include government housing, food, or medical assistance as public benefits. Still, the current advisory directs the consular officer also to consider these benefits when rejecting your claims for admission.
- In addition to health conditions, the new directions push consular officers to conduct a more rigorous review of whether the visa applicant’s age, education, skills, and financial situation indicate they are likely to become a public charge in the near future.
How to navigate?
Suppose you or your dependent has a chronic health condition that could impact your eligibility under the new guideline. In that case, the keyword here is “preparedness,” which can help one navigate this. Here are a few tips to look into:
Tip 1: Comprehensive medical documentation
Relying on a standard physician’s report might not be helpful. Prepare yourself to provide a much deeper dive into your medical condition. Get a letter from your treating physician with a long-term treatment prognosis and a future treatment plan. The letter should show that the condition is well-managed and unlikely to lead to emergency or institutional care. Make sure the doctor’s document also provides an estimate of the annual cost of routine maintenance care and medication.
Tip 2: Show robust financial preparedness
To directly counter the public charge question, one needs to show they have sufficient financial backup and planning in place to afford the medical care. Providing proof of insurance and financial assets is necessary, and if your family member is your sponsor, their Affidavit of Support (I-864) is more crucial.
Tip 3: Emphasize economic contributions
Mind it, the public charge test is a totality-of-circumstances test; your positive factors should outweigh the negative health factors. You should demonstrate your employability by highlighting your high income, valuable skills, and advanced education. You need to show that you are a positive economic contributor who is highly unlikely to need public assistance — medical or otherwise.
You can also emphasize a strong US-based support system — family members who are working, self-sufficient, and willing to assist.
Conclusion
The new guideline is troubling as it targets people even with manageable health issues, and you are at the mercy of untrained consular officers for your destiny. So, consulting an immigration attorney before the interview becomes more essential, as they can structure your case proactively by addressing these health concerns and help you present the strongest possible evidence of self-sufficiency before the consular officer.
