Pushback against Trump's $100K visa fee continues with new lawsuit
A federal lawsuit challenging the Trump administration's proclamation that $100,000 is required to get a H-1B visa was filed Oct. 3 in the U.S. District Court of California. The lawsuit was brought by Global Nurse Force and nine other groups concerned about this significant change to established visa policies.
The lawsuit states the executive branch cannot act beyond its authority under statute or the federal government's own regulations by immediately adopting the $100,000 requirement without notice and comment required by regulatory processes. The plates also state the $100,000 requirement is also "arbitrary and capricious."
"The government failed to consider how extorting exorbitant fees will stifle innovation," according to the lawsuit. "The government failed to consider harms to hospitals, churches, schools and universities, and small businesses and non-profits, or how the fee will harm communities across the nation. Indeed, economic data and studies confirm that the new $100,000 Requirement will harm, not help, the U.S. economy and workers and their families in the United States."
The lawsuit outlines the serious, growing shortage of physicians in the U.S. and that this proclamation will accelerate that shortage.
"The H-1B visa program is a critical pathway to hiring educators and healthcare workers, two categories in high demand in the U.S., who comprise 10% of all H-1B workers. The United States faces a projected shortfall of nearly 86,000 physicians in the next decade, particularly in medically underserved areas of the United States and places with health professional shortages, where nearly two-thirds of all foreign-trained physicians in the United States—including almost 23,000 H-1B workers, between 2001 and 2024 practice. Nurses, too, are in short supply, particularly after the COVID-19 pandemic drove many nurses out of the profession and insufficient staffing raises nurses’ stress level," the lawsuit states.
ACC, other medical societies speak out against new visa policy
This lawsuit is just the latest example of the negative response this policy has received throughout much of the country. There has been consistent pushback from many medical societies, including the American Medical Association (AMA), the American College of Cardiology (ACC) and a variety of major U.S. cardiology groups. In fact, several cardiology societies participated in a Sept. 25 letter to Kristi Noem, secretary of the Department of Homeland Security. The letter urged the Trump administration to exempt docs from a newly announced $100,000 visa fee. The primary concern of the medical groups is that by not creating a waiver for physicians, the fee will create a barrier that will accelerate the shortage of physicians.
"This is not good for medicine. As America grays and the number of people with coronary disease increases, about half of cardiologists and now foreign born and most are serving in rural areas, and rural hospitals cannot afford $100,000 for each new physician," explained Jeffrey Marshall, MD, chair-elect of the ACC Health Affairs Committee, in an interview with Cardiovascular Business.
ACC says shutting off flow of foreign doctors will impact rural hospitals
Without the ability to recruit foreign doctors to fill positions in more remote areas, Marshall said hospitals will have to start ending some services or close their doors. This could directly accelerate the closing of more rural hospitals.
"We don't want rural hospitals to close, and most of these hospitals provide care to underserved communities," Marshall explained. "But 50% of physicians in rural areas are foreign trained."
Concerns about the ongoing physician shortage started approximately 10 years ago. U.S. medical schools and residency programs are unable to replace doctors as fast as they are leaving the field. However, the shortage was greatly accelerated by the COVID pandemic and many physicians deciding to leave clinical practice or retire early, similar to what was seen in other professions.
"After COVID, we had the great exodus of doctors and we need to fill these positions," Marshall said. "It's very important for these foreign doctors to be allowed into the country because we don't graduate enough new physicians."
Lower reimbursements, increasing administrative burdens such as prior authorizations, the rapidly rising cost of supplies and medical equipment and the need to pay more to attract doctors have all been major drivers for why large numbers of rural hospitals have been closing.
Marshall used Georgia as an example, noting that nine rural hospitals have closed in the past few years. In additio, 70% of the state's remaining hospitals are considered at risk of closing.
"If they have to pay $100,000 per foreign trained physician, these slots will just remain unfilled," Marshall explained.
And it is not just rural hospitals. Urban hospitals with large Medicaid populations in low-income neighborhoods of major cities are also at risk for a similar reason: many American-trained doctors do not want to live in those areas.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]