AHA, AMA Warn New $100K H-1B Visa Fee Threatens to Deepen Clinician Shortages

Two of the nation’s largest healthcare groups are sounding alarms over a new $100,000 H-1B visa fee, warning that it will worsen workforce shortages and disproportionately harm rural and underserved communities. Among the critics is the aha association, which has joined the American Medical Association (AMA) in urging that healthcare professionals be exempt from this fee.

The policy, enacted under the Trump administration’s proclamation “Restriction on Entry of Certain Nonimmigrant Workers,” took effect September 21 and now applies to every new H-1B visa petition. The steep cost has drawn strong opposition from both the aha association and the AMA, which contend it will threaten patient care access.

In a letter signed by 53 leading medical societies, the AMA called the policy a direct threat to patient access. “There is a growing need for a larger physician workforce that the U.S. cannot fill on its own … H-1B physicians play a critical role … especially in areas of the U.S. with high-need populations,” the groups wrote.

Other signatories included the American Academy of Family Physicians, the American College of Cardiology, the American College of Emergency Physicians, the Infectious Diseases Society of America, the Association of American Medical Colleges, and the Medical Group Management Association. The letter urged DHS to clarify that physicians, residents, and fellows should be categorically exempt from the new charge.

International medical graduates remain a cornerstone of the U.S. healthcare workforce, making up roughly 23 % of licensed physicians in 2024. Many of these practitioners serve in high-need and rural settings: in 2021, about 64 % of foreign-trained physicians practiced in federally designated shortage areas, and nearly half worked in rural regions.

The AAMC projects a nationwide shortage of up to 86,000 physicians by 2036. Meanwhile, workforce data from the Health Resources and Services Administration anticipates a deficit of 187,130 full-time equivalent doctors by 2037, with rural communities being hardest hit. Nursing shortfalls and gaps in laboratory and allied health personnel are also forecasted, particularly outside metro areas.

The aha association, which represents nearly 5,000 hospitals and health systems, echoed the AMA’s warnings in its letter to DHS Secretary Kristi Noem. Of the nearly 400,000 H-1B petitions approved in fiscal year 2024, about 16,937 (4.2 %) were for medicine and health occupations; roughly half of those were for physicians and surgeons, the AHA noted. “Foreign-trained clinicians do not displace American workers. Instead, they play critical roles in ensuring the health of the communities our hospitals serve,” the AHA wrote.

Critics warn that the new fee will undermine hospitals’ ability to recruit not just physicians, but also nurses, therapists, pharmacists, and laboratory professionals—roles already difficult to fill. Without relief, patients in vulnerable communities may face longer wait times, reduced access, and worsening inequities in care.

---

Additional Content / Outlook

Looking ahead, the aha association and AMA are pushing for legislative and administrative remedies. They propose that the new fee be rescinded or modified so that healthcare workers—especially those in shortage specialties or underserved geographies—be exempted or subject to a lower rate. Some state hospital associations are preparing impact analyses to quantify how many clinical positions could go unfilled under the new cost burden.

Aha Association and AMA Unite Against the New Visa Fee

Use this near the beginning, after the opening paragraph, to introduce both organizations’ coordinated response.

Hospitals in rural and underserved areas may become less competitive in recruiting foreign-trained practitioners. Some institutions already struggling with recruitment could cancel or delay expansion plans, postpone specialty services, or reduce hours of operation. The AHA warns that such cutbacks may disproportionately affect vulnerable patient populations, particularly in regions where local medical training pipelines are limited.

To adapt, some health systems may pivot to increased reliance on telemedicine, locum tenens staff, or consolidation of services. But these are stopgap measures; sustainable care models depend on stable, local clinical workforce. Further, the added fee may discourage medical graduates abroad from seeking U.S. careers, redirecting talent to other countries or healthcare systems.

Legal challenges are also possible. Observers note that if the aha association and AMA can show that the fee unduly burdens essential health access and violates administrative or constitutional norms, courts might block enforcement or require modifications. Meanwhile, hospitals will need to revise budgets, reconsider visa policies, and revisit long-term staffing strategies.

In sum, the involvement of the aha association alongside AMA emphasizes that the $100,000 H-1B fee is not just an immigration policy issue—but a potential crisis for U.S. healthcare delivery. Over the coming months, how DHS, Congress, courts, and hospital systems respond will shape access to care in both urban centers and underserved communities.