A $100,000 application fee for H-1B visas, often used by international physicians for U.S. clinical employment, could have outsized consequences for Republican-led states, Politico reported Oct. 2.
President Donald Trump imposed a $100,000 fee for new H-1B visa applications, effective Sept. 21. Major healthcare organizations decried the order, saying the fee would disrupt an already fragile workforce. While the White House is reportedly considering exemptions for physicians, the fee remains in place.
About 1 in 6 U.S. hospital workers are immigrants, according to KFF. States with more pronounced physician shortages have a higher percentage of foreign-born clinicians. A study published in June found that Iowa, North Dakota and West Virginia employ the highest percentage of healthcare workers with H-1B visas.
These states are led by Republican lawmakers. Although the party often opposes the visa program, hospitals in West Virginia and Iowa are lobbying for healthcare employees to be exempt from the H-1B application fee, according to Politico. Sen. Kevin Cramer, R-N.D., is cosponsoring a bill that would make a limited number of green cards available to qualified physicians and nurses.
In 2024, about 4% of H-1B approved petitions were for medicine and health occupations, according to the American Hospital Association.
Across U.S. hospitals, foreign-born employees account for 27% of physicians and surgeons, 22% of nursing assistants, 16% of registered nurses, 29% of janitorial and maintenance workers, 20% of food prep employees and 11% of administrative workers.
Read more about recent visa policy changes here.
