Trump’s $100,000 visa fee will gut the immigrant workforce that keeps US hospitals – and patients – alive
The Trump administration announced last week that every new H-1B visa will now cost $100,000. Framed as a crackdown on Silicon Valley, the policy will devastate American hospitals. Its real casualties will be poor and rural Americans in need of medical care but who will be left with no one to provide it.
One in four US physicians is foreign-trained. Many enter through the H-1B program, disproportionately staffing rural and underserved hospitals where American graduates rarely go. In some facilities, every single doctor is an immigrant. These are the physicians who deliver babies in Mississippi Delta towns, staff emergency rooms in the Dakotas, and run primary care clinics in the Bronx. By raising visa costs from a few thousand dollars to $100,000, the administration is functionally cutting off their pipeline.
Eram Alam is a historian of medicine and migration in the department of the history of science at Harvard University. She is the author of the Care of Foreigners: How Immigrant Physicians Changed US Healthcare, forthcoming from Johns Hopkins University Press in October 2025
