The visa reciprocity rule is the arrangement John Kiriakou set out in November 2025, in response to a State Department announcement that applicants for immigrant and tourist visas would be refused on grounds of obesity — and, he added, of cancer or diabetes.[1][2]
Bilateralism
Rall’s question was whether visas are bilateral. Kiriakou’s answer was immediate: “Oh, yeah, they’re bilateral.”[3]
The agreement, which he named, exists with virtually every country in the world: the visa reciprocity agreement. What it normally means is that each side is allowed to set the price of its own visa, and the other matches it — if the visa is free for Americans, then American visas are free for that country’s nationals.[3][4]
His worked examples were straightforward. The Indians charge Americans a hundred dollars, so the United States charges Indians a hundred. The Chileans charge a hundred, so the United States charges the Chileans a hundred.[4]
The Russian exception
The rule is not always acknowledged by the country applying it. Kiriakou recalled going to Russia once when the visa cost $400 — and being told by the Russians that this was not them: it was the Americans doing it to them, because the United States had been trying in the 1990s to keep Russian organised crime out of the country.[4] Rall’s observation that $400 was unlikely to deter a mobster went unanswered except by laughter.[5]
The consequence
The application to the new policy is the point of the discussion. If the Americans are going to make you get on a scale when you come to the embassy to apply for a visa, then any country can decide to make Americans get on a scale too. Kiriakou’s answer to that was two words: “Yes. Absolutely.”[5]
He also thought the effect on travel would be real. Asked whether such a policy would cripple tourism, he said the shift was already under way: Spain and France are coming right up to the United States in visitor numbers every year, and “we’re not going to be number one anymore.”[3] Rall noted the country already had a long-standing bar on visas for people with AIDS, so the class of medical exclusion was not itself new.[2]