Immigration Law
In November 2025, the U.S. government quietly changed how consular officers review public charge concerns for immigrant visa cases. These updates came through an internal Department of State cable, and the changes are now affecting visa applicants worldwide. Many clients have reached out with questions, especially after news reports highlighted that officers may now pay closer attention to health conditions, obesity, English skills, finances, and past financial assistance.
My goal with this article is to explain what these new rules mean in simple, client-friendly terms so you can prepare for your medical exam and consular interview with more confidence.
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“Public charge” is a rule the government uses to decide whether someone is likely to depend on government assistance after coming to the United States. For most immigrant visa applicants, this rule applies during the consular interview at the U.S. Embassy or Consulate.
Consular officers look at the whole picture, including:
These factors are not new. What is new is how much weight officers are now encouraged to give to certain issues.
According to reporting and internal guidance, consular officers must now look more carefully at the medical exam and review any medical conditions that may require ongoing care or cost significant money to manage.
This includes:
Even conditions that do NOT make someone medically inadmissible can still raise public-charge concerns.
For example, news reports confirm that the government specifically listed obesity as a condition that could signal long-term medical risk. The concern is not the diagnosis itself—it is the potential cost of treating related conditions such as high blood pressure, diabetes, sleep apnea, asthma, joint problems, or depression.
Applicants should not panic, but they should understand that officers may now ask more questions or request more information if they believe a health condition could lead to high medical expenses in the future.
Another major change is that if the medical report does not include detailed remarks about a chronic condition, the consular officer may issue a 221(g) to send the medical exam back to the panel physician for additional explanation.
This does not mean you are denied—it simply means your case is delayed because the officer needs more information.
Applicants should be prepared for this possibility, especially if they have any long-term medical issues.
The new guidance encourages officers to consider whether an applicant can support themselves in the United States.
This means they may now look more closely at:
None of these issues automatically cause a denial, but officers may treat them as warning signs that someone could struggle financially in the U.S.
Applicants who have completed training programs, English classes, certifications, or new skills should bring proof to their interview.
Another change is that officers may ask questions about whether you ever received financial assistance in another country. In the past, most forms of foreign assistance were not treated as a problem. Now, however, officers may treat this history as a sign of financial instability.
Again, this does not mean an automatic denial, but applicants should be ready to explain their situation honestly and clearly.
Many clients rely on a U.S. sponsor to meet the financial requirements through an Affidavit of Support. That form is still required for most family-based applicants, but the new guidance reminds officers that the form is only one part of the decision.
Officers may now look more closely at:
Applicants should still prepare strong financial documentation, even if they have a qualified sponsor.
Although most nonimmigrant visas are judged under different rules, the government has reminded officers that public charge rules also apply to certain categories like H-1B and L-1 visas when 214(b) does not apply.
This means employment-based applicants should also be prepared to show financial stability.
One of the most difficult parts of the public charge rule is that, for immigrant visa applicants processing abroad, there is no waiver if the officer issues a public charge refusal. In very rare cases, a bond may be possible, but it is not common.
Because of this, preparation is extremely important.
Under the updated public-charge approach, consular officers now review an applicant’s overall financial stability, medical background, education, English skills, and any past financial assistance more closely. They also look more carefully at the reliability of the financial sponsor. Because of this increased scrutiny, it is important for applicants to ensure their records are accurate, consistent, and complete before the interview. Any missing information or discrepancies can lead to questions or delays under the new standards.
The new 2025 public charge guidance is stricter, and applicants may face more questions about health, finances, English ability, and education. But a well-prepared case can still succeed. The key is to understand what officers look for and to bring strong, organized evidence to your interview.
If you’re preparing for a consular interview or have concerns about how these new rules affect your case, I can guide you through the process and help strengthen your application. My team at SG Legal Group offers consultations in English, Russian, or Romanian.
Call 410-618-1288 or visit our Contact page to schedule a consultation.
Oleg Gherasimov, Esq.
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