What the changes to H-1B visas might mean for healthcare

Modern Healthcare – Tuesday, September 23, 2025
By Hayley DeSilva, Gabriel Perna, and Lauren Dubinsky

Healthcare employers of all sizes are grappling to determine how changes to the H-1B visa program will affect their ability to expand their workforces, ease staffing shortages and best serve customers and patients.

On Friday, President Donald Trump signed a proclamation requiring employers to pay a $100,000 fee for a H-1B application, in addition to current fees. Trump said the changes were necessary to thwart overuse of the program and encourage a more American-heavy workforce.

The announcement caught employers off-guard and caused chaos and confusion. While the White House made some clarifications over the weekend, there remains much uncertainty.

Here’s what to know about changes to the H-1B visa program and how it may impact healthcare employers.

How are H-1B visas changing?

Employers will have to pay a $100,000 fee for any new international employee applying for the H-1B program.

The administration also seeks to raise the prevailing wage levels and in the lottery prioritize applicants who are high-skilled and high-paid over those who are at lower wage levels.

The new fee will start being applied during the next lottery cycle in 2026. The H-1B lottery allows employers to register to sponsor international workers. If demand for workers exceeds the number of available visas, the Citizenship and Immigration Services Department selects beneficiaries at random.

More reforms are expected in the coming months, the administration said.

The $100,000 fee, the announcement of which caused much consternation, will be one time only and not an annual fee, according to a post on X from White House Press Secretary Karoline Leavitt.

How could hospitals and hiring processes be affected?

On the clinical side, all types of employers, and especially rural providers and home health facilities, have battled staffing shortages and looked to international workers to fill vacant positions. Rural providers in particular may not be able to afford the higher fees.

Urban employers are just as concerned.

Henry Ford Health, one of the top healthcare industry users of the H-1B program, is reevaluating where it will go from here.

“We rely on — and deeply value the talents of our international team members, and we’ve long held important and productive relationships with the international medical and research community,“ the system said in a statement Monday.

Other providers listed on the federal H-1B Employer Data Hub as top healthcare users of the program, including Cleveland Clinic and OhioHealth, said they were looking into the situation.
Could physicians and medical residents be spared?

White House officials said Monday physicians and medical residents could be exempted, after medical groups warned of the hit to rural providers. The H-1B program has long since been a pipeline for rural communities in need of physicians.

International medical residents make up nearly a quarter of overall medical residents, according to data from the Association of American Medical Colleges’ 2024 Report on Residents.

“The AAMC is concerned that the recent proclamation on H-1B visas will worsen the nation’s existing physician shortage and jeopardize patient access to care,” said Dr. Jonathan Jaffery, the group’s chief health care officer. “International physicians play a vital role in the U.S. health care workforce, particularly in rural and other underserved areas.”
How much could this hurt tech companies?

Companies such as Amazon, Google, Apple and Oracle are among the top users of the H-1B visa program, according to federal government data. These big tech companies, all of which have created products for the healthcare industry, are constantly bringing in engineers, software developers and other roles with similar skill sets from India, China and elsewhere.

Amazon and Oracle did not respond to a request for comment. Microsoft and Google declined to comment. Other stakeholders are still trying to figure out the potential impact.

AdvaMed, which represents more than 600 medtech companies, noted the complexity of assessing the changes due to its broad membership and is still in the early stages of evaluating the effects, a spokesperson said.

The Medical Device Manufacturers Association and companies including Medtronic, Johnson & Johnson, Abbott, Stryker, Philips, Becton Dickinson, Edwards Lifesciences and Dexcom did not respond to a request for comment. Siemens Healthineers and GE HealthCare declined to comment.

How could changes hurt startup companies?

The effects could be magnified, said Garry Tan, CEO of incubator Y Combinator, in a LinkedIn post Sunday.

Smaller companies can’t absorb that sum and the policy will drive startups to Canada and other locations, Tan wrote.

Y Combinator did not respond to a request for comment Monday.

Sami Inkinen, founder and CEO of virtual diabetes company Virta Health, also spoke out against the changes on LinkedIn. Inkinen, who grew up in Finland, said the H-1B visa program allowed him to start his first venture, real estate company Trulia, before becoming a U.S. citizen. He said the latest announcements have sent many companies, including Virta Health, scrambling for more information.

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