美國《Politico》（中文常譯為「政治」新聞網）於 11 月 13 日報導，美國國務卿馬可．魯比歐（Marco Rubio）已向美國駐外簽證官員下達新指示，要求在簽證審查當中，將「肥胖」及多項慢性疾病納入拒發簽證的考量範圍。這項指令的核心，是要阻止那些可能增加美國「公共負擔」的外國人入境，也就是一旦政府認定某些申請者很可能進入美國後會需要醫療補助或社會援助，就有權拒絕其簽證申請。

《Politico》取得的一份美方內部電報詳細列出美國政府對「健康風險」的標準。電報指出，成年人肥胖會大幅提高罹患高血壓、呼吸道疾病、膽結石及膽囊疾病的機率，並引用美國疾病管制與預防中心（CDC）的數據，強調上述疾病往往需要「昂貴且長期的醫療照護」。因此，若簽證官認為申請者可能因肥胖或其他慢性病導致醫療負擔過重，就需審慎評估是否核發簽證。

除了肥胖之外，電報還指示簽證官特別留意並「篩查」心血管疾病、癌症、糖尿病等慢性病患。這意味著申請者的健康狀況將成為比過去更顯著的審核因素。

根據此前央視新聞的報導，這項政策是特朗普政府近期一系列收緊移民政策中的一環。美國國務院上週以內部電報形式發布新命令，要求美國駐外使領館在審查簽證時更加嚴格地評估申請人是否具備足夠的健康條件與經濟能力。換句話說，若申請人患有糖尿病、嚴重肥胖，或財務狀況無法證明能在美國維持生活，也可能因此無法取得簽證或長期居留許可。

電報列出的評估標準十分全面，除了健康與財務能力，還包括申請人的年齡、家庭狀況、教育背景、技能、英語能力，以及是否曾經使用過公共援助。若任何因素顯示申請人未來可能依賴美國公共福利，簽證官都有權拒絕發放簽證。

國務院發言人湯米．皮戈特在解釋該政策時表示，特朗普政府的目標是「確保美國的移民制度不會成為納稅人的負擔」。從官方的用詞與電報內文來看，這項政策的導向非常明確——強化美國的「自給自足」移民標準，排除那些可能需要醫療與福利支援的外國人。

這一政策在美國國內外都引發激烈爭議。支持者認為，政府有責任保護公共資源，確保移民不會加重稅負；批評者則指出，將肥胖與慢性病納入拒簽理由可能具有歧視性，也可能讓本來無法負擔昂貴醫療費用的弱勢申請者完全喪失移民機會。由於政策調整影響範圍甚廣，各界目前正密切關注後續的具體執行與國際反應。

On November 13, U.S.-based political news outlet Politico reported that U.S. Secretary of State Marco Rubio has issued new instructions to American consular officers, directing them to consider obesity and various chronic diseases as grounds for denying visas to foreign applicants. The stated purpose of this directive is to prevent individuals who could become a “public charge” from entering the United States—that is, if the government determines that certain applicants are likely to require public assistance or healthcare support after entering the country, their visa applications can be rejected.

According to internal U.S. government cables obtained by Politico, the new guidance explicitly identifies health risks associated with obesity. The cable notes that obese adults face significantly increased risks of hypertension, respiratory issues, gallstones, and gallbladder disease, citing data from the U.S. Centers for Disease Control and Prevention (CDC). The cable emphasizes that these conditions often require “expensive and long-term medical care,” and instructs consular officers to carefully assess applicants whose health status could result in a substantial burden on U.S. public resources.

Beyond obesity, the guidance directs visa officers to screen for chronic illnesses including cardiovascular disease, cancer, and diabetes. In effect, applicants’ health conditions have become a more prominent factor in visa adjudication than in previous years.

CCTV News previously reported that this policy aligns with a broader series of immigration tightening measures under the Trump administration. Last week, the U.S. Department of State issued an internal cable requiring consulates and embassies abroad to rigorously evaluate applicants’ health and financial stability. This means that foreign nationals with diabetes, severe obesity, or insufficient financial resources may face increased difficulty obtaining visas or long-term residency permits in the United States.

The assessment criteria outlined in the cable are comprehensive. Officers are instructed to evaluate applicants based on age, health, family circumstances, financial resources, educational background, professional skills, English proficiency, and past use of public assistance. If any of these factors indicate a likelihood of dependence on U.S. public welfare, consular officers are authorized to deny the visa.

State Department spokesperson Tommy Piggott explained that the policy is intended to “ensure that the U.S. immigration system does not become a burden on taxpayers.” Both the language in the official cable and the spokesperson’s statement make the policy’s objective clear: to strengthen standards of self-sufficiency among immigrants and exclude individuals who might require government-funded healthcare or social support.

The policy has sparked heated debate both domestically and internationally. Supporters argue that the government has a responsibility to protect public resources and prevent increased tax burdens, while critics contend that using obesity and chronic illness as grounds for visa denial may be discriminatory, potentially barring vulnerable applicants who cannot afford expensive medical care. Given the broad scope of the policy’s impact, observers are closely monitoring its implementation and the potential international responses that may follow.