What immigrants must now do under Trump’s new green card policy
Fresh guidelines increase costs and delays for adjustment of status seekers
DUBAI: The Trump administration has unveiled immediate changes to the green card application process, affecting thousands of immigrants – particularly from South Asian countries.
The revised rule mandates that a new medical examination form (Form I-693) must now be submitted with each new application for permanent residency in the United States.
Previously, this form could be reused, especially in cases where an applicant had withdrawn and reapplied. However, United States Citizenship and Immigration Services (USCIS) now deems this flexibility a potential public health risk.
Green card: No reuse allowed
The policy, effective from June 11, 2025, applies to all applications currently pending or submitted on or after that date. Any Form I-693 signed on or after November 1, 2023, will now only be valid while the associated application is active. If an applicant withdraws or is denied, the form becomes void – regardless of whether it has expired or not.
USCIS officials argue this change ensures timely and accurate health assessments. “By limiting the validity period… we ensure that aliens get timely and proper medical examinations and treatment,” the agency stated.
The updated version of Form I-693 will be required starting July 3, 2025.
Higher costs, new burdens
The move significantly impacts South Asians – especially those from Pakistan, India, Bangladesh, Nepal, and Sri Lanka – who form a major share of applicants adjusting status from within the US. Many are applying through family sponsorships, employment, asylum, or student visas.
This updated process adds between $100 to $500 in medical fees, and those who previously believed they had completed the requirement must now undergo the exams again and resubmit updated documentation.
Increased delays are expected, and legal experts warn that the sudden implementation provides no grace period. Immigration attorneys stress that while seemingly procedural, the policy introduces serious complications for lawful applicants.
Stricter enforcement strategy
This rule change is part of a broader Trump-era crackdown on immigration. In addition to the medical form revisions, USCIS also announced that it has initiated removal proceedings against more than 26,700 undocumented individuals since February 2025.
This follows new guidance based on an Executive Order focused on national security and system integrity. USCIS has now returned to issuing 1,840 Notices to Appear (NTAs) per week, including 500 in asylum-related cases and 100 involving Temporary Protected Status (TPS).
The intensified vetting and enforcement approach has led to a 2,811% increase in fraud-related NTAs compared to the previous administration.
Although USCIS claims these updates serve public interest, advocacy groups and legal professionals argue that they create procedural minefields for immigrants who are navigating the system legally.