TL/DR –
The decision by the Trump administration to impose a $100,000 fee on new visas for skilled foreign workers, which could include foreign-born physicians, could have serious consequences for the U.S. healthcare system. The U.S. is expected to face a shortfall of 86,000 doctors in just over a decade, and this fee could worsen the situation by making it too expensive to recruit these necessary medical professionals from overseas. A bipartisan bill known as the Resident Physician Shortage Reduction Act of 2025, which proposes to add 14,000 medical residency positions over the next seven years funded by Medicare, could help mitigate this problem if passed.
New Visa fee hurdles for foreign-trained physicians
The Trump administration’s move to impose a $100,000 fee on new visas for skilled foreign workers is anticipated to have repercussions on the US healthcare system. The US, facing a severe shortage of physicians, depends on foreign-born doctors. The six-figure visa fee, projected to exacerbate the forthcoming shortfall of 86,000 doctors within a decade, would impact patient care and the healthcare system.
Role of foreign-born healthcare workers in US hospitals
Foreign-born doctors who complete their medical residency training in the US constitute a quarter of US physicians and surgeons. Many are integral foreign-born health care workers in the frontline roles during the pandemic. The majority of these doctors serve underserved communities, illustrating their importance to the national healthcare system.
New policy potentially affecting healthcare system
The new policy could hamper the training of primary care doctors. Presently, over 30% of medical residents in the US are international medical school graduates, with around 10,000 of the 43,000 annual medical residency slots filled by H-1B visa holders. The American Medical Association and 50 national health organizations have requested the administration to exempt foreign-born physicians from the new fee in a recently sent letter.
Implication of new visa fee
Previously, the cost of processing an H-1B visa was a few thousand dollars. The new policy, effective this week, imposes a prohibitive fee, impacting hospitals’ ability to employ overseas doctors. Hospital patient care in regions already under financial stress would suffer, with patients forced to wait longer or travel farther for care.
Increased physician demand due to population growth and ageing
The US population has grown by over 70 million since the 1990s, necessitating complex care for the largest growth group, older adults. Compounded with the high retirement rate of the current, nearly half of all practicing physicians in the U.S. are 55 or older, the demand for doctors is increasing.
Doctor shortage due to cap on funded residency positions
The Balanced Budget Act of 1997 capped the number of residency positions funded by Medicare – a constraint that has led to an insufficient number of doctors. The average salary for a medical resident ranges between $60,000 to $75,000, depending on the specialty. The number of federally funded residencies hasn’t kept pace with patient demand, even with the addition of 1,000 new federally funded residency slots in recent years.
Concerns over new visa fee decision
Tens of thousands of H-1B visa holders are physicians and other healthcare professionals. This policy, primarily targeting tech giants, could disadvantage hospitals that lack the funds to cover the increased visa fees. They may be forced to bear the brunt of the increased costs, particularly in areas with doctor shortages.
Proposed legislation for physician shortage
The bipartisan Resident Physician Shortage Reduction Act of 2025 currently before Congress could help close workforce gaps. The main solution proposed is to add 14,000 medical residency positions funded by Medicare over the next seven years. Enacting this legislation would be transformative and would help address severe doctor shortages in communities, primarily in rural areas and states with new medical schools.
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