House Bill Seeks to Waive Trump-Era $100,000 H‑1B Fee for Foreign Doctors and Nurses
A bipartisan group of House members on Tuesday introduced legislation to waive the Trump administration’s $100,000 application fee for H‑1B visas when employers sponsor foreign doctors and nurses to work in the United States. The fee, imposed last September on new skilled international hires, has alarmed hospitals that rely on foreign medical residents and internationally trained physicians, many of whom staff rural and medically underserved areas and hard‑to‑fill primary care positions. The bill is sponsored by Reps. Mike Lawler (R‑N.Y.), Sanford D. Bishop Jr. (D‑Ga.), Maria Elvira Salazar (R‑Fla.) and Yvette Clarke (D‑N.Y.), and has been welcomed by the American Medical Association, which warns the fee could worsen a projected shortage of up to 86,000 physicians by 2036. The measure also comes amid an ongoing national nursing shortfall, with about 500,000 immigrant nurses—roughly one in six U.S. registered nurses as of 2022—facing dramatically higher sponsorship costs under the current fee regime. While tech and finance firms also use H‑1Bs, this bill is narrowly tailored to health‑care workers, setting up an early test of whether Congress is willing to carve out exceptions to Trump’s broader crackdown on employment‑based visas when it collides with U.S. health‑care capacity.
📌 Key Facts
- The Trump administration imposed a $100,000 application fee for each new H‑1B hire starting in September, covering all employers that sponsor skilled foreign workers.
- A new bipartisan House bill would waive that $100,000 fee specifically for H‑1B visas used to bring foreign doctors and nurses into the United States.
- Sponsors include Reps. Mike Lawler (R‑N.Y.), Sanford D. Bishop Jr. (D‑Ga.), Maria Elvira Salazar (R‑Fla.) and Yvette Clarke (D‑N.Y.).
- The American Medical Association projects a U.S. shortage of up to 86,000 physicians by 2036 and says many international medical graduates staff rural and underserved areas.
- As of 2022, about 500,000 immigrant nurses worked in the U.S., accounting for roughly one in six of the nation’s more than three million registered nurses.
📊 Relevant Data
Approximately 25% of licensed physicians in the United States are international medical graduates (IMGs), with this share increasing slightly over recent years.
How IMGs have changed the face of American medicine — American Medical Association
From 2010 to 2022, international medical graduates filled 17.2% of primary care specialty residency positions in the US, with 22.1% in internal medicine.
US-trained doctors often avoid rural and primary care areas due to factors like professional isolation, limited access to continuing education, lower compensation, and higher burnout rates.
Recruitment challenges, solutions, and outlooks for the rural doc shortage — National Rural Health Association
Black rural residents in the US are two to three times more likely to die from diabetes and high blood pressure compared to White rural residents, reflecting disparities in healthcare access.
The Detrimental Effects of Race-Neutral Rural Health Policies — PMC
The US physician shortage is driven by population growth (projected 8.4% increase), an aging population (34.1% increase in those over 65 by 2036), and physician retirements (20% of clinicians aged 65 or older).
Addressing Physician Shortages in the United States With Novel Solutions: A Review — PMC
As of 2022, immigrant nurses in the US account for about 16% of registered nurses, with higher concentrations in states like California (37%) and Nevada (34%).
Immigrant Health-Care Workers in the United States — Migration Policy Institute
Rural areas in the US have lower physician density (68 per 100,000 people) compared to urban areas (80 per 100,000), contributing to health inequities.
Bridging the gap: Addressing health inequities in rural communities — National Rural Health Association
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