Lawmakers introduced a bipartisan bill Tuesday that would exempt physicians and other healthcare workers from a $100,000 fee for H-1B visa petitions critics said would exacerbate workforce shortages.
The Physicians and the Healthcare Workforce Act (PDF) is endorsed by a slew of provider and hospital associations. Alongside addressing the elevated, $100,000 fee outlined in President Donald Trump’s September executive order and implemented by the Department of Homeland Security (DHS) shortly after, it would also block additional fees for healthcare workers beyond those already outlined in immigration law.
“Hospitals, community health centers and other critical facilities are facing serious workforce shortages that threaten access to care. And they can't pay a $100,000 price tag on new immigrant workers,” Rep. Mike Lawler, R-N.Y., who introduced the bill, said in a release. “Without the clarification provided in this bill, the physicians and the wider healthcare workforce would effectively be shut out of the H-1B program, furthering workforce shortages and limiting care options.”
Joining Lawler in introducing the legislation were Reps. Sanford Bishop Jr., D-Ga.; Maria Elviar Salazar, R-Fla.; and Yvette Clarke, D-N.Y. Lawler and Clarke were also the lead signatories of a December letter to the DHS calling for a healthcare exemption, which more than 100 legislators signed.
The president’s executive order described widespread abuse of the H-1B statute and its regulations “using practices now widely adopted by entire sectors” the White House said “artificially suppress wages, resulting in a disadvantageous labor market for American citizens, while at the same time making it more difficult to attract and retain the highest skilled subset of temporary workers.” The order points to science, technology, engineering and math fields and places particular focus on IT employers but does not explicitly address hiring within the healthcare sector.
Dozens of major medical groups warned nearly from the get-go that the policy change would be widely felt in light of ongoing and projected clinician shortages.
International medical graduates comprise around 23% of the country’s practicing physicians. Though H-1B applications represented just under 1% of the national physician workforce during the 2024 federal fiscal year, sponsored physicians had a greater presence in rural areas (1.6% of the workforce) and in counties with a greater share of impoverished residents (2%), according to an October study.
“Patients across the country are feeling the effects of the growing physician shortage,” Bobby Mukkamala, M.D., president of the American Medical Association (AMA), said in statements supporting the bill. “Medicare patients and people in rural and underserved areas already struggle to get the care they need. In many such communities, international medical graduates play a vital role in providing care and ensuring patients can see a doctor when they need one.”
Joining the AMA in endorsing the lawmakers' bill are the American Association of Medical Colleges, the American Hospital Association, the Association for Advancing Physician and Provider Recruitment, the Greater New York Hospital Association, the Healthcare Association of New York State and Physicians for American Healthcare Access. In statements, leaders from each outlined the threat workforce shortages could have on care access and the financial strain a $100,000 fee would place on healthcare employers.
The DHS’ fee has been challenged in multiple lawsuits filed by state attorneys general, the U.S. Chamber of Commerce and various healthcare organizations and unions. Alongside the fee increase, the DHS has also proposed changing the selection process for H-1B from a random lottery to a weighted selection process favoring higher wage levels—for which healthcare groups have similarly called for healthcare roles to be given preferential treatment.