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By Dan Gooding
Associate News Editor
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The Trump administration announced Wednesday that it was making immediate changes to green card applications, stating a previous policy introduced just over a year ago could threaten public health.
The United States Citizenship and Immigration Services (USCIS) stated that it was making it a requirement that every new permanent residency application require a renewed medical examination form, after applicants were previously allowed to use forms indefinitely.
Why It Matters
The change could directly impact immigrants currently applying for adjustment of status, who would have been allowed to use a previous form signed by a civil surgeon until June 10. Usually, when USCIS makes changes to application processes, there is some lead time for applicants and immigration attorneys to prepare.
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What To Know
USCIS stated that the change applies to the medical exam form known as the I-693, "Report of Immigration Medical Examination and Vaccination Record," which is completed by an immigrant in the U.S. who is applying for adjustment of status or to become a permanent resident.
In April 2024, the agency updated its policy to say that any I-693 completed and signed by a civil surgeon on or after November 1, 2023, could be used indefinitely. If an immigrant withdrew a green card application and re-applied, or filed for a different immigration benefit later, they could use the same form again.
Under USCIS's new guidance, effective June 11, 2025, if an application is withdrawn, the I-693 is invalidated, and the applicant must retake the exam to obtain a new, signed copy.
"This is pretty typical of the kind of changes we've been seeing. Time was that they would at least give you some grace period, some lead up, but this means that things that were in the mail this week are going to be invalid potentially," Matt Cameron, an immigration attorney at Cameron Micheroni and Silvia in Boston, told Newsweek.
The move will likely affect thousands of applicants currently looking to file their adjustment of status application, known as Form I-485.
Medical exams are similar to physical exams and include checks for specific conditions or diseases that could render a person inadmissible to the U.S. The examiner, a civil surgeon, also checks an applicant's vaccination records. The exam can cost between $100 and $500. Cameron said this could mean immigrants have to pay twice over.
Before December 2024, only individuals who needed to prove they were not inadmissible on medical grounds were required to file a medical examination form. Now, every green card applicant is required to file one. Other immigrants applying for different visas may also be asked to file an I-693 at USCIS' discretion.
The change comes amid increased scrutiny of immigrants as they apply for temporary and permanent visas in the U.S., as the Trump administration looks to crack down on those violating immigration laws.
In March, immediate changes to a swathe of application forms caused confusion for applicants, leading to a lawsuit from attorneys, and USCIS being forced to change course and offer at least two weeks' buffer time for the changes to take effect.
Is ICE Deporting People with Green Cards?
The Trump administration has been seen to take a tougher stance on immigration enforcement, including the revocation of green cards belonging to those it views as having broken immigration or other laws.
In March, federal agents detained green card holder Mahmoud Khalil, a Columbia University graduate and pro-Palestinian protester. The administration said his actions had gone against U.S. foreign policy and sought his removal from the country, despite his permanent resident status.
There have been other reported cases of green card holders being detained within the U.S. or denied reentry following travel abroad. This is not necessarily new, but it was seen as less common before January 20.
The federal government has repeatedly said that green cards do not mean citizenship, and that they can be revoked on national security grounds, as well as for immigration law violations or criminal convictions.
What People Are Saying
Immigration attorney Matt Cameron, speaking to Newsweek: "They usually would give this until the end of the month or something, so the applications that are just about to be filed can be honored. It's not a radical change, but I think it's very much of a piece of the trend here in just making everything more difficult. Across the board [they] have made every kind of contact with the immigration system more difficult."
Elissa Taub, an immigration attorney at Siskind Susser in Houston, Texas, told Newsweek: "Previously, I-693s all had an expiration date, so we had clients needing to get multiple exams done while their I-485s were pending over many years due to backlogs.
"Currently, I-693s don't expire, and it sounds like they are clarifying that if you withdraw that application or it's denied, you can't reuse the same unexpired I-693 with a new application. I don't think this is too earth-shattering, and I'm happy that this policy change is relatively narrow and that they didn't decide to create a new pre-filing expiration period."
USCIS, in its statement on the changes: "We have since determined that the April 4, 2024, policy is overly broad and could potentially threaten public health in the United States. By limiting the validity period to only the current immigration benefit application or request, we ensure that aliens get timely and proper medical examinations and treatment, which safeguards public health."
What Happens Next
The new policy takes effect on Wednesday, June 11, 2025, while a new version of the form takes effect on July 3, 2025.
Update 11/6/25, 1:57 p.m. ET: This article has been updated with comment from Matt Cameron and additional information.
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