Can America Afford a $100K H-1B Fee With a Healthcare Worker Shortage Looming?
The Trump administration’s move to impose a one-time $100,000 fee on new petitions for H-1B visas has ignited controversy across business, legal, healthcare, and immigrant communities.
Officials argue the fee will encourage companies to hire U.S. workers first, but critics warn the reality may be far more complex.
What Is the New H-1B Fee?
According to the Department of Homeland Security, the new rule requires companies to pay $100,000 for each new H-1B application as of September 21, 2025.
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Current H-1B visa holders and renewals are exempt.
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The administration frames it as a way to limit foreign labor and push employers to prioritize American workers.
How It Could Affect American Jobs
Supporters argue:
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The high fee will deter companies from abusing the H-1B system.
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It could open more opportunities for U.S. citizens and permanent residents.
But experts say:
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Small and mid-sized businesses may abandon H-1B hires entirely.
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Large corporations may offshore jobs instead of paying six-figure fees.
The Healthcare Workforce Shortage: A Major Concern
While much of the debate focuses on tech jobs, the healthcare sector may be hit hardest:
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Nurses: The U.S. faces a shortage of over 200,000 nurses by 2031 (BLS). Hospitals rely heavily on foreign-trained nurses via H-1B and other visa pathways. With a $100,000 fee, smaller facilities may stop sponsoring them, worsening staff shortages.
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Doctors: The AAMC projects up to 86,000 physician shortages by 2036. Many international doctors on H-1B visas serve rural and underserved communities where U.S. physicians are scarce.
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Patient Care Risks: The AMA has warned that restricting international healthcare professionals could reduce access to care, increase burnout among existing staff, and compromise patient safety.
Instead of “bringing back” jobs, the fee could worsen the healthcare access crisis, a sector where U.S. workers simply don’t exist in sufficient numbers.
Expert Predictions
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Recruitment Chill: Smaller firms may abandon H-1B hiring; larger ones may shift jobs overseas.
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Innovation at Risk: Skilled immigrants, especially in STEM and healthcare, often complement U.S. workers rather than replace them, fueling innovation and job creation.
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Legal Challenges: Immigration attorneys argue the executive branch may lack authority to impose such a high fee without Congress. Lawsuits are already expected.
Human Side of the Policy
For international graduates and healthcare workers hoping to build careers in the U.S., the new fee could shut doors instantly.
For American workers, it may create some openings, but only if they have the specialized skills employers need.
Bottom Line
Will the $100,000 H-1B visa fee really “bring back” jobs to Americans? Not necessarily.
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Some jobs may shift to U.S. workers.
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Many others could be lost to automation, offshoring, or stalled recruitment.
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In healthcare, the fee could worsen critical staff shortages, putting patients at risk.
Rather than a clear win for American workers, the fee represents a high-stakes gamble that may reshape hiring practices, innovation, and even healthcare delivery in the U.S.
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