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- Posted November 3, 2025
Rural Counties Will Be Hardest Hit By U.S. Visa Fee Hike, Experts Say
A recent hike in U.S. visa fees could cause a medical brain drain in America’s rural regions.
Rural areas have nearly twice the percentage of medical professionals working under H-1B visas as urban counties, researchers reported Oct. 29 in the Journal of the American Medical Association.
Likewise, the percentage of H-1B doctors is nearly four times greater in impoverished counties compared to wealthy locales, researchers found.
“Our findings suggest that the most socioeconomically vulnerable communities will be hit hardest in terms of health care worker supply and care access by the recent visa application policy change,” said lead researcher Dr. Michael Liu, a resident physician in the Mass General Brigham Department of Medicine in Boston.
“Foreign health care workers fill critical gaps in health systems such as primary care and rural health, and millions of Americans depend on them to receive timely and high-quality health care,” Liu said in a news release.
In September, President Donald Trump issued an executive order increasing the fee for an H-1B visa to $100,000, up from an average of $3,500, researchers said in background notes.
The H-1B visa program allows U.S. employers to hire foreign workers in occupations that require specialized knowledge, including the medical field, researchers said.
For this study, researchers analyzed data on all H-1B visa applications in fiscal year 2024 from the U.S. Department of Labor.
Results show more than 11,000 doctors in the U.S. were sponsored by H-1B visas, nearly 1% of the nation’s entire physician workforce.
Rural counties had a higher percentage of H-1B-sponsored doctors, 1.6% versus less than 1% in urban areas, researchers found. Other health care workers on an H-1B visa like podiatrists, chiropractors and optometrists also were more likely to work in rural counties.
Likewise, counties with the highest poverty levels had a significantly higher percentage of H-1B-sponsored docs, 2% versus around 0.5% in the wealthiest counties.
“Our study provides evidence supporting proposed exemptions from H-1B visa fee increases for physicians, along with their extension to other health care workers,” senior researcher Dr. Rishi Wadhera said in a news release. He’s associate director of the Richard A. and Susan F. Smith Center for Outcomes Research at Beth Israel Deaconess Medical Center in Boston.
More information
The U.S. Centers for Disease Control and Prevention has more on rural health care.
SOURCE: Mass General Brigham, news release, Oct. 29, 2025
