In November 2025, the Trump administration began rejecting some visa applicants based on health problems, asking if applicants and their children have “disabilities, chronic medical conditions, or other special needs.” On Tuesday this week, the State Department ordered a pause on all immigrant visa appointments worldwide to better train consular officers on more restrictive guidance, enforcing these rules as well as others intended to exclude immigrants likely to use public benefits.
Although some immigrants do become disabled, this analysis finds that immigrants, legal and illegal, were 24 percent less likely to be disabled than the US-born population in 2024, and were less likely to be disabled at nearly every age regardless of immigration status. Their lower disability rate led to significantly less use of disability benefits, but even disabled immigrants draw on those benefits less than disabled US-born citizens.
Regulations Regarding Immigrants’ Health
This concern about immigrants’ disability status has a long history. The first general immigration law of 1882 targeted people with (perceived) learning disabilities and mental illnesses, and the 1891 act created the first physical examinations of immigrant arrivals. As Prescott Hall, the notorious eugenicist leader of the Immigration Restriction League, said in 1907, the immigration law’s goal was to “protect the country from those who tend to lower the average of health and intelligence.”
Today, the law still requires physical exams for “diseases or mental or physical defects or disabilities,” though not all “defects” can lead to exclusion. By statute, immigrants can be excluded only for having a dangerous communicable disease, certain addictions, or a threatening “physical or mental disorder.” Having children who are “helpless from sickness, mental or physical disability, or infancy” can also trigger a denial.
However, the hook for the Trump administration’s new rules is the provision excluding those likely to become a “public charge”—or welfare dependent—because the statute requires accounting for an immigrant’s health. The new rules permit denials for a broad range of health concerns, including but not limited to obesity, cardiovascular diseases, respiratory diseases, cancers, diabetes, metabolic diseases, neurological diseases, and mental health conditions.
Immigrant Disability Rates
To estimate disability prevalence by immigration status, we analyzed the Census Bureau’s 2024 American Community Survey and 2025 Annual Social and Economic Supplement (ASEC) 1‑year samples from IPUMS. The ASEC reports on the 2024 calendar year. Disability types include cognitive, ambulatory, vision, hearing, independent living, and self-care difficulties. These categories may not capture all health conditions, but they provide a broad sense of immigrant health status.
To identify likely illegal immigrants, we used a modified residual method developed by economist Christian Gunadi. In addition to several other proxies for legal status, our method includes carve-outs for state-specific Medicaid and CHIP eligibility changes throughout the last decade, as well as assumptions for certain occupations that require citizenship or licensing. We also employ a larger undercount population adjustment that decays the longer an immigrant has resided in the US. Legal immigrants identified by this method include those who hold non-immigrant work visas and immigrants who have become naturalized citizens.
Immigrants are less than 12 percent of the US disabled population, despite making up roughly 15 percent of the total US population. In 2024, 11.1 percent of immigrants, legal and illegal, were disabled. Illegal immigrants reported the lowest rate of any group—just 5.34 percent—compared to 13.0 percent among legal immigrants and 14.6 percent among US-born citizens.
These gaps have remained consistent over the past decade, even as public-charge rules, welfare eligibility restrictions, and enforcement priorities have shifted. This is not the result of any single administration’s policies, but rather the fact that undocumented immigrants report lower disability rates regardless of public-charge enforcement.
Figure 2 shows that this gap is not simply because immigrants are younger, as the gap persists even after accounting for age. US-born citizens have the highest disability rate at nearly all ages, and the gap widens through working age into retirement. This reflects the pattern that migration tends to self-select for healthier individuals who are already capable of undertaking both the physical and financial burdens of relocating.
Veterans
In 2024, veterans made up a modest share of both native-born and legal immigrant populations (roughly 15,000,000 native-born citizens and 782,000 legal immigrants). Disability rates among veterans are higher than those of the civilian population, due to both older average age and service-related conditions. However, the disability gap remains in this group: 26 percent of legal immigrant veterans are disabled, compared to 32.5 percent of US-born veterans.
Disability Income
Since they are less likely to be disabled, immigrants are also less likely to receive disability benefits. However, even among those who report having a disability, immigrants are still less likely to receive assistance in the forms of Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or other disability income (DI).
We use the American Community Survey (ACS) to estimate disability rates by nativity because its larger annual sample size supports more precise estimates for small subgroups such as illegal immigrants. For the benefit receipt analysis, we switch to the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), as it is the only major survey that allows us to isolate disability-related benefit receipts.
Our analyses include pretax disability income from SSDI, SSI, and DI. DI reflects sources such as workers’ compensation, US military retirement disability, and private disability insurance. We do not include payments from the Department of Veterans Affairs or income received on behalf of children in the following calculations, which would inflate the differences between immigrants and the US-born.
In 2024, immigrants were nearly half as likely to receive any disability income from the government. 2.61 percent of immigrants received disability income in any form, compared to 5.11 percent of US-born citizens.
Within each disability income source, immigrants are less likely to receive benefits, even among those who report having a disability. Among the disabled population, 21.4 percent of US-born citizens receive welfare income based on their disability. Immigrants were 26 percent less likely to receive disability income, legal immigrants 19 percent less likely, and illegal immigrants 98 percent less likely. This isn’t a story only about immigrants simply being healthier, but also one of immigrants being less costly even after becoming disabled.
A portion of this gap reflects law, as illegal immigrants are generally ineligible for SSI, SSDI, and other federal assistance. However, legal immigrants still receive disability benefits at lower rates than US-born citizens, which suggests that the gap is about more than just who is allowed to apply.
Disability Benefit Consumption
Immigrants consume less than half the disability benefits, in dollar terms, that US-born citizens do. In 2024, per capita disability income among immigrants totaled $411.42. Illegal immigrants accounted for almost none of this spending. Most cases in our dataset come from a small number of respondents concentrated in only a few states, such as California, Texas, New York, and Colorado.
The fact that immigrants are less likely to be disabled and receive less disability income should come as little surprise when considering other research showing that immigrants are generally much healthier overall than the US-born population. They report lower rates of chronic disease, obesity, substance use, and mental illness, and higher life expectancy overall. Even immigrants from countries with lower life expectancies demonstrate elevated health outcomes in the United States.
Given that immigrants and their children make up an increasing share of the US population, the immigrant health advantage carries significant economic effects. Immigrants put less strain on the health care systems and disability programs. Consequently, they also participate at higher rates in the labor force despite having less access to health care. While mechanisms behind the immigrant health advantage are debated, the evidence here is clear: Immigrants are far from burdensome to systems designed to help the disabled. This analysis suggests that the State Department’s public charge rules are an unwarranted addition to America’s immigration system.
This post was coauthored with Carol Xu for the Cato Institute.
Oh David, tough day pal.
I would be fine if 0% of immigrants were disabled. However, since screening is costly, and people can become disabled over time, this 0% ideal is not possible. Practically, we can calculate the average cost of a disabled person, the cost of screening, and then do enough screening to be fiscally justified. But it’s cool that, overall, immigrants tend to be less disabled than the average American.