H-1B visa petition fee increase could complicate hospital staffing, experts say

Back in September, the Trump administration instituted a new rule to charge $100,000 for new H-1B petitions, up from an average of $3,500 for an international temporary worker permit, according to a study by Mass General Brigham and Beth Israel Deaconess Medical Center.

Created back in 1990, the H-1B program has targeted “high-skilled” workers, particularly in STEM fields. The program previously doled out 85,000 new visas annually, and as many as 730,000 workers are currently H-1B holders, according to fwd.us, an immigration and criminal justice advocacy group.

Employers sponsored H-1B visas for 0.97% of physicians (11,080), 0.02% of advanced practice providers (122), 0.40% of dentists (1,004), and 0.07% of other healthcare workers (132) in 2024, according to that same October 2025 research from Mass General Brigham and Beth Israel Deaconess Medical Center.

The Trump administration, however, said in a presidential proclamation the program has “been deliberately exploited to replace, rather than supplement, American workers with lower-paid, lower-skilled labor.” Rep. Greg Steube (R-Fla.) proposed a bill on Feb. 9 to end the H-1B visa program entirely.

In rural counties, the researchers reported, foreign national physicians were twice as likely to be H-1B holders compared to urban areas.

Shortages worsening. In a Dec. 19 letter to the Department of Homeland Security Secretary Kristi Noem, Danielle Turnipseed, chief public policy officer at the Association of American Medical Colleges (AAMC), said the fees would likely worsen the existing physician shortage, strain the entire healthcare workforce, and “ultimately jeopardize patient access to care.”

Healthcare has long faced workforce shortages, and they’re only expected to get worse. ​​The Health Resources and Services Administration projects the US will be lacking 141,160 physicians by 2038.

American Hospital Association (AHA) President and CEO Richard Pollack wrote in a separate letter to Noem on Sept. 29 that the US needs to invest more into training healthcare workers.

But, he added, “we believe that recruiting qualified foreign-trained medical professionals is an effective short-term approach that is vital to ensuring access to care in communities across the country.”

AHA and AAMC both asked for healthcare professionals to be exempted from the higher fees.

Marcel Botha, CEO and founder at medtech startup 10XBeta, had an H-1B visa before receiving his green card and, later, US citizenship. He told us he was “disappointed” when he first heard about the new fee.

“It’s always been a pathway for highly skilled workers from anywhere to be educated and kept within the US to prevent brain drain,” he said.

America first, tech second? Though initially surprised by the high price tag, Botha said the fee is now so high it may push domestic industries to make their fields more accessible to US workers.

“It’s intentionally significant so that we would consider investing in the local ecosystem in terms of education before we pay for a foreign national to come take a job and skip over that step,” he said.

The higher fee also makes it more likely industries will have to turn to technology like AI to supplement staffing, Botha added.

With AI on the rise, there are more tools that can lighten workloads—like ambient scribes as well as back-office tools to handle revenue cycle management and scheduling—and potentially free clinicians up for more appointments.

“I do think it’s a wake-up call on [whether we should] take a long view on how we invest in both talent acquisition, training, and technology adoption in the US healthcare system,” Botha said.