100 lawmakers urge DHS: spare American health care from $100,000 H-1B fee

Congress urges DHS to act on doctor shortage

A bipartisan group of 100 members of Congress sent a letter to Department of Homeland Security Secretary Kristi Noem on Feb. 11, 2026, asking her to exempt the health care sector from a $100,000 fee on H-1B visa petitions.

The letter was led by Rep. Yvette D. Clarke, a New York Democrat, and Rep. Michael Lawler, a New York Republican.

Both the House and Senate signed on, including Sen. Kirsten Gillibrand.

Trump signed the fee into law in Sept. 2025

President Trump signed a proclamation on Sept. 19, 2025, called “Restriction on Entry of Certain Nonimmigrant Workers.”

It imposed a $100,000 fee on employers filing new H-1B visa petitions for workers located outside the United States.

The fee took effect two days later and lasts 12 months unless extended. The H-1B program lets U.S. employers hire foreign professionals in specialty fields like medicine, engineering, and technology.

Each year, about 65,000 visas are available under the regular cap, plus 20,000 more for applicants with advanced U.S. degrees.

Lawmakers say hospitals can’t absorb this cost

The lawmakers wrote that health care providers have used the H-1B program for more than 30 years to recruit international physicians, lab workers, researchers, and other specialists.

They said those staffing gaps cannot be filled by the domestic workforce alone. The $100,000 fee, they warned, could push underfunded hospitals to the financial brink.

Without the ability to petition for new visas at a manageable cost, critically needed positions would simply go unfilled.

Millions of Americans already lack enough doctors

The numbers behind the shortage are significant.

The lawmakers cited Health Resources and Services Administration data showing nearly 87 million Americans live in areas that do not have enough medical professionals.

The American Association of Medical Colleges projects the U.S. could face a physician shortage of between 13,500 and 86,000 by 2036.

Clinical laboratory science programs are producing fewer than half the professionals needed. About one in five practicing physicians in the U.S. is 65 or older, meaning a large share of the workforce is nearing retirement.

Rural hospitals face the sharpest cuts

Rural hospitals like Mercy Regional Medical Center in Durango and urban safety-net hospitals would feel the effects most sharply, the lawmakers said.

These facilities run on thin financial margins and serve large populations of Medicaid patients and people without insurance.

They depend heavily on international recruitment to keep staffing levels up and offer full services in high-need areas. The $100,000 fee could force these hospitals to redirect money away from patient care.

For communities that already struggle to attract doctors, that trade-off could mean fewer services or longer waits.

A second letter focused only on rural care

A separate bipartisan letter, sent on Feb. 5, 2026, focused specifically on rural health care.

Rep. Jill Tokuda, a Hawaii Democrat, and Rep. Don Bacon, a Nebraska Republican, led that effort, which drew 33 signatures.

That letter noted that between 2016 and 2022, more than 8,300 physician H-1B petitions supported care in rural counties.

For small rural hospitals and clinics already operating on thin or negative margins, the lawmakers wrote, the fee’s cost is prohibitive.

40 health organizations backed the letter

The Clarke-Lawler letter drew endorsements from 40 organizations, including the American Hospital Association, the Association of American Medical Colleges, and the American Academy of Pediatrics.

The Greater New York Hospital Association called the fee a grave threat to hospitals’ ability to deliver care, train physicians, and conduct research.

The California Medical Association said the fee directly threatens patient access, especially in rural communities.

The Healthcare Association of New York State called the H-1B program a critical lifeline for easing workforce shortages statewide.

The law already allows Noem to grant exemptions

The Sept. 2025 proclamation gives the DHS Secretary authority to grant exemptions for specific workers, companies, or entire industries.

An exemption can be granted if the Secretary determines it serves the national interest and does not threaten U.S. security or welfare.

The lawmakers argued that health care meets that standard because of the direct impact on patient access and public health.

As of mid-February 2026, DHS has not announced any sector-wide exemptions.

DHS says the fee protects American workers

A DHS spokesperson told Newsweek the fee changes aim to address concerns about program integrity and the impact on the U.S. workforce.

The spokesperson said the policy pushes employers to prioritize hiring American workers in high-skilled fields.

Supporters of the fee within the administration argue it protects against employers using the program to replace American workers with lower-paid foreign labor.

The Trump administration has said it remains committed to protecting opportunities for American workers.

Courts are already weighing the fee’s future

The U.S. Chamber of Commerce and the Association of American Universities filed a lawsuit challenging the fee in October 2025.

A federal judge in Washington, D.C., upheld the fee in December 2025, ruling it fell within the president’s authority under immigration law.

The Chamber filed an appeal on Dec. 29, 2025, and the D.C. Circuit Court of Appeals agreed to fast-track the case.

Oral arguments were expected in February 2026, just weeks before the fiscal year 2027 H-1B registration opens in March 2026.

Hospitals plan budgets as the deadline nears

The fiscal year 2027 H-1B cap registration is expected to open in March 2026, and hospitals are finalizing their budgets and hiring plans now.

DHS also finalized a new weighted lottery rule, effective Feb. 27, 2026, that favors higher-paid workers in H-1B selection.

At least two other federal lawsuits challenging the fee are pending in courts in California and Massachusetts.

The D.C. Circuit’s ruling on the Chamber of Commerce appeal could determine whether the $100,000 fee stays in place, gets blocked, or changes in some form.

This article was created with AI assistance and human editing.

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