The American Medical Association, alongside numerous specialized medical groups, is strongly urging the Trump administration to waive the new, exorbitant fees for H-1B visas that affect foreign doctors. They argue these charges will severely worsen current physician shortages, compromise patient care quality, and ultimately inflate healthcare expenses across the nation.
Foreign-trained doctors constitute almost a quarter of the entire U.S. physician workforce. These dedicated professionals are vital, often serving as the backbone of medical care in rural and underserved regions. Furthermore, they frequently take on critical roles in fields less favored by domestically trained doctors, such as primary care, psychiatry, and pediatrics.
Many of these physicians hold H-1B visas, specifically designed for highly skilled foreign workers in “specialty occupations.” Just this week, President Trump unveiled plans to impose a staggering $100,000 fee for each new H-1B visa.
Dr. Bobby Mukkamala, president of the American Medical Association, voiced his serious concerns: “If a hospital requires 50 foreign residents, and each visa costs $100,000, that totals $5 million. This is simply unsustainable, and it will inevitably lead to critical shortages.”
He emphasized that this financial burden, which falls directly on employers, would be immense for hospitals and healthcare systems. Many of these institutions are non-profits, and those in rural areas are already struggling, often scaling back services or even shutting down completely.
Dr. Mukkamala warned that without exemptions for international physicians dedicated to serving Americans, hospital positions would remain vacant. He predicted a direct consequence: “Wait times will increase, and patients will face even longer delays in emergency departments.”
Notably, Dr. Mukkamala, an ear-nose-throat surgeon practicing in Flint, Michigan, is the son of physicians who themselves immigrated from India during the 1970s.
The A.M.A. projects that the U.S. could experience a deficit of up to 86,000 physicians by 2036. This shortage is exacerbated by an aging population demanding more care and a growing prevalence of chronic and behavioral health conditions.
Adding to the complexity, these new visa fees could also worsen the ongoing nursing shortage. The healthcare sector heavily relies on registered nurses from other nations; as of 2022, approximately half a million immigrant nurses were employed in the U.S., representing one-sixth of the country’s total three million-plus registered nurses.
These new visa expenses arrive at a time when hospitals are already under severe financial strain, bracing for an influx of uninsured patients following recent cuts to health insurance subsidies and reduced Medicaid reimbursements.
In an official letter addressed to Kristi Noem, the Secretary of Homeland Security, the A.M.A. and other medical bodies formally requested a waiver of the new H-1B visa fees specifically for physicians.
The executive order establishing these fees specifies that they should not be applied to “specialty occupation workers” whose employment demonstrably serves the national interest and poses no threat to the security or welfare of the United States.
President Trump implemented the $100,000 fees on September 21st, asserting their necessity to safeguard American jobs, prevent abuses, and guarantee that only highly skilled and well-compensated foreign nationals are granted these visas. It’s important to note that these new fees do not impact existing H-1B visa holders.
Neither the White House nor the Department of Homeland Security immediately responded to requests for comment. However, White House spokesman Taylor Rogers indicated to Bloomberg News this week that the proclamation “permits potential exemptions, which may encompass physicians and medical residents.”
This recent policy is not an isolated incident; similar visa restrictions have repeatedly jeopardized staffing levels at U.S. hospitals in recent months.
In late May, President Trump had previously halted new interview appointments for J-1 visas. These visas are crucial for international doctors beginning their residencies and internships in the U.S., roles known for demanding 80-hour workweeks and modest salaries. Hospitals heavily depend on these residents for essential staffing.
International medical graduates represent one-sixth of all medical residents and specializing fellows in U.S. teaching hospitals. In 2024 alone, the Educational Commission for Foreign Medical Graduates facilitated the placement of over 15,500 doctors from more than 150 countries into residency or fellowship training positions across 770 hospitals.
Despite efforts by some hospitals to expand training programs and increase the domestic supply of health professionals, Colin Milligan, a spokesman for the American Hospital Association, stated that “the use of foreign-trained healthcare workers remains one of the primary short-term strategies for U.S. hospitals to combat personnel shortages.”
The association affirmed its commitment to collaborate with the administration, emphasizing the critical need to include healthcare personnel in any potential exemptions from these new policy changes.
Dr. Mukkamala recounted that when his own parents immigrated to the U.S., “it was an open door, because the country genuinely needed physicians.”
He concluded grimly, “Now, that open door is gone. It’s a closed door, and you’ve got to pay $100,000 just to get it to budge.”