Why Is the US Punishing Legal Immigrants?

By Raul A. Reyes

Immigration Attorney and Television Commentator

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Under new guidelines from the State Department, foreigners seeking visas to work, visit, or live in the U.S. can now be rejected if they have medical conditions like diabetes, obesity, or heart disease. The government has also instructed consular officials worldwide that visas can be denied based on an applicant’s age or the likelihood that they might become a financial burden on the U.S.

While these new guidelines might seem sensible at first glance, they are unnecessary, impractical and possibly illegal. They open the door to subjective decisions and unfair treatment of people seeking to enter the country the right way.

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The State Department’s new visa guidelines are flawed because applicants already undergo significant physical vetting. Potential immigrants must pass a health screening and a medical exam, and they are tested for communicable diseases. They must show proof of vaccinations and complete a questionnaire about their full medical history, including any drug use, violence, or mental health issues.

Our country does not need new guidelines that go beyond CDC recommendations on immigrant admissibility. Since the new guidelines are written so broadly, they will inject more confusion and uncertainty into our immigration system. These new regulations will add an additional level of bureaucracy into what is a long, difficult process.

The State Department’s directive notes that “certain medical conditions ... can require hundreds of thousands of dollars’ worth of care.” It cites medical issues ranging from sleep apnea to high blood pressure to cancer as factors that can be used to deny visas. Consular officials are even told to judge whether visa applicants have enough financial resources to cover their potential medical expenses over their entire life span.

But consular officers are not actuaries or financial planners. They do not have medical training or health care experience. How can they make accurate assessments of the lifetime medical costs of visa applicants?

Just for context, the CDC estimates that three out of four American adults themselves have at least one chronic health condition, and that over half of Americans have two or more chronic conditions. It seems cruel to apply such stringent health requirements to people who want simply to live, visit, or join their relatives in the U.S.

The new visa guidelines are especially troubling because they appear to rest on shaky legal grounds. They did not go through the normal channels for review. The Washington Post reported that the rules were drafted by political leadership at the State Department. The rules are at odds with regulations in the Foreign Affairs Manual, which prohibit consular officials from engaging in speculation or “what if” scenarios when making visa decisions. And under U.S. law, penalizing overweight, sick, or retired people is a de facto form of discrimination.

"It's no secret the Trump Administration is putting the interests of the American people first," a State Department spokesperson said in a statement. "This includes enforcing policies that ensure our immigration system is not a burden on the American taxpayer."

However, the State Department guidelines are based on the notion that people coming here with a medical condition will end up on public assistance, as a so-called public charge. This assumption is not supported by evidence. Research shows that immigrants access public services at lower rates than the native-born, and the major federal public benefits programs exclude non-citizens anyway. Besides, existing visa regulations require that potential immigrants prove that they have financial resources, a job, and/or a qualified sponsor.

There is no sound basis for these guidelines, except to limit legal immigration. The Trump administration is sending the message that immigrants are to be viewed with suspicion, as possibly unhealthy or harmful to the U.S.

Clearly, the guidelines fit in with the administration’s restrictions on legal immigration, which includes raising visa fees, slashing refugee admissions and attempting to ban immigrants from certain countries. Yet President Donald Trump was elected to crack down on illegalimmigration, not to punish people seeking lawful admission. Consider that a Gallup survey found that 62 percent of Americans disapprove of the president’s handling of immigration, while 79 percent believe that immigration is good for the country.

The State Department’s new visa guidance goes too far. It gives officials more reasons to deny visas to people who are trying to come here legally—rather than supporting lawful pathways to entry.

Raul A. Reyes is an immigration attorney and analyst in New York City. Follow him at X: @RaulAReyes, IG: @raulareyes1.

The views expressed in this article are the writer's own.

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