Washington D.C. — U.S. Representatives Terri Sewell (AL-07), Chair of the New Democrat Coalition Health Care Working Group, and Emilia Sykes (OH-13), Chair of Coalition's Housing Task Force, led members of the New Democrat Coalition and other lawmakers in a letter calling on the Department of Homeland Security to exempt health care workers from a new H-1B visa fee that is now in effect and already placing added strain on hospitals and health care providers.

In September 2025, the Trump Administration implemented a $100,000 fee on certain H-1B visa petitions, a dramatic increase that health care leaders warn will worsen workforce shortages, raise costs, and reduce access to care, particularly in rural and underserved communities. The United States is already facing critical shortages of physicians, nurses, behavioral health providers, and other medical professionals.

Providers say the fee is already making it harder to recruit and retain doctors, especially in pediatric and specialty care. They also note that rural communities are particularly vulnerable due to limited infrastructure, transportation challenges, and fewer local medical professionals. The added cost and uncertainty for employers threatens innovation, research, and the quality of patient care across the region.

“As Members of Congress, access to health care is one of our top priorities,” the lawmakers wrote. “The Proclamation issued September 19, 2025, poses a serious threat to the healthcare workforce in our districts. Fewer healthcare workers means higher costs, longer wait times, and greater distance traveled for our constituents to access the care they need. We urge the administration to prevent any disruptions in access to care and exempt health care professionals from these fees.”

The lawmakers urged the administration to act quickly to exempt health care professionals from the new fee and prevent further disruptions to patient care nationwide.

The full letter can be read here and below:

Dear Secretary Noem:

As Members of Congress, access to health care is one of our top priorities. The Proclamation issued September 19, 2025, titled “Restriction on Entry of Certain Nonimmigrant Workers,” poses a serious threat to the healthcare workforce in our districts. Fewer healthcare workers means higher costs, longer wait times, and greater distance traveled for our constituents to access the care they need. We urge you to consider the impact this Proclamation will have on our health system and exempt healthcare workers from this Proclamation.

Our districts are home to some of the world’s leading medical institutions and committed health care professionals. Unfortunately, we continue to see our health system hampered by significant workforce shortages across a range of professions. Currently, the Human Services & Resource Administration (HRSA) estimates that 13,075 additional physicians are needed to remove all primary care shortage designations and this physician shortage is expected to grow to 87,150 by 2037. Nurses, behavioral and pediatric health professionals, and laboratory personnel are also facing shortages. We cannot afford to lose any additional healthcare workers, and we remain committed to working with the administration and our colleagues in Congress to address these shortages and invest in our workforce.

On September 19, 2025, President Trump issued a Proclamation, “Restriction on Entry of Certain Nonimmigrant Workers,” which requires H-1B petitions filed at or after September 21, 2025 be accompanied by an additional $100,000 payment as a condition of eligibility. Before this proclamation, employers were charged a $215 registry fee for an H-1B visa. The H-1B visa is a nonimmigrant classification that applies to people who provide highly skilled labor in “specialty occupations,” and it requires that visa holders have at least a bachelor’s degree or its equivalent. The program has standards in order to protect similarly employed U.S. workers from being adversely affected by the employment of nonimmigrant workers, including requiring employers to attest that they are paying the prevailing wage for the occupation. Today, there are nearly three-quarters of a million H-1B workers in the United States. Currently, Congress allows 85,000 H-1B visas to be issued through a lottery each year.

In 2024, 16,937 of the 400,000 approved H-1B petitions were for medicine and health professionals. The H-1B program does not displace healthcare workers, it helps keep our health care system afloat. Especially as providers are facing rising costs due to the Big Ugly Law’s (P.L. 119-21) cuts to Medicaid and the expiration of the Affordable Care Act’s enhanced premium tax credits, our health care providers cannot afford these additional fees. These visa fees will be especially burdensome for providers in rural and underserved areas, which are already under threat of closure and facing the worst workforce shortages.

We are committed to strengthening our domestic workforce through investing in our communities, expanding educational and training opportunities, and protecting workers’ rights. The H-1B program includes protections to ensure it does not displace American workers and instead supports institutions and businesses that are the backbone of our communities. As our health care system faces shortages across the board, H-1B visa holders are essential to ensuring that Americans get the care they need. We urge you to prevent any disruptions in access to care and exempt health care professionals from the H-1B visa fees outlined in the Proclamation.