H-1B Visa Program Fee Threatens to Deepen U.S. Healthcare Worker Shortage and Limit Access to Care
Hospitals across the United States are bracing for deeper workforce shortages following an increase in H-1B fees last fall. Healthcare leaders believe this policy change could make it more difficult to recruit highly skilled foreign-born clinicians, technicians, and other vital healthcare professionals, especially in rural areas that rely heavily on the program.
The increased fee, issued by President Trump in a proclamation in September 2025, imposes a $100,000 fee on new H-1B petitions filed for workers outside of the U.S. With exemptions for extensions, renewals and transfers of existing visa holders, these fees would only apply when a new petition is filed. This fee is a significant increase from previous fees that normally totaled under $10,000.
While the President defended the policy as part of broader efforts to protect American jobs, saying companies replace American workers with these visa holders, hospitals and the healthcare system are currently facing workforce staffing challenges directly related to these changes.
The Impact of H-1B Visa Program Changes
The U.S. continues to experience a shortage of healthcare workers. In 2024, the Health Resources and Services Administration projected a shortfall of 187,130 full-time equivalent physicians by 2037. Healthcare leaders warn that the new H-1B fee could worsen the shortage by making it financially prohibitive for hospitals and clinics to recruit foreign-trained professionals.
The American Hospital Association (AHA) continues to urge the administration to offer an exemption for healthcare personnel from the H-1B requirements. In a Sept. 2025 letter, AHA explained the changes to the program would threaten hospitals’ ability to hire physicians, nurses, clinical lab experts and other roles, especially in rural and underserved regions where workforce shortages are most severe.
Research published in The Journal of the American Medical Association reflects the potentially damaging impacts of these fees on the underserved regions. After analyzing data on all H-1B visa applications in fiscal year 2024 from the Department of Labor, the data indicates that H-1B-sponsored healthcare professionals accounted for more than 12,000 physicians, advanced practice providers, dentists, and other healthcare workers in that year alone.
Increased Immigration Restrictions and Operating Challenges
Additional immigration actions may further strain the healthcare workforce. The Department of State recently announced a pause of all immigrant visas from 75 countries. Analysis from KFF shows that workers from 69 of the 75 countries comprise near 8% of the U.S. healthcare workforce.
Hospitals are indicating the financial impact of the fee increase has also created immediate operational challenges. In Akron, Ohio, pediatricians at Akron Children’s Hospital have warned lawmakers that the fee is making it harder to recruit and retain doctors, particularly in pediatric and specialty care.
It is also important to note that many hospitals did not anticipate such a substantial fee increase and have not budgeted for it, adding financial strain and uncertainty to an already tight labor market. This added cost and uncertainty for employers threatens not only the quality of patient care across Northeast Ohio, but also innovation and research.
Rural Communities Face the Largest Impact of H-1B Visa Fee Increases
Rural communities and underserved areas already face barriers to healthcare access and greater challenges in attracting young doctors.
In many cases, hospitals have been able to respond to the shortage of physicians by turning to foreign-born and internationally trained clinicians as the H-1B visas are seen as a way to attract professionals with specialized skills for roles that may otherwise remain vacant.
With many rural hospitals operating with narrow margins as small as 1-2%, the $100,000 fee could be a massive financial burden, with a devastating impact. AHA reported that in 2023, 48% of rural hospitals operated at a financial loss. In these underserved areas, this fee could cover the salary of a nurse, the purchase of critical medical equipment or the funding of essential community health programs.
Without relief or exemptions for healthcare employers, industry leaders warn that rural hospitals may be forced to scale back services, delay patient care or leave critical positions unfilled, further widening healthcare disparities between urban and rural communities.
Given ongoing workforce shortages across the healthcare industry, WellLink supports exemptions for healthcare workers. Organizations including the Association of American Medical Colleges, the American Medical Association and the American Hospital Association have petitioned the U.S. Department of Homeland Security to grant an exemption for healthcare workers in the H-1B visa program.
As legal challenges and lawsuits against the fee move forward and hospital groups continue pressing for exemptions, the long-term impact of the policy may ultimately be measured in access to care for the communities that desperately need it the most.
