America is running out of doctors. The Trump administration is making it harder to hire the ones who want to come here.
In September 2025, President Trump ordered a $100,000 fee on employers hiring workers through the H-1B visa — the program hospitals use to bring in doctors trained in other countries. Before that, employers paid somewhere between $2,000 and $5,000.
Courts have blocked the fee. The administration keeps coming back. And hospitals have already started pulling back, according to a Stateline report published October 13.
Who these doctors are
About one in four doctors in the U.S. got their medical degree abroad, Stateline reports. In some fields it's far more:
- 41% of internal medicine doctors
- 46% of endocrinologists — the doctors who treat diabetes
- 52% of geriatric doctors, who care for older Americans
Foreign-trained doctors are slightly more likely to work in places that don't have enough primary care. Doctors here on H-1B visas are more likely to work in high-poverty areas.
How short we already are
The federal government's own health workforce agency says an estimated 102 million Americans already live in communities without enough primary care providers. It projects the country will be short 141,160 full-time doctors by 2038.
That's the hole foreign-trained doctors have been filling for decades. It's why about two dozen states — red and blue — have passed laws making it easier for foreign doctors to get licensed. A Georgia Republican state senator who is himself a doctor told Stateline there simply aren't enough U.S. medical graduates to keep pace with population growth, and that one of his main goals is getting more doctors into rural areas.
What the $100,000 fee did
The White House said the fee was aimed at tech companies replacing American workers with cheaper foreign ones. But it applies to everyone who uses the visa — including hospitals.
In a survey of its members, the American Hospital Association found that 64% of hospitals that use the H-1B program had paused, delayed or limited recruitment because of the possible $100,000 fee.
Twenty Democratic-led states sued, and a federal judge ruled for them in June. The administration lost again in September. Its answer was a new proposal: a $103,265 fee for some H-1B applicants.
The fee isn't the only barrier. The administration has also banned travel from 39 countries and, this month, widened its review of visa applicants' online activity.
"Don't come here"
The people who help hospitals hire foreign doctors say the message has landed.
"We've created a system where we depend heavily on physicians trained abroad, and at the same time, we create immigration policies that make it harder for those physicians to enter, to train, to remain in the country," Dr. Tarun Ramesh, a Massachusetts General Hospital physician and Harvard health policy researcher, told Stateline.
Andrew Wizner, a lawyer who represents medical institutions, said the message foreign doctors are hearing is simple: "Don't come here."
An analyst at the Association of American Medical Colleges said most hospitals can't afford the fees and legal fights, and that the uncertainty is likely making would-be doctors think twice about moving their families here to train.
Who pays
The patients who lose aren't in Silicon Valley. They're in the places that were already short on doctors — rural towns, poor neighborhoods, and the specialties that care for older and chronically ill Americans. Those are the places foreign-trained doctors have been filling, and the places a hospital that stops recruiting leaves behind.
Some Republicans running for office want to go further. In Iowa, governor candidate Zach Lahn is promising to "ban H-1B visa holders from being hired by Iowa government and universities".
What the record shows
The Trump administration raised the cost of hiring a foreign worker through the H-1B visa from $2,000–$5,000 to $100,000, and after courts blocked it, proposed a $103,265 fee instead. Hospitals depend on that visa for foreign-trained doctors, who make up a quarter of all U.S. physicians and more than half of geriatric doctors, and 64% of hospitals that use it have paused, delayed or limited recruiting. The country is already short of primary care for an estimated 102 million people.
Source
Trump immigration policies could turn away much-needed foreign doctors, critics say — Stateline
