A group of 100 US lawmakers have urged Department of Homeland Security (DHS) Secretary Kristi Noem to exempt the health care sector from new restrictions linked to the H-1B visa programme. In the letter dated February 11, 2026, the lawmakers expressed concern over the September 19 Presidential Proclamation that imposed a $100,000 fee on employers filing new H-1B visa petitions, warning that the fee could worsen staffing shortages across the health care system. The lawmakers says that the presidential order allows DHS to grant sector-wide exemption as long as it “is in the national interest and does not pose a threat to the security or welfare of the United States.” In the letter, the lawmakers argued that health care qualifies for such exemption. The lawmakers further cited federal data showing widespread shortages of doctors, laboratory professionals, and other skilled workers. They also warned that hospitals and clinics, particularly in rural areas and urban communities, rely heavily on international health workers to maintain services. “These shortages cannot be filled by the domestic workforce alone,” the letter says, further stating that the added cost could leave critical roles unfilled and reduce access to care for millions of Americans.

Read the 400-plus word letter that US lawmakers sent to DHS secretary

“Dear Secretary NoemWe are deeply concerned about the impact of the September 19 Presidential Proclamation, “Restriction on Entry of Certain Nonimmigrant Workers,” on the health care workforce. The Proclamation imposes a $100,000 fee on employers that petition for a new H-1B visa, but also recognizes the Department of Homeland Security Secretary’s authority to grant sector-wide exemptions, so long as it “is in the national interest and does not pose a threat to the security or welfare of the United States.” We urge you to create a health care sector exemption to prevent additional strain on the health care workforce.Worsening workforce shortages across all health care professions are significantly diminishing access to care in rural and urban communities across the nation. According to the Health Resources and Services Administration, nearly 87 million Americans live in areas Federally designated as lacking enough medical professionals to address the community’s health care needs.Physician demand could exceed supply by up to 86,000 in the next decade and clinical laboratory science programs are educating less than half the number of clinical laboratory professionals needed. These shortages cannot be filled by the domestic workforce alone, and projections will worsen if health care employers cannot continue to recruit and retain international health care workers.For over 30 years, health care employers have used the H-1B visa program to recruit and retain the finest international talent, positioning the US as a global leader in health care delivery and innovation. Many members of the care team—including highly skilled physicians, advanced practice professionals, clinical laboratory workers, and researchers—come to the U.S. from around the world to offer specialized services, deliver care in underserved areas, and contribute to cutting-edge biomedical research.Health care organizations must be able to recruit staff in the most cost-effective manner so they can use their financial resources to hire as many caregivers as possible to take care of their communities. Rural hospitals and urban safety net hospitals face uncommon recruitment and retention issues and will most acutely feel the effects of the $100,000 fee. These hospitals rely heavily on the H-1B visa to maintain adequate staffing and offer comprehensive services in high-need areas. 21 million Americans live in areas where foreign-trained physicians account for at least half of all practicing physicians.Imposing a $100,000 fee for new H-1B visa petitions will exacerbate hospitals’ existing staffing challenges and could push chronically underfunded hospitals to their financial brink. If these hospitals cannot petition for new H-1B visas to address their staffing needs without also having to pay this fee, it will further damage their financial viability. Critically needed open positions will simply go unfilled, leaving rural and high-poverty urban areas without adequate access to care.We strongly urge you to exempt the health care sector from this burdensome fee. Thank you for considering our request.”