Oakton Health Center

The Trump administration has announced an immediate revision to green card applications, mandating a renewed medical examination for all new permanent residency applications. The change is designed to ensure health-related admissibility and reduce the number of RFEs (Requests For Evidence)sent during the application process, thereby streamlining the process and reducing delays. Under the new guidelines, the medical examination form, known as the I-693, Report of Immigration Medical Examination and Vaccination Record, must be redone and resubmitted if an application is withdrawn or a different immigration benefit is later filed.

This new policy will directly impact immigrants currently applying for adjustment status, a process known as Form I-485. Prior to this change, applicants could use an I-693 form completed and signed by a civil surgeon after November 1, 2023, indefinitely. However, under the new policy, a renewed exam and new signed copy of the form would be necessary if an application was withdrawn, re-applied for, or if a different immigration benefit was later requested.

Medical exams, much like physical exams, check for specific conditions or diseases that could render a person inadmissible to the U.S. They also include checks of an applicant’s vaccination records, completed by a civil surgeon. The cost of these exams can range from $100 to $500, meaning immigrants may now face these costs more than once.

This change in policy is one of many recent moves by the Trump administration to increase scrutiny of immigrants applying for temporary or permanent visas in the U.S. This attempt to crack down on those violating immigration laws has, in some cases, led to confusion for applicants and lawsuits from attorneys, forcing USCIS to offer buffer times for new changes to take effect.

Alongside these changes, President Trump has announced the introduction of a “gold card” program. Successful applicants would be able to purchase a green card for $5 million in what appears to be a plan to replace the pre-existing EB-5 offers providing green cards to those who invested in the U.S. Although some legal experts challenge whether President Trump can amend or remove the EB-5 Visa program without congressional approval, they suggest that the new “gold card” program could exist alongside the EB-5.

Overall, these changes highlight a continued shift towards increasing scrutiny and tighter controls on immigration under the Trump administration.

1. United States Citizenship and Immigration Services (USCIS) has announced that medical and vaccination reports must now be submitted along with the green card application Form I-485. This change aims to streamline the immigration process and cut down on additional evidence requests. Previously, a substantial workload was generated by USCIS sending Requests for Evidence for people to complete necessary paperwork. Changes include extending the validity of certain documents and insisting on full information completion at the start of immigration processes. USCIS clarified that beginning April 4, 2024, any Form I-693 properly completed and signed by a civil surgeon on or after November 1, 2023, would not expire. Hence, USCIS advises applicants to consult with immigration lawyers or organizations accredited to provide immigration services before submitting any application form.

2. Several policies and procedures regarding Asylum Applicants and Torture Victims (AATV) and Victims of Trafficking, Torture, or Other Serious Crimes (VTTC) have been updated. Changes include new procedures for processing AATV/VTTC cases, verification of status for AATV/VTTC, and clarification of state-funded medical coverage versus federally funded Medicaid. Additionally, several requirements for state-funded VTTC benefits have been amended. Critics argue single adult applicants without a child, spouse, or other family members are no longer eligible. On the other hand, new policies stipulate that the application process for work-based residence permits should be streamlined, with all requirements for such permits assessed at once.

3. A number of significant global immigration updates have been reported this week, spanning countries including Australia, China, Finland, Kazakhstan, and the USA. Australia announced its Mobility Arrangement for Talented Early-professionals Scheme (MATES) for India, offering 3,000 visa spots for graduates and professionals from top Indian universities. Meanwhile, China and the Solomon Islands signed a mutual visa exemption agreement. Finland is pausing the processing of certain work-based permits in January 2025, transferring work permit services from TE Offices to the Finnish Immigration Service. Kazakhstan is implementing updated visa regulations to attract skilled professionals and business immigrants. Furthermore, the US is updating policy guidance on naturalization requirements, adjusting how a visa applicant’s burden to demonstrate their lawful residence applies. USCIS also announced that immigration medical examination documentation will be valid indefinitely for certain Afghan nationals who arrived in the US during Operation Allies Welcome.

In Kansas City, immigrants pursuing permanent residency face difficulty obtaining the necessary medical examination due to high costs and long waiting lists. These exams, required for most green card holders, are only carried out by qualified physicians of Immigration Services and consist of health reviews, physical examinations, and several tests and inspections. Costs will vary as there is no limit to the charges for these exams. Coverage of the procedure by most insurance policies is rare since this procedure is not a health cost or a substitute for a physical examination. Further costs would arise if one is found to require vaccinations.

For Priyanka Raeburn, who sought affordable healthcare, the fee for her examination was $1,400, which was much beyond her financial reach. Ultimately, she found a cost-effective solution at KC CARE Health Center, where exams are offered at a base cost of $250. KC CARE Health Center was designed to serve the dual-purpose of screening for diseases, and to act as their first interaction with the health system.

US Citizenship and Immigration Services requires medical exams to assess the medical conditions and vaccination records of immigrants to ensure public health. The exam consists of physical and mental health evaluations and tests for diseases like tuberculosis. Your own doctor or health care provider cannot conduct the examination, you must select a physician from the government-approved USCIS list of “Civil Surgeons”. The results of the examination, valid for two years, are sealed in an envelope that applicants must not open, or the exam will be invalidated.

The government has mandated immunization against Covid-19 for applicants in light of the pandemic. If a specific vaccination is deemed “medically inappropriate”, the civil surgeon can certify this fact and record it on Form I-693. However, critics argue that some doctors with histories of patient abuse or criminal records were certified and that there is potential for abuse by some civil surgeons. There are also calls for subsidies and controls on vaccine costs to ease the financial burden on immigrants. The examination serves as a crucial step in the long and expensive immigration process that provides a first point of contact for immigrants with the health system.