The Trump administration has levied a $100,000 fee on new petitions for H-1B visas, causing widespread concern across industries that rely heavily on international workers, including healthcare, technology and higher education.
The fee was created after President Donald Trump signed a proclamation on Sept. 21. It applies only to new H1B petitions filed on or after that date. The White House says the fee is designed to force companies to hire American workers first. However, critics of the policy, from universities to rural hospitals, claim it could only worsen shortages in industries already struggling to fit key positions.
Scott Darius, executive director of Florida Voices For Health, who works with rural communities struggling to get the basic care they need, says Florida is already seeing these concerns.
“We’re already facing an incredible shortage when it comes to providers,” said Darius.”This just adds another barrier for folks trying to get the care that they need.”
Research shows H-1B physicians are more likely than American-trained doctors to practice in rural and low-income areas.
Medical groups like the American Hospital Association and the American Medical Association urged the administration to exempt healthcare workers from the fee, arguing rural and low-income communities will be the most affected.
But so far, no exemption for healthcare workers has been issued.
Nationally, data shows around 442,000 H-1B beneficiaries currently work in the U.S.. Historically, the vast majority of visas go to people doing computer-related jobs, while only around 5,640 were approved in 2023 for healthcare and social assistance jobs.
Higher education groups like the American Council on Education have also voiced their concerns.
In letters sent to the Department of Homeland Security they explain how the fee can negatively impact institutions of higher education by discouraging international students from enrolling. They also can make it difficult to hire international researchers and professors.
Major tech companies also warn the fee could cause a “skill cliff,” meaning a large dropoff of workers with a particular expertise.
However, Dr. Ron Hira, a professor at Howard University who has researched the program for years, says major tech firms are using the program, not because they can’t find available American workers but because it’s cheaper.
“Instead of turning to the H-1B program kind of as the last resort, when they can’t find American workers, they go to it first,” said Hira. “Because, hey, if I’m an employer and I could pay H-1B workers a lot less than if I had to hire an American, I’m gonna hire the H-1B worker.”
In a recent analysis for the Economic Policy Institute, Dr. Hira found that 60% of H-1B jobs certified by the Labor Department were assigned prevailing wages below the local average for those occupations. In an example, Hira says that a H-1B software programmer in Washington was certified by the Labor Department at $75,000 when the average local pay for that position is $117,000.
There are only 85,000 available H1B visas each year, but in 2025 more than 340,000 people applied. Most of them go to the tech industry, and while they dominate the program, Darius says any disruption to the few approved international visas for healthcare could make things worse.
“Even if you are of the idea that the number of providers we currently have is enough, I think what is true on the face of it is that they’re not in the right areas,,” said Darius, that we’re not fundamentally getting the people we need where we need them.”
