The White House on Monday signalled that doctors may be spared from the Trump administration’s newly imposed USD 100,000 fee on high-skilled H-1B visa applications.
In a statement, White House spokesperson Taylor Rogers said, “The Proclamation allows for potential exemptions, which can include physicians and medical residents.”
The clarification came after hospitals and medical groups warned that the new charge would worsen staffing shortages in the healthcare sector.
The H-1B visa programme is regarded as vital for hospitals that rely on foreign-trained doctors to work in remote and underserved regions. Many health systems bring in medical residents and specialists through the visa route, often to serve areas that struggle to attract US-trained professionals.
According to federal data compiled by the health research group KFF, more than 76 million Americans live in regions officially designated as short of primary care doctors.
American Medical Association (AMA) President Bobby Mukkamala, a Michigan-based head and neck surgeon, cautioned that the new fee “risks shutting off the pipeline of highly trained physicians that patients depend on, especially in rural and underserved communities.”
He said international graduates are “a critical part of our physician workforce.”
Federal immigration records show that leading institutions such as Mayo Clinic, Cleveland Clinic and St. Jude Children’s Research Hospital rank among the top sponsors of H-1B visas.
Mayo alone holds more than 300 approved visas, meaning the proposed charge could add millions of dollars in extra labour costs for such organisations.
President Donald Trump signed the proclamation on September 19, introducing the USD 100,000 charge on H-1B applications and restricting the entry of certain non-immigrant workers.
The administration said the fee would ensure only “extraordinarily skilled” individuals are admitted, while discouraging companies from hiring foreign workers in place of American employees.
Commerce Secretary Howard Lutnick defended the decision as a corrective measure, arguing that earlier employment-based visa policies had allowed applicants earning below-average wages and at times reliant on government support.
He said the new policy would eliminate the “bottom quartile” of applicants and was expected to generate more than USD 100 billion in revenue for the US Treasury. President Trump added that the funds would help reduce the national debt and lower taxes.
The White House confirmed that the charge would apply only to new petitions filed on or after September 21, with applications submitted before that date unaffected. Officials also clarified that the fee is a one-off payment rather than an annual levy.
The announcement triggered unease among H-1B workers and their employers, particularly in India, whose nationals made up about 71 per cent of visa holders in 2024. Overseas workers rushed to book flights back to the United States, unsettled by the sudden change.
For decades, the H-1B programme has served as a pathway for many of India’s top professionals to enter the US workforce.
India’s USD 250 billion IT services industry, led by firms such as Infosys, Wipro, Cognizant and Tata Consultancy Services, has long relied on the visa system to deploy engineers and developers on US projects.
With visas valid for three years and renewable for up to six, the new fee could make it prohibitively expensive for firms to retain Indian employees, many of whom already face long waits for Green Cards.
Observers warn that if companies decline to pay the new charge per worker, opportunities for Indian professionals could shrink, eroding the country’s competitive advantage in the global technology market. The US technology sector, a major user of H-1B visas, also faces uncertainty.
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While Trump has insisted that “big tech loves the idea”, investors reacted cautiously. IT services firms, including US-listed Indian companies, fell between 2 per cent and 5 per cent following the announcement.
Critics argue that the policy could hinder talent mobility and stifle innovation, while supporters contend it will prevent wage suppression and encourage investment in training American graduates.
A White House memo stated that “information technology (IT) firms in particular have prominently manipulated the H-1B system, significantly harming American workers in computer-related fields.”
The administration maintains that the proclamation allows for case-by-case exemptions if deemed in the national interest. Physicians and medical residents could be among those excluded, citing spokesperson Rogers.
Donald Trump has accused companies of abusing H-1B visas to suppress wages, describing the practice as a security risk.
Medical professionals, however, remain concerned that the new policy could restrict the flow of international graduates into the US, putting further strain on a healthcare system already facing shortages.
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