$100K H‑1B Fee Threatens Access to Care: AMA Sounds the Alarm

A proposed $100,000 supplemental fee for H‑1B visa petitions could severely restrict the U.S. physician workforce, especially in underserved areas like parts of Los Angeles County. In response, the American Medical Association (AMA), along with 53 medical organizations, has urged the U.S. Department of Homeland Security (DHS) to exempt physicians from this steep new cost. READ THE LETTER.

The one-time fee, part of a sweeping immigration reform proposal, applies to petitions filed between September 21, 2025, and September 21, 2026. The AMA warns that this change will limit access to care, worsen physician shortages, and put added strain on small and solo practices.

Why It Matters to L.A.

Los Angeles depends heavily on foreign-trained physicians to meet growing patient needs. According to the California Health Care Foundation:

• 28% of California’s active physicians received their medical degrees outside the U.S.

• More than 3.7 million L.A. County residents live in areas federally designated as primary care shortage zones.

• Small practices and safety-net clinics—especially those serving lower-income or immigrant communities—often rely on H‑1B visa holders to fill critical roles.

For these providers, an additional $100,000 fee could make it financially impossible to hire or retain essential staff.

Beyond the Bottom Line

The AMA and partners argue that the fee will:

• Discourage international medical graduates (IMGs) from training or working in the U.S.—despite the fact that they often serve in high-need areas.

• Disrupt care continuity in teaching hospitals and community health clinics.

• Worsen physician burnout by shrinking the pipeline of new doctors entering the workforce.

• Undermine health equity by limiting access in communities already struggling with workforce shortages.

A Call for Exemption

In its letter to DHS, the AMA requests:

• A categorical exemption for physicians—including residents, fellows, and research faculty.

• Clear guidance that medical professionals fall under the “national interest” exemption language outlined in the executive order.

Without swift clarification, the health system—especially in regions like Los Angeles—could face lasting disruptions.

The Bottom Line

This is more than a visa issue. It’s a health equity issue. It’s a workforce issue. And it’s a patient access issue.

Without an exemption, the $100K H‑1B fee risks worsening physician shortages, limiting care access, and undermining the diverse physician pipeline Los Angeles so heavily relies on.