For people who are in the United States already, healthcare can be a significant issue. For example, in 2020, there were more than 22 million noncitizens in the United States, that include a combination of lawfully present and undocumented immigrants. Many people in the United States live in mixed immigration status households, and one in four children has an immigrant parent.
With that in mind, noncitizens are significantly less likely to have health insurance coverage than citizens. In 2020, among the nonelderly population of lawfully present immigrants in the U.S., 26% lacked insurance coverage. For undocumented immigrants, that went up to 42%.
Some things leading to the lower rates of coverage for immigrants include fear of participating in programs and seeking services.
This also brings to light another topic of conversation when it comes to immigration and health. There’s the question of whether or not health issues can make you inadmissible to the United States altogether.
Most recently, USCIS implemented changes to the N-648 that make it easier to apply for citizenship with a Medical Citizenship for Disability easier.
That’s something that we discuss more below, and we also talk about how your health can affect your overall admission to the U.S. as an immigrant.
Health-Related Grounds of Inadmissibility
Everyone who applies to visit or live in the United States, whether that’s on a temporary visa or a permanent green card, has to prove they don’t present a health risk to the public. These requirements are called health-related grounds of inadmissibility.
You might be prohibited from entering the U.S. if you have a Class A condition.
A Class A condition means you:
- Have a communicable disease that would be significant to public health. This doesn’t mean a common cold. It’s more significant than that.
- You lack the required vaccinations.
- You have a physical or mental health disorder that could cause you to engage in behavior harmful to yourself or others.
- You have a history of substance abuse or addiction.
Even if you haven’t been officially diagnosed with a substance use disorder if you have a record that includes arrests related to drugs or alcohol, that could lead to inadmissibility on health grounds.
There are waivers for health-related grounds of inadmissibility except in the case of addiction and substance abuse.
There are also Class B conditions that a medical exam looks for.
Class B conditions are serious or permanent diseases or disabilities. They don’t automatically make you inadmissible, but they are considered significant to the point that they interfere with your ability to care for yourself or work, or could require future medical treatment.
This can then bring about a different concern for admissibility. The concern is that if you have one of these Class B conditions, you might be at a higher likelihood of becoming a public charge. A public charge is someone who can’t financially take care of themselves and has to rely on government assistance.
How Are These Issues Discovered?
Immigration officials can find out about health inadmissibility issues in a few different ways. It could be when they review your answers to questions about your health that you provide in your green card or visa application.
It’s also possible they’ll find the issues from the results of your immigration medical exam. The immigration medical exam is required for all immigrants and sometimes for temporary visitors. Permanent residents are visa or green card holders.
It can also be found in the court or criminal records or any other information or documents that you submit with your application or provide at interviews.
You do have to answer questions about your health on almost all applications, whether it’s for a nonimmigrant or immigrant visa.
The Immigration Medical Exam
In an immigration medical exam, a physician will go over your medical records, your lab results, vaccinations, and chest X-rays. They’ll also do a physical exam.
If you’re outside of the U.S. and you’re applying to enter and permanently reside, you’ll have to go to a physician the Department of State certifies.
If you’re already in the U.S. and applying for an adjustment of status for permanent residency, you’ll have to go for a medical exam by a physician certified by USCIS.
The physician will administer any needed vaccines, including for COVID-19. They’ll also create a report that summarizes their findings for immigration authorities.
Communicable Diseases
The Centers for Disease Control and Prevention keeps a list of communicable diseases that prevent people from entering the country. There are diseases like smallpox and yellow fever, as well as tuberculosis and leprosy, that are included on the list.
The list also includes any illness that’s recognized as a public health emergency of international concern.
At one point, HIV was on the list, but it was removed.
Physical or Mental Disorder
If someone has a physical or mental disorder that’s harmful to safety, property, or public welfare, they may be inadmissible. A history of suicide attempts or behavior that’s a threat to safety is included.
Mental illness without harmful behavior won’t make you inadmissible.
Substance Abuse
A history of drug abuse or addiction will prevent you from coming to the U.S. on health grounds. Anything that’s beyond one instance of non-medical use of a controlled substance for these purposes is considered drug abuse.
A physician may administer a drug test during the medical exam.
Pregnancy
It’s not an outright reason for inadmissibility, but pregnancy can result in the denial of an application for a B-2 visitor visa. This is the result of a 2020 change to regulations by the U.S. State Department to prevent so-called birth tourism.
Medical Disability Waiver
Finally, somewhat related to this topic is the medical disability waiver. This is actually pertinent to the requirement that to become a naturalized citizen, someone is able to demonstrate basic proficiency in English and knowledge of American civics rather than being an actual health issue.
It is possible to get a waiver for this based on a disability or impairment that results in an inability to learn English or civics. This is a Medical Disability Waiver or N-648 case.
Recently, changes have been made to this process, so it’s simpler and hopefully applied more universally rather than being left up entirely to the judgment of an immigration officer.
