The visa applications of foreigners seeking residence in the US face the possibility of rejection if the applicants have certain medical conditions, including diabetes or obesity, according to US-based news outlet KFF Health News.

The publication reported this on Thursday, citing a new directive from the Trump administration.

According to the outlet, this new directive was outlined in a cable issued by the US State Department to embassy and consular officials.

It “directs visa officers to deem applicants ineligible to enter the US for several new reasons, including age or the likelihood they might rely on public benefits”, KFF reported.

“The guidance says that such people could become a ‘public charge’ — a potential drain on US resources — because of their health issues or age,” the report said.

“You must consider an applicant’s health,” the cable read, according to KFF. It added: “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.”

According to KFF, the cable also encouraged visa officers to consider conditions like obesity — which it noted could cause asthma, sleep apnea and high blood pressure — while assessing whether an immigrant could become a public charge and should therefore be denied entry into the US.

“All of these can require expensive, long-term care,” the cable read, additionally directing visa officers to determine if applicants had the means to pay for medical treatment without financial assistance from the US government.

KFF reported that the instruction also directed visa officers to consider the health of the applicant’s family members, including children or older parents.

Tommy Pigott, the US State Department’s principal deputy spokesperson, also said in a statement: “It’s no secret the Trump administration is putting the interests of the American people first. This includes enforcing policies that ensure our immigration system is not a burden on the American taxpayer.”

Separately, the official told reporters that the decision to issue a visa had always been at the discretion of an officer.

Officers are not being instructed to reject an applicant because they have a certain medical condition, but to consider the “overall impact” if someone would be unlikely to be able to pay for their own medical care, they clarified.

“It’s addressed on an individual, case-by-case basis,” the official added.