Washington, D.C. — A new bipartisan bill in the House would eliminate a $100,000 H-1B visa fee that critics say is accelerating a healthcare staffing crisis already pushing rural nursing homes and long-term care facilities toward the breaking point.
Introduced on March 17 by Reps. Mike Lawler (R-New York), Sanford D. Bishop Jr. (D-Georgia), Maria Elvira Salazar (R-Florida), and Yvette Clarke (D-New York), the H-1Bs for Physicians and Healthcare Workforce Act would exempt foreign doctors, nurses, and other healthcare professionals from a six-figure fee imposed by executive order last year.
A Fee That’s Hitting Rural Care Hardest
International medical graduates make up roughly one in four practicing physicians in the United States — and they’re disproportionately concentrated in rural and underserved communities. Nearly 87 million Americans live in areas that already don’t have enough healthcare providers. The $100,000 fee, bill sponsors argue, threatens to widen that gap dramatically.
“The $100,000 H-1B filing fee adds insult to injury to hospitals, especially in rural areas,” Rep. Bishop said in a statement. “The fee will have a detrimental impact on their ability to recruit qualified healthcare professionals to some of the nation’s most underserved areas.”
For long-term care operators — who’ve spent years battling a staffing shortage that prompted the CMS nursing home staffing mandate and billions in workforce investment — the legislation hits close to home. Skilled nursing facilities in underserved markets rely heavily on international staff, and any reduction in the pipeline of foreign healthcare workers ripples directly through their census.
Major Medical Groups Back the Bill
The American Medical Association, the American Hospital Association, and the Association of American Medical Colleges have all lined up behind the measure. AMA President Bobby Mukkamala, MD, put the stakes plainly.
“Medicare patients and people in rural and underserved areas already struggle to get the care they need,” Mukkamala said. “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.”
The AMA and 53 other medical societies had previously urged the Department of Homeland Security to exempt physicians from the fee — a sign of how broadly the healthcare industry views this as a threat to patient access.
What the Bill Would Actually Do
Under the Physicians and Healthcare Workforce Act, healthcare workers seeking H-1B visas would not pay the $100,000 filing fee. The bill would also block any additional charges beyond what current law permits.
The legislation is bipartisan by design — a recognition that healthcare workforce shortages cut across political lines. As industry reports have long documented, the long-term care workforce crisis has no easy fix, and restricting the pipeline of international professionals at a moment of heightened demand could hit nursing homes in the most vulnerable markets hardest of all.
Whether Congress moves quickly enough to matter remains to be seen. New H-1B selection rules take effect for the fiscal year 2027 cap season, and some healthcare employers may already be rethinking their hiring plans — leaving patients in underserved communities to feel the gap.
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