Passing bipartisan legislation to exempt physicians and other health care professionals from the $100,000 filing fee for new H-1B visa petitions is a crucial step Congress must take to ensure patients can see a physician when needed.
The AMA strongly supports the newly introduced H-1Bs for Physicians and the Healthcare Workforce Act, in keeping with our longstanding position that a robust, accessible physician workforce is central to improving health outcomes everywhere.
The current $100,000 fee for H-1B visa applications threatens access to physician-led care for patients nationwide, but particularly those in rural and underserved communities such as Flint, Michigan, where I practice. The AMA and our partners in the Federation of Medicine continue to push policymakers to exempt physicians from this new fee, which is only compounding the projected shortage of up to 86,000 physicians by 2036.
IMGs meet vital need
Today, roughly one-fourth of America’s physician workforce are international medical graduates (IMGs), most of whom are foreign-born and trained within U.S. residency programs. These physicians are a critical component of our health care system who fill gaps in care and provide services in communities with scarce health care resources. For example, nearly 40% of internal medicine resident interns are IMGs, many of whom possess an extraordinary commitment to treating patients where the need is greatest.
My own parents emigrated from India to Flint in the early 1970s to practice medicine, my father in radiology and my mother in pediatrics. As they ran a successful (and desperately needed) medical practice in Flint, they became fixtures in the city and raised a family, which included a son who would not only follow them into medicine in Flint but would go on to become AMA president.
There is simply no way that hospitals or health systems in underserved communities, many of which already operate under considerable financial strain, can afford such a steep and unnecessary new fee to bolster their physician workforce. Had it been in place at the time, this fee would have been an insurmountable barrier for my parents, and the people of Flint would have been denied the benefit of their service and clinical expertise throughout their long careers—and mine as well.
Impact on patient access
Since the fee was enacted, talented physicians have had their path to practicing medicine in America blocked, and communities like mine continue to lose the benefit of their skills, knowledge, and clinical expertise. The result is longer wait times for patients, greater distances to travel for care, and a heavier burden on existing providers. The impact of the fee on health care threatens to worsen the very physician shortages that policymakers should aim to resolve.
The AMA remains committed to working constructively with policymakers and our partners in medicine so that this policy does not stand in the way of caring for our patients and communities.
Residency position funding
The H-1B visa fee is not the only issue involved in addressing the physician shortage. The AMA continues to support legislative solutions such as the Resident Physician Shortage Reduction Act of 2025, which would add 14,000 Medicare-funded graduate medical education (GME) residency positions over the next seven years.
This legislation also enjoys bipartisan support. It targets hospitals in rural areas, institutions affiliated with historically Black medical schools, states with new medical schools, and hospitals already training residents above their cap, to ensure that relief is directed where physician shortages are most severe.
The need is urgent. Consider that 89% of counties in my home state of Michigan have at least a partial designation as a primary care health professional shortage area. At the same time, legislation passed nearly 30 years ago continues to restrict the number of residency positions Medicare can fund. Although some new slots have been added, the number is insufficient to meet today’s needs, let alone tomorrow’s.
Medicare remains the largest source of GME funding, supplemented by Medicaid, the Department of Veterans Affairs, the Health Resources and Services Administration, and the Children’s Health Insurance Program, among others. Expanding residency slots and removing unwarranted barriers, such as the H-1B visa fee, are vital steps toward securing the stable physician workforce upon which our patients and our communities depend.
Ensuring access to care
As physicians, we see every day how policies affect the lives and health of our patients. Ensuring access to care should never be threatened by measures that impede our ability to recruit and retain qualified physicians.
It is essential that we mobilize as a profession and urge policymakers to act now. I invite you to join your voice with ours calling for a physician exemption from the new H-1B visa fees. You can find a sample letter to send to your members of Congress here, through the Physicians Grassroots Network.
Expanding residency slots and smoothing the pathway for highly skilled professionals to practice medicine in the U.S., regardless of where they are born or trained, are two sides of the same coin. Achieving these objectives will benefit our patients, our health system, and our nation.
