Indian doctors in the United States are raising alarms that a new $100,000 fee for H-1B visas could cripple rural healthcare systems, as a significant portion of physicians in underserved areas are foreign-trained, primarily from India. This fee hike, part of a Trump administration policy, threatens to disrupt the pipeline of medical professionals essential for communities with limited access to care. The H-1B visa fee increase to $100,000 for new applicants was announced last month, causing immediate concern among immigrant doctors, many of whom are from India and work in remote parts of the US. These physicians often serve in Health Professional Shortage Areas where American graduates are less likely to practice, making them vital for local healthcare infrastructure. For example, Dr. Mahesh Anantha, an interventional cardiologist in Batesville, Arkansas, is one of the few specialists for miles, and his practice handles emergencies that would otherwise require long travel times.
In response, over 50 groups led by the American Medical Association have written to Homeland Security Secretary Kristi Noem, emphasizing that the fee could discourage hospitals from hiring H-1B doctors. This could worsen the projected doctor shortage of 124,000 by 2034, as identified by research from the University of California San Diego. The AMA argues that international medical graduates are not taking jobs from US physicians but are filling critical gaps in care, especially in rural and low-income areas. Medical associations highlight that foreign-trained doctors are overrepresented in specialties like nephrology and cardiology, which are crucial for underserved regions.
The Trump administration has stated that exemptions are possible if deemed in the national interest, and a White House spokesperson clarified that current visa holders are unaffected. However, medical associations warn that without clear exemptions, the fee hike could deter future doctors from coming to the US. Dr. Bobby Mukkamala, president of the AMA, noted that health systems have described the fee as devastating and called for quick action to prevent loss of qualified physicians. The lack of immediate clarity has fueled uncertainty among doctors who have spent years building careers and communities in America.
Historically, immigrant doctors have been crucial to the US healthcare system, arriving since the 1960s and serving during crises like the HIV epidemic and COVID-19 pandemic. Programs like the Conrad waiver allow them to work in underserved areas after training, but the new fee imposes additional costs on rural hospitals already struggling financially. Dr. Rakesh Kanipakam, a nephrologist in Alabama, travels hundreds of miles weekly to treat patients with kidney failure, illustrating the reliance on such doctors in regions with scarce medical resources. Many of these professionals face job instability while waiting for green cards, adding to their vulnerabilities.
Economically, foreign medical workers contribute millions to the US economy; for instance, Dr. Anantha’s hospital credited him with boosting annual revenue by over $40 million. Studies from institutions like UCSD show that relaxed visa requirements do not impact US medical graduate jobs but enable care in remote areas. Supporters of the fee argue for protecting American workers, but experts counter that the policy could harm healthcare access where it is needed most, particularly in states like Michigan, New Jersey, and Florida that rely heavily on immigrant physicians.
As the situation unfolds, the AMA remains encouraged by the administration’s openness to exemptions but stresses the urgency of decisions. The outcome will likely influence where international medical graduates choose to practice, potentially reshaping rural healthcare access for the foreseeable future. Without swift action, rural hospitals may face increased financial pressure, exacerbating existing disparities in healthcare delivery across the country.