H-1B Visa Fee Leaves Clinics Struggling to Keep Doors Open

When the Trump administration announced last month that every new H-1B visa application would carry a $100,000 fee, the goal seemed simple — to encourage American companies, especially those in tech, to hire U.S. workers and stop relying on foreign talent to fill skilled roles. But the real-world ripple effects are now hitting an unexpected sector — the U.S. health care industry, particularly hospitals and clinics in rural and underserved areas.

For these facilities, the H-1B Visa $100,000 Fee has created a new crisis: it threatens their ability to bring in international medical graduates who are vital to keeping essential services running.

H-1B Visa: Rural Hospitals Fear Collapse Amid Physician Shortage

At St. Luke’s Hospital in Chesterfield, Missouri, residency program coordinator Carolynn Lundry is alarmed. Each year, she selects 16 internal medicine residents, many of whom are international graduates working under H-1B visas. But with the new six-figure fee, that hiring pipeline could vanish.

“There’s no way we’re going to pay $100,000,” Lundry said. “If we’re going to take away the H-1Bs, it’s going to shrink our pool of choices dramatically.”

That pool isn’t just large — it’s indispensable. According to a 2021 study from the National Institutes of Health, more than 64% of international medical graduates serve in medically underserved or shortage areas, and over 45% work in rural regions. These professionals form the backbone of health care delivery in towns where American-trained physicians are scarce.

The Health Resources and Services Administration (HRSA) estimates that the U.S. already needs 13,075 more physicians just to meet existing demand. By 2037, that gap could widen to a staggering 87,150 primary care physicians.

For hospitals like St. Luke’s, already struggling to attract American graduates, the new policy could be devastating. “We need so many physicians in this country, and there just aren’t enough American medical graduates to fill all of those positions. We have to draw from other places,” Lundry added.

White House Defends Policy as a Boost for American Workers

The White House has defended the new H-1B visa $100,000 fee, calling it part of President Donald Trump’s broader effort to “put American workers first.”

“President Trump promised to put American workers first, and this commonsense action does just that by discouraging companies from spamming the system and driving down wages,” said White House spokesperson Taylor Rogers. “It also gives certainty to American businesses who genuinely want to bring high-skilled workers into our great country.”

Currently, the U.S. Citizenship and Immigration Services (USCIS) has clarified that the $100,000 fee applies only to new H-1B applicants living abroad, not to existing visa holders or those changing status within the U.S. However, critics say that distinction offers little comfort to employers that rely on global recruitment to fill essential positions.

H-1B Visa: Business and Medical Groups Push Back

The policy has drawn strong criticism from industry leaders, who warn that the massive fee increase — from roughly $3,000 to $100,000 — could cripple small and mid-sized organizations.

The U.S. Chamber of Commerce, one of the nation’s largest business advocacy groups, has filed a lawsuit against the administration, calling the move “cost-prohibitive” and contrary to congressional intent.

“The new $100,000 visa fee will make it impossible for startups, small businesses, and hospitals to use the H-1B program,” said Neil Bradley, the chamber’s executive vice president. “The program was created to ensure that American companies can access global talent and grow their operations here in the U.S.”

Similarly, the American Medical Association (AMA), joined by over 50 health care societies, has urged the government to exempt international medical graduates from the fee. In a letter to Homeland Security Secretary Kristi Noem, the coalition wrote, “States with a higher percentage of H-1B physicians are often those with lower physician density. The U.S. health care workforce relies upon physicians from other countries to provide high-quality and accessible patient care.”

Clinics Struggle to Stay Afloat

For organizations like ATI Physical Therapy, the challenge is not just about cost — it’s about survival.

“We already have way more jobs than we have qualified applicants,” said Dr. Chuck Thigpen, chief clinical and strategy officer at ATI. The company currently has 450 open clinical roles, with 49 employees on H-1B visas and 97 dependents on H-4 visas.

“With this new fee, I simply can’t afford to hire internationally anymore,” Thigpen explained. “It’s not just a financial issue — it’s a public health issue. We’re already under severe pressure to keep clinics open. If I now layer on an additional $100,000 per hire, I can’t do it. I’ll have to close clinics.”

The consequences, he warns, will fall squarely on American patients. “The real loss will be borne by Americans who really need the help.”

Also Read : Venkatraghavan Ganesan: Leading the Future of Nanotechnology