MGMA supports bipartisan effort to eliminate $100K visa fee for healthcare workers
The U.S. healthcare system is facing a deepening workforce shortage driven by policy constraints, limited training capacity and immigration barriers. These issues could significantly worsen in the coming years without reforms, according to Anders Gilberg, senior vice president, government affairs at Medical Group Management Association (MGMA) in the above video interview.
Gilberg said the Trump Administration's changes to the H-1B visa program, including a $100,000 fee for visa recipients will have a major impact on healthcare, which relies on foreign doctors to fill positions in rural or lower-income areas that are less desirable for American-trained doctors. While the policy was intended to target the tech sector, he warned it will have unintended consequences for healthcare.
"I'm not sure it was intentional, it was aimed at technology companies and brain drain. But the implementation of a stiff fee for H-1B visa recipients definitely impacts healthcare. And that can be physicians or other clinicians, such nurses and others," Gilberg explained.
Healthcare organizations, including MGMA, have supported efforts to shield clinicians from such fees, noting that international medical graduates play a critical role in staffing underserved areas. MGMA applauds a recent bipartisan, bicameral letter led by Representatives Clarke (D-NY) and Lawler (R-NY), signed by 100 members of Congress, urging the Department of Homeland Security (DHS) to exempt healthcare workers from the $100,000 H‑1B visa application fee.
"Imposing a $100,000 fee on employers petitioning for H‑1B workers further strains healthcare workforce shortages and recruitment challenges, leaving critical positions unfilled, placing additional pressure on remaining staff, and contributing to burnout," Gilberg explained at the time the letter was announced,
He also pointed to a structural bottleneck in the U.S. physician pipeline due to the lack of medical residency positions, which are largely funded through Medicare. Without congressional action to increase Medicare funding to increase the number of these residency slots, even domestically trained medical graduates face limited opportunities to enter practice.
"So the fact that we're restricting foreign physicians at the same time we are not expanding domestic opportunities for physicians just creates a real problem for access to physicians in this country," Gilberg said.
The consequences are especially acute in rural America, where shortages already exist across primary care and key specialties such as interventional radiology. If current trends continue, Gilberg warned rural hospitals and practices could struggle to maintain adequate staffing levels over the next five years.
Compounding the issue are broader healthcare insurance coverage and reimbursement pressures. Policy changes that would lower the number of people eligible for Medicaid and the expiration of subsidies tied to the Affordable Care Act could leave millions uninsured. Gilberg said this will increase uncompensated care burdens on providers, particularly in rural and low-income areas. This directly impacts physician practices that are already operating on thin margins.
Rural hospitals and medical practices are going to suffer the most in terms of their ability to recruit physicians. I was talking to some members recently in various specialties. You think of some of these subspecialties, like interventional radiology, very important specialties, but there's a shortage of physicians in those areas, let alone primary care doctors. It's a real big problem," Gilberg explained.
Workforce dynamics within medicine also contribute to the shortage. Medical students often gravitate toward higher-paying specialties due to substantial educational debt, leaving gaps in lower-compensated but essential fields like primary care.
To address the growing crisis, Gilberg and MGMA advocate for a multi-pronged approach: exempting healthcare workers from restrictive immigration policies, expanding federally funded residency positions, and reassessing reimbursement structures to better support primary care. Without these changes, he warned the system could face a widening gap between patient demand and provider capacity.
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]