The American Hospital Association is urging the Trump administration to exempt healthcare workers from a new $100,000 visa fee policy, warning that the cost could worsen clinician shortages and force some hospitals to reduce services, particularly in rural and underserved areas.
The request follows a Sept. 19 proclamation from President Donald Trump that imposed the fee on new H-1B visa applications for foreign workers seeking high-skilled roles. The policy took effect Sept. 21. It allows for case-by-case exemptions if the Homeland Security secretary determines that hiring a worker is “in the national interest.”
In a Sept. 29 letter to Homeland Security Secretary Kristi Noem, the AHA noted that nearly 400,000 H-1B petitions were approved in fiscal year 2024, and 4.2% of those — or 16,937 — were for medicine and health occupations, with about half for physicians and surgeons. The association said these workers are vital to maintaining hospital staffing levels, especially in hard-to-fill roles.
Hospitals and health systems frequently use the H-1B program to recruit physicians and medical residents, with more than 4,000 hospitals and research centers sponsoring visas as of June, according to federal data cited by Bloomberg. The AHA said about 17% of hospital clinicians are immigrants, and 26% of those are noncitizen immigrants.
Rochester, Minn.-based Mayo Clinic, Cleveland Clinic and Memphis, Tenn.-based St Jude Children’s Research Hospital rank among the nation’s top H-1B sponsors, each employing hundreds of foreign-born physicians.
The AHA also asked the administration to clarify whether international physicians working under the Conrad 30 Waiver Program are subject to the fee.
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