Nov 23, 2025
After comments about new health requirements for U.S. visas, President Donald Trump’s immigration policies are coming under fire again.
A recent cable examined by KFF Health News and sent by the State Department to embassy and consular officials contained guidance on denying visa applications for several new reasons. One of these reasons included the likelihood that the application could become a drain on U.S. resources, specifically due to their health issues or age (1).
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"You must consider an applicant's health," the cable reads, according to NPR. "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 (8)."
Although some health requirements are already embedded into the U.S. visa process, like vaccine requirements, the idea that overweight applicants cannot get approved for a U.S. visa is new (2).
President Trump’s stance on the heightened health requirements is to prevent incomers from putting a strain on the U.S. healthcare system (3).
Potential for healthcare system strain
Currently, the U.S. visa process does involve some health checks. However, these health requirements are focused on communicable diseases and other public health threats.
Under the potential policies outlined in the State Department cable, examined by KFF Health News, this could expand to consider other medical details, including his or her weight (2).
Unfortunately, focusing on weight could open a path to extensive discrimination concerns. After all, it seems unfair to consider someone’s Body Mass Index (BMI) when accepting or denying a visa application.
In a Truth Social post, Trump said, “We will not ban all fat people from entering our Great Country, only those whose poor health will overburden our health care system. Visa applicants who are only slightly overweight have nothing to worry about.”
He continued, “The bigger ones will need to trim down to get approved (3).” Trump went on to say these new health requirements might be extended to cover Expats in the near future.
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The primary concern seems to be preventing applicants from entering the country if they might put a strain on the healthcare system. The country’s healthcare system is already under tremendous strain, with many claiming that the system might need to be torn down and rebuilt, including Harvard Health, the Cato Institute and the American College of Surgeons (4, 5, 6).
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Long-term impacts
Generally, new immigrants must wait years before gaining access to federally funded medical care. For example, most immigrants must wait five years before enrolling in Medicaid or CHIP. However, many can enroll in Marketplace coverage and receive subsidies to offset health insurance costs during this waiting period (11).
This waiting period could make it difficult for newcomers to gain access to quality healthcare for a variety of conditions, including obesity. If Trump’s State Department is looking to see that immigrants can pay for their own medical care, it’s possible they’ll have to pay out of pocket for their health care costs.
The State Department’s directive to consider whether or not the applicant has adequate financial resources to cover a lifetime of care without government support is a high bar. But would this requirement protect the American healthcare system from further strain (1)?
With 41.64% of American adults overweight, according to World Obesity, it’s difficult to see how allowing overweight immigrants into the country would significantly impact the healthcare system (7).
According to the CDC, obesity costs the U.S. healthcare system $173 billion each year. And those costs are expected to rise as obesity and chronic obesity rates rise (9).
Whether or not this new immigration policy would mitigate the potential strain on the healthcare system, or is even legal, is difficult to determine. But if this new policy prevents visa applicants from entering the country, some experts worry that labor shortages could worsen. Even across the healthcare industry, where staff is stretched thin, this policy could prevent qualified workers from filing positions within the U.S. (10)
Article sources
We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.
KFF Health News (1); U.S. Department of State (2); X (3); American College of Surgeons (4); CATO Institute (5); Harvard Medical School (6); World Obesity (7); NPR (8); CDC (9); American Immigration Council (10); KFF (11)
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Sarah Sharkey is a personal finance writer who enjoys helping people make optimal financial decisions for their situation. She loves digging into the nitty-gritty details of financial products and money management strategies to root out the good, the bad, and the ugly. Her goal is to help readers find the best course of action for their needs.
