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The directive, sent by the US State Department to embassies and consulates on Thursday and reviewed by KFF Health News, instructs officials to consider applicants ineligible if their health conditions or age could make them a potential “public charge”, meaning someone who might rely on public benefits or become a financial burden on the US.

“You must consider an applicant’s health,” the advisory reads. “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, ” CBS News reported.

The guidance expands the list of health factors used in assessing visa applicants, giving visa of

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