In a move stirring equal parts confusion and controversy, the Trump administration has rolled out a new immigration directive that could leave clinically obese foreigners and people with chronic health conditions watching their American dream from the departure lounge.

According to KFF Health News, U.S. embassies and consulates have been instructed to weigh medical conditions such as obesity, diabetes, high blood pressure, sleep apnea, cardiovascular and respiratory diseases, certain cancers, and even some neurological and mental-health disorders when evaluating visa applications.

These conditions, the directive warns, can rack up medical bills “running into the hundreds of thousands.”

Put simply:
If your health could cost the U.S. money, your visa might cost you your entry.

The new guidelines require applicants to show they have enough financial resources or insurance to cover their healthcare needs over a lifetime—without touching U.S. public assistance. Failure to do so could mean an automatic “no” at the border.

A State Department spokesperson defended the shift, saying the policy keeps immigrants from becoming “a burden on the American taxpayer.” Customs and Border Protection chimed in to reassure that law-abiding travelers have “nothing to fear,” but offered this blunt warning for others: “Don’t even try.”

Immigration advocates, meanwhile, are raising eyebrows—and alarms. They note that visa officers are not medical professionals, yet are now tasked with predicting whether someone’s health might one day require government support.

Experts say the policy will mostly affect those seeking permanent residency, not short-term visitors. Still, with non-citizen immigrants far more likely to lack health insurance, according to the Kaiser Family Foundation, the ripple effects could be significant.

The new rule marks another bold step in the administration’s push for “self-sufficiency” in immigration—one that could reshape who gets to settle in the United States, and who gets turned away before they even pack their bags.