A Republican representative from Florida has introduced legislation that would eliminate the federal H-1B visa program, which allows employers to hire highly skilled foreign professionals through temporary work visas.
Rep. Greg Steube, R-Fla., introduced the Ending Exploitative Imported Labor Exemptions, or EXILE, Act, Feb. 9. The bill would amend a section of the Immigration and Nationality Act to end the visa program, which critics argue has disadvantaged American citizens. The H-1B program has been in place since 1990.
Hospitals and health systems are among the employers that rely on the visa program, sponsoring physicians and medical residents to fill staffing gaps, particularly in rural and medically underserved areas. Healthcare groups have warned disruptions to the program could worsen access to care, especially in communities where international medical graduates make up a significant share of the physician workforce.
In September, the Trump administration imposed a $100,000 fee for each new H-1B visa application — up from the $3,500 employers previously paid. Healthcare groups have urged federal officials to exempt physicians and other healthcare workers from the policy, warning the steep fee may deter recruitment of international clinicians, exacerbate existing staffing shortages and potentially force service reductions in some areas.
The White House has signaled it would consider case-by-case exemptions for physicians and medical residents if their hiring is deemed in the “national interest.” However, there have been no public reports of such exemptions being granted. In the meantime, many teaching hospitals are weighing contingency options such as reducing the number of sponsored residents they initially planned to hire, hiring more physician assistants or reconsidering applicants who require H-1B sponsorship.
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