In September 2025, a new executive order introduced sweeping changes to the H-1B visa program, one of the main pathways for highly skilled foreign professionals to work in the U.S. The most controversial update? A $100,000 petition fee for new applicants, effective September 21. While renewals and current H-1B holders are exempt, the steep cost has sent shockwaves through industries that rely on global talent, including the healthcare industry.

For hospitals, clinics, and staffing firms already navigating shortages, this development raises urgent questions: How will the new fee reshape recruitment? What alternatives should employers consider? And what does this mean for the future of hiring in healthcare?

What Changed in the H-1B Program

Here are the key updates employers need to be aware of:

• $100,000 Petition Fee: All new H-1B applications now carry a six-figure filing cost.
• 12-Month Limit: The fee will expire in September 2026 unless extended.
• Lottery Overhaul: The Department of Homeland Security must prioritize applicants with higher skills and wages.
• “Project Firewall” Enforcement: The Department of Labor will directly certify H-1B investigations—an unprecedented move.

Important: Renewals and current H-1B workers are not subject to the new fee.

Why This Matters for Healthcare Employers

The healthcare sector already faces one of the tightest labor markets in the U.S. According to the Bureau of Labor Statistics, demand for healthcare roles, from nurses to physical therapists, continues to outpace supply. Many hospitals and staffing agencies rely on foreign-trained professionals to fill these gaps.

Here’s how the new fee could impact healthcare recruitment:

1. Higher Hiring Costs

For staffing firms and hospitals working with limited budgets, a $100K surcharge per petition makes H-1B hiring nearly impossible for mid-level roles like medical technologists, therapists, or entry-level physicians.

1. Widening Talent Shortages

With fewer organizations able to afford visa sponsorship, shortages in critical areas (nursing, rehabilitation, and rural healthcare) may worsen.

1. Shift Toward Offshoring

Just as tech firms may move operations overseas, some healthcare providers could consider outsourcing support services or expanding telehealth roles outside the U.S.

1. Competitive Disadvantage

Large hospital systems with deeper pockets may still sponsor visas, while smaller community hospitals risk falling further behind in recruitment.

Industry Reactions

• Staffing Associations: Warn the fee could wipe out mid-sized staffing firms and consolidate hiring power among large corporations.
• Advocacy Groups: Call the move “drastic and unlawful,” arguing it will limit patient care access.
• Supporters: Believe the new system ensures visas go only to “high-value” roles, aligning with the administration’s “Hire American” push.

For healthcare, the reality may lie somewhere in between: higher barriers to entry for staffing agencies, but continued demand for critical, high-paying roles.

What Employers Can Do Now

The policy is temporary, but the 12-month window could reshape hiring strategies. Healthcare employers should act quickly to adapt:

• Reevaluate Workforce Planning: Assess where H-1B hires have been most essential and identify alternative talent pipelines.
• Invest in Domestic Talent Development: Strengthen partnerships with nursing schools, residency programs, and allied health training pipelines.
• Leverage Technology in Hiring: Use AI-powered platforms like ProfiHitch to streamline recruitment, reduce costs, and identify candidates who align with both qualifications and organizational culture.
• Monitor Legal and Legislative Updates: With lawsuits already brewing and Congress considering reforms, policies could shift again. Staying informed will be key.

The Bigger Picture

The $100,000 H-1B fee isn’t just an immigration update, it’s a turning point in how the U.S. balances job protection, global competitiveness, and access to essential talent. For healthcare, where workforce shortages directly affect patient outcomes, the stakes couldn’t be higher.

Employers that adapt by strengthening domestic pipelines, leveraging technology, and staying ahead of policy changes will be best positioned to continue delivering high-quality care despite uncertainty.

Final Thoughts 

Healthcare organizations can’t afford to wait and see how this plays out. By rethinking recruitment strategies today, you’ll protect your teams, your patients, and your bottom line tomorrow.

Looking for smarter, more cost-effective hiring solutions? ProfiHitch connects healthcare employers with top talent through skill-based, bias-free matching. Explore how our platform can help you build strong teams, even in challenging times.