The Trump administration announced a major reversal of a short-lived immigration policy on Wednesday, requiring all green card applicants to submit a new medical examination form — even if their application was already filed or pending.
The updated rule, released by U.S. Citizenship and Immigration Services (USCIS), will affect all applications for lawful permanent residency filed on or after June 11, 2025, and retroactively applies to any current pending applications.
What’s Changing?
The main shift involves Form I-693, the medical examination report and vaccination record used to prove applicants are not medically inadmissible to the U.S. Under a rule introduced just last year — in April 2024 — these forms were considered valid indefinitely as long as they were properly completed. That is no longer the case.
Effective immediately, applicants must now file a current I-693 with every I-485 green card application. If a pending green card case lacks an associated medical exam form, it will be denied — no exceptions.
Also reversed is a relatively new December 2024 rule that had already expanded medical exam requirements. Prior to that, only applicants who had specific health-related admissibility concerns needed the medical screening. Now, every green card applicant must undergo the exam, regardless of circumstances.
“This rollback adds an extra step — and cost — for everyone seeking permanent residency,” said immigration attorney Carla Jiménez. “In practical terms, this means people may need to undergo these exams more than once, especially if their application is delayed, denied, or withdrawn.”
What’s Involved in the Medical Exam?
The exam, conducted by USCIS-approved civil surgeons, includes screening for communicable diseases and verifying required vaccinations. Costs vary but often range from $300 to $600. And with the new policy, applicants may now need to repeat the exam if they reapply — adding financial and logistical burdens.
A New ‘Gold Card’ for $5 Million?
In a separate announcement the same day, President Trump unveiled a new immigration initiative: a so-called “gold card” that would allow individuals to purchase a green card for $5 million. Interested parties can now register their intent via a newly launched website.
Trump framed the plan as a way to generate revenue and reduce the national debt, projecting it could raise $50 trillion. But economic and legal analysts swiftly questioned the figure.
"Even under the most generous assumptions, this would likely raise between $25 billion and $40 billion, not trillions," said David Lin, a policy analyst at the Migration Policy Institute.
Legal Questions Remain
The proposal appears to be a radical extension — or replacement — of the existing EB-5 investor visa program, which grants green cards to individuals investing in U.S. businesses that create jobs. However, legal experts note that Trump cannot unilaterally dismantle or amend the EB-5 program without Congress.
“This gold card idea might be designed to run parallel to EB-5, but implementing it would still require significant regulatory groundwork — and likely, lawsuits,” said immigration law professor Sophia Wang of Georgetown University.
In Summary
All green card applicants must now file a medical exam form, regardless of health status.
Pending applications without a current Form I-693 will be denied.
Medical exams may now need to be repeated if an application is withdrawn or denied.
Trump’s new “gold card” initiative is raising eyebrows — and legal questions — over its feasibility and projected revenue.
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