In February 2026, bipartisan members of Congress renewed pressure on the Department of Homeland Security (DHS) to protect hospitals and other healthcare employers from a new $100,000 H‑1B visa filing fee. This proposed fee would apply to certain large H‑1B users and could dramatically increase the cost of sponsoring international healthcare professionals, including foreign nurses and allied health workers.
For healthcare organizations already battling severe staffing shortages, this policy could be devastating. That’s why VisaMadeEZ is closely tracking these developments and helping hospitals prepare smart immigration strategies to continue hiring qualified international nurses and clinicians.
Congressional Leaders Urge DHS to Protect Healthcare Employers
On February 11, 2026, a bipartisan group of 100 members of Congress sent a formal letter to DHS, calling for an outright exemption for healthcare employers from the $100,000 H‑1B filing fee.
The letter was led by Representatives Yvette D. Clarke (D‑NY) and Michael Lawler (R‑NY) and was supported by the American Hospital Association (AHA). Lawmakers stressed that:
- U.S. hospitals and health systems rely heavily on international healthcare workers, including registered nurses, nurse practitioners, therapists, and other clinicians.
- Foreign-born professionals are essential for maintaining access to care in rural, inner-city, and medically underserved communities.
- Imposing a $100,000 H‑1B fee on healthcare employers would cripple recruitment and worsen already extreme workforce shortages.
In essence, Congress is telling DHS: if you don’t carve out healthcare, patients will pay the price.
How the Proposed $100,000 H‑1B Fee Threatens Healthcare Staffing
Under current proposals, certain employers who file large numbers of H‑1B petitions could be subject to a $100,000 supplemental filing fee per petition. While this policy was pitched as a way to deter heavy use of the H‑1B program in the tech and outsourcing sectors, it sweeps in hospitals and health systems as well.
For hospitals and healthcare organizations, the impact could be severe:
- Reduced ability to sponsor international nurses and other clinicians
Many healthcare employers already operate on thin margins. Adding a $100,000 fee per H‑1B petition would make it nearly impossible to sponsor foreign nurses, physical therapists, occupational therapists, and other critical professionals.
- Unfilled positions in critical units
If hospitals can’t afford H‑1B sponsorship, vacant roles in ICUs, med‑surg floors, emergency departments, long-term care, and specialty units may stay open indefinitely.
- Reduced access to care for vulnerable patients
Rural hospitals, safety‑net institutions, and community health centers count on international healthcare workers to keep doors open. Losing access to H‑1B visa sponsorship could translate directly into longer wait times, reduced services, or even closures.
- Increased burnout for existing staff
As hospitals struggle to fill gaps, U.S. nurses and clinicians face heavier workloads, leading to burnout, turnover, and a downward spiral in staffing stability.
From an immigration law perspective, the $100,000 fee would effectively shut off the H‑1B visa as a viable tool for many healthcare employers, at a time when the industry desperately needs flexible, lawful immigration pathways.
AHA, Hospitals, and Healthcare Associations Rally for an Exemption
The American Hospital Association, academic medical centers, and numerous healthcare advocacy groups have joined forces to fight for a healthcare-specific exemption from the $100,000 H‑1B visa fee. Their message to DHS is clear:
- Healthcare is not like other industries.
- Limiting access to international professionals endangers patient care and public health.
- Hospitals serving high‑need populations cannot absorb six‑figure per‑petition costs on top of rising labor and operational expenses.
These organizations argue that policy makers must distinguish between high‑volume IT outsourcing firms and hospitals using the H‑1B visa program to maintain safe staffing levels. Without a targeted exemption, the policy would unintentionally punish healthcare employers who are already struggling to meet demand.
As an immigration law firm focused on healthcare recruitment, VisaMadeEZ is aligned with this advocacy and continually advises clients on how to adjust their hiring strategies in light of evolving H‑1B regulations.
Why International Nurses Are Essential to the U.S. Healthcare System
For many hospitals, especially in underserved regions, international nurse recruitment is not optional it’s a lifeline.
Healthcare organizations rely on foreign nurses and other international healthcare workers to:
- Fill chronic shortages in bedside nursing roles
- Staff specialty units that require experienced nurses and advanced training
- Cover night shifts, rural facilities, and hard‑to‑recruit locations
- Maintain safe nurse‑to‑patient ratios and meet quality standards
Even though many international nurses use the EB‑3 immigrant visa or other employment‑based immigrant categories, the H‑1B visa remains an important tool for certain roles, especially advanced practice positions, clinical educators, and specialized clinical roles that qualify as specialty occupations.
If DHS adopts the $100,000 H‑1B filing fee without a healthcare exemption, hospitals may lose a critical legal pathway for recruiting and retaining highly skilled international professionals.
What Healthcare Employers Should Do Now
While the final details of the H‑1B fee policy are still under review, healthcare organizations should not wait to act. VisaMadeEZ recommends that hospitals and healthcare employers:
1. Review current and projected staffing needs
Identify roles currently filled by international staff or likely to require foreign recruitment particularly hard‑to-fill nursing specialties, advanced practice providers, and allied health professionals.
2. Evaluate your immigration mix
Work with experienced immigration counsel to examine all available options:
- H‑1B visas for specialty occupation roles
- TN status (for eligible Canadian and Mexican professionals)
- EB‑3 immigrant visas for nurses and other shortage occupations
- J‑1 waivers, O‑1 visas, and other employment-based categories where appropriate
3. Assess potential exposure to the $100,000 H‑1B fee
Larger health systems and staffing entities may be more likely to fall within the fee’s scope. A proactive legal assessment can help you understand your risk and plan accordingly.
4. Adjust recruitment timelines
If you anticipate needing H‑1B workers, you may want to file earlier or explore alternative visa categories now, before any new fee structure takes effect.
5. Collaborate with legal counsel on advocacy and comments
Regulatory changes often include a public comment period. Partnering with immigration counsel and industry associations allows your organization’s voice to be heard in the policymaking process.
At VisaMadeEZ, we work exclusively with healthcare organizations and understand the realities of nurse staffing, accreditation standards, and budget constraints. We integrate immigration strategy with workforce planning, so you’re not just reacting to policy changes, but preparing for them.
How VisaMadeEZ Supports Healthcare Organizations
As an immigration law firm specializing in helping healthcare organizations hire international nurses and other clinical staff, VisaMadeEZ provides:
- Strategic immigration planning for nurse recruitment
We help hospitals design long-term recruitment pipelines using EB‑3, H‑1B (where appropriate), and other employment-based visa options tailored to healthcare roles.
- End‑to‑end case management
From prevailing wage and labor certification (PERM) to petition filing, consular processing, and onboarding, we manage the full lifecycle of your international nurse cases.
- Compliance and risk management
We ensure that your use of the H‑1B visa, EB‑3 green cards, and other visa categories aligns with DHS, USCIS, and Department of Labor regulations protecting your organization from costly compliance missteps.
- Policy monitoring and rapid updates
Our team closely tracks changes like the proposed $100,000 H‑1B fee and immediately advises clients on the impact for hospital staffing and international nurse recruitment.
- Customized solutions for rural and underserved facilities
We understand the unique challenges of rural hospitals, critical access facilities, and safety‑net institutions, and tailor immigration strategies to help you remain competitive in a tight labor market.
Looking Ahead: What to Expect from DHS
DHS is still evaluating how and when to implement the $100,000 H‑1B filing fee and whether to grant targeted exemptions for healthcare employers. While the outcome is uncertain, several trends are clear:
- Demand for international healthcare workers, especially nurses, will remain high.
- Immigration policy will continue to be a critical factor in hospitals’ workforce strategies.
- Organizations that plan ahead and coordinate closely with immigration counsel will be better positioned to weather regulatory changes.
Congress, the AHA, and a wide range of healthcare stakeholders have made it clear: without an exemption, the $100,000 H‑1B visa fee could worsen workforce shortages and threaten access to care nationwide.
Need Help Navigating H‑1B and Nurse Immigration?
If your hospital or healthcare organization relies on international nurses or other foreign-trained professionals, now is the time to review your immigration strategy.
VisaMadeEZ focuses exclusively on healthcare immigration. We help hospitals, nursing homes, and health systems:
- Recruit and sponsor international nurses
- Structure efficient, compliant immigration programs
- Adapt quickly to changes like the proposed $100,000 H‑1B filing fee
Contact VisaMadeEZ to schedule a consultation and explore how we can support your nurse staffing and international recruitment goals in this evolving immigration landscape.
