The U.S. healthcare workforce could undergo a transformation amid employment visa restrictions and future Medicaid cuts.
In August, healthcare was one of only a handful sectors that posted job gains, adding more jobs than the overall economy, but growth had slowed significantly by September. The Trump administration’s visa and travel restrictions, increase in deportations and Medicaid changes could further disrupt healthcare’s workforce, as well as the nation’s at large.
Four things to know:
1. International clinicians account for approximately 20% of America’s healthcare workforce, making up 27% of physicians and surgeons, 22% of nursing assistants and 16% of registered nurses. Immigrants also account for 29% of janitorial and maintenance workers, 20% of food prep employees and 11% of administrative workers in U.S. hospitals.
2. Between May and mid-June, travel limitations and bans on 19 countries temporarily suspended interviews for J-1 visa applications, which are typically used in healthcare for residency or fellowship programs. About 1,000 of the 6,653 international physicians accepted into a U.S. residency were stuck in “visa limbo.”
Nearly 17,000 physicians in residencies and fellowships are on J-1 visas, according to the American Hospital Association.
The AHA is advocating for the Department of Homeland Security to maintain program “duration of status” for these visas, as a current proposal would establish a four-year fixed period.
3. On Sept. 19, President Donald Trump ordered a $100,000 fee on new applications for H-1B visas, which are often used by physicians for clinical employment. In 2024, about 4% of H-1B approved petitions were for medicine and health occupations, according to the AHA.
The change became active Sept. 21, and while the White House is reportedly considering exemptions for physicians, senators from 10 states are cosponsoring a bill that would allow unused green cards to be allotted to foreign-born clinicians.
4. Regarding Medicaid, the One Big Beautiful Bill Act, signed in July, will result in 16 million more uninsured individuals while reducing Medicaid spending by nearly $1 trillion by 2034, according to the Congressional Budget Office.
The law will also eliminate 1.2 million jobs nationwide in 2029, according to estimates from the Commonwealth Fund. Approximately 497,000 healthcare jobs will be lost, CBO estimated, including 77,200 jobs in California and 51,100 in New York.
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