Exempting doctors from $100,000 H-1B fees | Bills & Laws

The skinny

Members of Congress have crafted a bill to exempt doctors and healthcare workers from the new $100,000 H-1B fee put in place last fall. They introduced the bill this week.

Sponsors

U.S. Reps. Mike Lawler, R-N.Y., is the lead sponsor of the bill (H.R. 7961). The co-sponsors include U.S. Reps. Sanford D. Bishop Jr., D-Ga.; Maria Elvira Salazar, R-Fla.; and Yvette Clarke, D-N.Y.

Summary

The bipartisan bill would exclude doctors and other healthcare workers from the $100,000 fee, and it would also prevent new H-1B fees from being placed on healthcare workers that surpass existing fees, lawmakers say.

President Trump signed a proclamation in September calling for a $100,000 annual fee for organizations recruiting skilled workers from other countries through the federal H-1B visa program. The fee had been $215.

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Analysis

Hospitals and health systems rely on doctors and other healthcare workers from other countries, especially as they struggle with staffing shortages. In 2024,16,937 individuals were granted H-1B visas for medicine and health occupations, and half of those were doctors and surgeons, according to federal data.

When Trump issued the proclamation last fall, healthcare organizations urged the administration to reverse the policy. Dozens of medical societies asked for exemptions for doctors. They argued that health systems are already facing financial pressures and can ill-afford paying a $100,000 H-1B fee for every additional international doctor or medical staffer.

Lawler said with the fees, doctors and other key healthcare staff are essentially shut out of the H-1B program.

“Hospitals, community health centers, and other critical facilities are facing serious workforce shortages that threaten access to care. And they can't pay a $100,000 price tag on new immigrant workers,” Lawler said in a statement.

Bishop said the fees are especially difficult for hospitals with modest resources.

“The $100,000 H-1B filing fee adds insult to injury to hospitals, especially in rural areas,” Bishop said in a statement. “The fee will have a detrimental impact on their ability to recruit qualified health care professionals to some of the nation’s most underserved areas.”

Dr. Bobby Mukkamala, the president of the American Medical Association, outlined the problem during a panel discussion at the HLTH conference last fall. He cited a hospital in his home state of Michigan that typically brings in 30 to 35 foreign physicians.

“There's no way my inner city hospital can afford 35 times $100,000: $3.5 million,” Mukkamala said. “It’s just not going to happen.”

“This isn't a matter of economics. This is a matter of the health and life of the communities,” he said.

Supporters

Hospitals and physicians quickly endorsed the legislation.

Stacey Hughes, executive vice president of the American Hospital Association, said the legislation would help maintain access to the care.

“This important bill will maintain critical staffing for areas of the country where there are well-documented shortages of health care workers,” Hughes said.

The American Medical Association offered its support for the legislation. About a quarter of the practicing physicians in America are international medical graduates, according to the AMA.

“The $100,000 filing fee for H-1B petitions adds significant costs for hospitals and private practices, making it more difficult to hire physicians and other health care professionals,” the AMA said. “The added cost will worsen shortages, increase wait times, and force patients to travel farther for care.”

Danielle P. Turnipseed, chief public policy officer of Association of American Medical Colleges, called the bill an “important first step to addressing the H-1B issue that poses a significant, real challenge to the academic medicine workforce.”

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