DHS proposes new $103K H-1B visa fee

The Department of Homeland Security (DHS) is proposing a $103,265 fee on H-1B petitions subject to the annual visa cap, marking the Trump administration’s second attempt to significantly increase the cost of employing foreign specialized workers in the U.S.

H-1B visas allow U.S. employers to temporarily hire foreign workers in occupations that require highly specialized knowledge and at least a bachelor’s degree or its equivalent. Medicine is among the many occupations eligible for H-1B status. For physicians trained outside of the U.S., the visa can provide a pathway to remain in the country and practice after completing medical training.

In a September 2025 proclamation, President Trump directed that new H-1B visa petitions submitted by employers be accompanied by a $100,000 payment. Before this proclamation, H-1B visa fees were typically less than $5,000.

Attorneys general from 20 states sued the Trump administration over the policy three months later, arguing that it violated the Administrative Procedure Act. In June 2026, a federal judge vacated the directive, ruling that the executive branch lacked the authority to impose the fee because it functioned as a tax.

Now, the Trump administration is trying again. This time, however, DHS is pursuing the fee through formal rulemaking and proposing to establish it as a standing charge for cap-subject petitions.

The proposed $103,265 fee would not apply to hospitals across the board. DHS stated that the fee would apply to cap-subject H-1B petitions. Employers and institutions whose petitions are exempt from the annual H-1B cap—including qualifying universities, nonprofit research organizations, and certain affiliated organizations—would not be subject to the fee. However, many health systems, community hospitals, private practices, and other healthcare employers still rely on cap-subject H-1B petitions and therefore could face the fee.

The potential impact is significant because international medical graduates make up a substantial portion of the U.S. physician workforce. Foreign-trained doctors have helped fill gaps in locations and specialties particularly affected by physician shortages, especially in rural areas and underserved communities.

DHS is accepting public comments on the proposal through September 24, 2026.