The imposition of a $100,000 fee on new H-1B visa petitions is expected to exacerbate workforce shortages in the U.S. health care system, particularly in rural areas, according to a survey conducted by the American Hospital Association.
Hospitals and health systems across the United States are grappling with significant shortages of health care professionals, a situation that is projected to worsen over the next decade. The H-1B visa program, which allows U.S. employers to hire foreign professionals in specialty occupations, has been a crucial mechanism for filling these gaps, particularly in fields like medicine, nursing, and allied health services. However, a recent policy change requiring a $100,000 fee for each new H-1B petition is raising alarms among health care leaders regarding its potential impact on patient care and access to qualified professionals.
Survey Highlights Impact on Health Care Access
In November 2025, the American Hospital Association (AHA) conducted a survey of over 1,000 member hospitals and health systems. The results revealed that more than 70% of respondents believe the increased H-1B filing fee will have a direct negative impact on patient care. As a result of the fee, nearly 65% of hospitals that utilize the H-1B program reported having to pause, delay, or limit recruitment efforts, particularly for direct-care roles. This limitation is particularly concerning given the existing shortages of health care providers, especially in rural and underserved areas.
The Need for Health Care Workers
According to the U.S. Health Resources and Services Administration (HRSA), more than 92 million people live in regions designated as primary care Health Professional Shortage Areas. Additionally, around 137 million individuals reside in regions lacking sufficient mental health providers. The AHA emphasizes that while hospitals are actively working to enhance domestic recruitment and retention, these efforts are often slow to yield results.
Health care professionals on H-1B visas currently represent less than 5% of the total H-1B holders in the United States. However, they play a vital role in addressing workforce shortages in communities that need them most. While 14% of Americans live in rural areas, only 10% of U.S. physicians practice in these regions, highlighting a critical imbalance in workforce distribution that the H-1B program seeks to address.
Background on the H-1B Visa Program
The H-1B visa program was established to allow U.S. employers to temporarily employ foreign workers in specialty occupations that require highly specialized knowledge and at least a bachelor’s degree. In September 2025, a presidential proclamation mandated a $100,000 fee for new H-1B visa petitions, with very limited exceptions. This fee is intended to discourage the use of the program for roles that can be filled by domestic workers, but critics argue it could have unintended consequences on health care delivery.
Many hospitals have indicated that, especially in rural communities, the ability to sponsor even one H-1B visa can be the difference between maintaining essential services, such as oncology or obstetrical care, and facing significant reductions. The AHA reports that shortages of health care providers already exceed hundreds of thousands, with demand projected to increase significantly in the coming years.
Future Projections and Implications
According to the National Center for Health Workforce Analysis, the U.S. is expected to face a shortage of more than 141,000 physicians, 108,000 nurses, and 30,000 pharmacists by 2038. Additionally, shortages of social workers, physical and occupational therapists, and other health professionals are anticipated to reach tens of thousands. The growing demand for health care services, coupled with an inadequate supply of health professionals, is likely to result in longer wait times, delayed diagnoses, and increased emergency visits, ultimately raising costs for patients and straining health systems.
Call for Policy Change
The AHA is advocating for the Department of Homeland Security to exempt health care professionals from the $100,000 H-1B visa fee, arguing that such a move is essential for ensuring continued access to timely and high-quality care across all communities. Following the policy change, more than 70% of AHA survey respondents expect patient care will be impacted, with nearly 40% anticipating significant effects. In rural and underserved areas, where access to specialty providers is already limited, the consequences could be particularly dire.
As the health care system strives to adapt to increasing demands, the imposition of the H-1B visa fee presents a significant obstacle to recruiting essential health care workers. With millions of Americans living in areas already facing severe provider shortages, it is imperative that federal policies support, rather than hinder, the recruitment of qualified health care professionals.
