More than 30 applicants from the Philippines and Nigeria have sought a lab technician position at West River Health Services, a nonprofit hospital in Hettinger, North Dakota. Since none of these candidates are U.S. citizens, each would require an H-1B visa to be employed.
Previously, employers such as West River paid up to $5,000 in fees to sponsor each H-1B visa for skilled foreign workers. However, under a new policy announced by President Donald Trump in September, the cost has increased significantly. Now, sponsoring an H-1B visa for workers residing outside the United States costs $100,000 per applicant. The change does not affect foreign workers or students already present in the country on a visa.
H-1B visas are typically used for highly skilled roles that face chronic shortages of American workers, including those in rural health care settings.
Eram Alam, associate professor at Harvard and author of a book on the history of foreign doctors in the U.S., said: "The health care industry wasn't even considered. They're going to be collateral damage, and to such an extreme degree that it was clearly not thought about at all."
Federal guidance states that exemptions from this fee will only be granted in "extraordinarily rare circumstance."
A coalition consisting of the American Hospital Association, two national rural health organizations, and over 50 medical societies has asked Homeland Security Secretary Kristi Noem for categorical exemptions for health care providers. They argue that the increased cost will disproportionately impact rural communities already facing difficulties recruiting and retaining enough staff.
The Department of Homeland Security referred questions about possible exemptions or waiver timelines to the White House. White House spokesperson Taylor Rogers responded with a statement defending the policy: it will "put American workers first."
At this time there is no indication that relief is forthcoming for health care providers seeking skilled foreign professionals under the new $100,000 fee structure.
