In late September 2024, a new federal policy shocked the U.S. healthcare industry: a $100,000 application fee for new H-1B visa petitions, a visa category widely used by foreign-born nurses, international physicians, and other healthcare workers seeking employment in American hospitals.
The order, issued by President Donald Trump and effective September 21, has raised serious concerns about staffing shortages particularly in rural states and communities that already struggle to recruit medical professionals. While the White House is reportedly examining possible exemptions for physicians, the fee currently remains in place without special provisions for the rest of the healthcare workforce.
Why the H-1B Fee Matters for Healthcare Employers
The H-1B visa program is a critical tool for hospitals and clinics to hire international nurses, foreign-trained physicians, therapists, and other skilled healthcare talent. According to the KFF (Kaiser Family Foundation), roughly 1 in 6 hospital employees in the United States is an immigrant filling essential roles not just in medicine and nursing, but also in support services that keep hospitals running.
Foreign-born healthcare workers make up:
- 27% of physicians and surgeons
- 22% of nursing assistants
- 16% of registered nurses
- 29% of janitorial and maintenance staff
- 20% of food preparation staff
- 11% of administrative employees
For hospitals already facing staffing crises, adding a $100,000 upfront fee could make it financially difficult to sponsor new international hires.
Impact on States With the Greatest Physician & Nurse Shortages
The effects are expected to be felt most sharply in Republican-led states such as Iowa, North Dakota, and West Virginia, which have some of the highest percentages of healthcare workers hired through H-1B visas. In these states, hospitals rely heavily on international nurses and foreign-born physicians to meet patient demand especially in rural areas with limited access to medical care.
Despite general political opposition to the visa program, hospitals in West Virginia and Iowa are now lobbying for healthcare workers to be exempt from the steep application fee. Meanwhile, Sen. Kevin Cramer (R-N.D.) is cosponsoring legislation that would offer a limited number of green cards to qualified physicians and nurses as a potential solution.
What Healthcare Organizations Should Do Now
For hospitals and healthcare staffing agencies, the new H-1B fee underscores the importance of strategic workforce planning and expert immigration legal guidance. Partnering with an experienced immigration law firm like VisaMadeEZ can help organizations:
- Navigate evolving H-1B visa requirements
- Identify possible exemptions or alternative visa categories (e.g., EB-3 green cards for nurses)
- Streamline complex application processes
- Ensure compliance with federal regulations while minimizing recruitment delays
FAQ – H‑1B Visa Sponsorship for International Healthcare Workers
Q1: Can hospitals still sponsor international nurses under the H‑1B visa program in 2024?
Yes, hospitals can still petition for H‑1B visas for qualified international nurses, but the new $100,000 application fee makes it cost-prohibitive for many employers. There may be alternative visa options, such as EB-3 green cards and TN visas for eligible candidates.
Q2: Are physicians likely to be exempt from the new H‑1B visa fee?
The White House has indicated it is reviewing possible exemptions for physicians, but no official policy change has been announced yet. Hospitals hiring doctors from abroad still need to budget for the new fee unless exemptions become law.
Q3: Which U.S. states will be most affected by the new H-1B fee for healthcare workers?
States like Iowa, North Dakota, and West Virginia which rely heavily on foreign-born medical staff are expected to experience the most severe impact, especially in rural and underserved areas.
Q4: How can healthcare organizations overcome H‑1B visa sponsorship challenges?
Partnering with a specialized immigration law firm for healthcare employers like VisaMadeEZ can help hospitals explore fee exemptions, alternative visas, and workforce planning strategies to keep positions filled.
Q5: Why are immigrant healthcare workers essential to U.S. hospitals?
Immigrant medical professionals make up a significant share of the U.S. healthcare workforce 27% of physicians, 16% of registered nurses, and more than 20% of hospital support staff helping to close critical care gaps.
The Bottom Line
With foreign-born professionals playing a vital role in addressing America’s healthcare labor shortages, policy changes to the H-1B visa program such as this unprecedented $100,000 application fee could have far-reaching consequences for hospitals nationwide.
Hospitals that depend on international nurses and other skilled healthcare workers should act quickly to understand the new rules, explore legal options, and secure the talent they need before staffing gaps jeopardize patient care.
Contact VisaMadeEZ today to speak with an immigration law expert who can guide your hospital through the complexities of hiring and sponsoring international healthcare workers.
