A group of US lawmakers has urged the Trump administration to exempt healthcare professionals from a newly imposed $100,000 H-1B visa fee, warning that the policy could severely strain hospitals and worsen critical workforce shortages, particularly in rural and underserved communities.

In a letter addressed to Homeland Security Secretary Kristi Noem, members of the New Democrat Coalition and other congressional lawmakers expressed concern that the fee, introduced under a presidential proclamation issued on September 19, 2025, poses a serious threat to access to healthcare across the country.

“As Members of Congress, access to health care is one of our top priorities,” the lawmakers wrote. “The Proclamation issued September 19, 2025, poses a serious threat to the healthcare workforce in our districts.”

The proclamation mandates that certain H-1B visa petitions filed on or after September 21, 2025, must include an additional $100,000 payment, a dramatic increase from the previous $215 registry fee. Healthcare leaders argue that the sudden escalation in costs is already discouraging hospitals and medical institutions from hiring foreign-trained physicians and specialists.

Lawmakers warned that fewer healthcare workers would translate into higher costs, longer wait times, and increased travel distances for patients seeking care. These challenges, they said, would be felt most acutely in rural and underserved areas that already struggle to attract and retain medical professionals.

Local healthcare providers have echoed these concerns. Pediatricians from Akron Children’s Hospital told lawmakers that the fee has made it significantly more difficult to recruit doctors, especially in pediatric and specialty care. They cautioned that rural hospitals, which often face infrastructure limitations and transportation barriers, are particularly vulnerable to the policy’s impact.

“The current H-1B fee is cost-prohibitive and will exponentially magnify our workforce shortage in the coming years,” said Dr. Shefali Mahesh, Pediatrician in Chief at Akron Children’s Hospital. She warned that children’s hospitals could be forced to consolidate services and reduce access for vulnerable patients if the policy remains in place.

Federal workforce data cited in the letter highlights the severity of existing shortages. According to the Health Resources and Services Administration, the US currently needs 13,075 additional physicians to eliminate primary care shortage designations nationwide. That shortfall is projected to grow to 87,150 physicians by 2037. Lawmakers also pointed to shortages in nursing, behavioral health, pediatrics, and laboratory services.

The lawmakers stressed that the H-1B visa program supplements, rather than replaces, the domestic healthcare workforce. In 2024, they noted, just 16,937 of approximately 400,000 approved H-1B petitions were for medicine and health professionals. Losing even a portion of these workers, they argued, would further strain hospitals already grappling with rising operational costs.

The letter also warned that the new fee coincides with broader financial pressures on healthcare providers, including Medicaid funding cuts under the “Big Ugly Law” and the expiration of enhanced Affordable Care Act premium tax credits. Rural hospitals, many of which are already at risk of closure, would be disproportionately affected.

“We cannot afford to lose any additional healthcare workers,” the lawmakers wrote, urging the Department of Homeland Security to act swiftly.

The letter was led by Representatives Emilia Sykes and Terri Sewell and signed by more than two dozen members of Congress, including Representatives Raja Krishnamoorthi, Ted Lieu, Debbie Wasserman Schultz, and Kim Schrier.