Background

On September 19, 2025, President Trump issued a proclamation entitled, “Restriction on Entry of Certain Nonimmigrant Workers.” The Proclamation imposes a $100,000 fee on employers for each initial H-1B application filed after September 21, 2025, including those filed for international medical graduates (IMGs). 

Imposing such a steep fee on IMGs requiring H-1B visas will discourage the hiring of these physicians, worsen workforce shortages, and directly compromise patient care. It would also disrupt graduate medical education, undermining the training pipeline for the next generation of physicians. 

Section 1(c) of the Proclamation gives the Secretary of Homeland Security discretion to exempt workers whose employment serves the national interest and poses no threat to U.S. security or welfare.

IMGs – including those on J-1 and H-1B visas - comprise approximately 25% of the U.S. physician workforce and are disproportionately represented in underserved communities and rural areas, where workforce shortages are most acute. They play a vital role in ensuring access to care in these areas.

It is projected that the U.S will face a shortage of 86,000 physicians by 2036, these fees will only make the problem worse, which will limit patient access to care. 

Action Requested: Please contact your members of Congress and ask them to urge the Department of Homeland Security to issue an exemption for physicians from H-1B visa fees. A sample message has been provided for you that can be personalized. 

Please contact Shuan Tomlinson at stomlinson@acponline.org with any questions about this campaign. Thank you for your continued advocacy.