SHM Joins Sign-On Letter Endorsing H-1Bs for Physicians and the Healthcare Workforce Act

Dear Representatives Lawler, Bishop, Salazar, and Clarke:

On behalf of the undersigned organizations, we are writing to strongly support the introduction of the “H-1Bs for the Physicians and Healthcare Workforce Act” (H.R. 7961). This bipartisan legislation would exempt physicians and other health professionals from the new $100,000 H-1B fee, thereby ensuring patients continue to have access to the physicians and health care workers that millions of Americans depend on.

On September 19, 2025, the Trump Administration issued a Presidential Proclamation requiring employers to pay a $100,000 fee for each new H-1B visa application. While the Proclamation provides the Secretary of the Department of Homeland Security (DHS) with the authority to exempt certain individuals, or entire professions, when it is in the national interest, no physicians or other healthcare workers have been granted exemptions to date.

The consequences of this fee, and lack of exemptions, are already being felt. The added cost is causing health employers, including safety-net hospitals and other practices, to pause or abandon recruitment of physicians and other providers, recruitment that in many cases has been in progress for over a year. These employers, especially independent physician practices, many of which operate on razor-thin margins and serve the nation’s most vulnerable populations, simply cannot absorb a six-figure fee on top of existing onboarding costs. Each month of delay translates directly into longer patient wait times, deferred care, and risks straining already overburdened emergency departments.

The health care workforce was already under growing strain prior to the imposition of this new fee. An aging population is driving rising demand for healthcare services, and many of the physicians currently serving rural and underserved communities are themselves nearing retirement, threatening to leave gaps in areas that are already critically short-staffed. Decades of insufficient investment in physician payment and graduate medical education continue to constrain the pipeline of new physicians needed to replace them. Today, more than 80 million Americans lack adequate access to primary care, exacerbating health disparities across the country, and with a persistent shortage of up to 86,000 physicians in the next decade, these challenges are only expected to worsen.

International medical graduates are essential to a high-functioning U.S. healthcare system. They make up one in four practicing physicians in the country, disproportionately serving in rural and underserved communities and filling critical gaps in specialties facing persistent shortages. In many of these communities, an international medical graduate is the only physician available. Without these providers, many communities would have little to no access to the care patients depend on, and the fee is now actively undermining the pipeline that delivers them.

The “H-1Bs for the Physicians and Healthcare Workforce Act” is a narrowly tailored, commonsense solution. The bill ensures that physicians and other essential health care providers are not unnecessarily swept into a fee structure designed to address other workforce sectors.

Thank you for your leadership on this bipartisan legislation. Congress must act with urgency to advance this bill and ensure the pipeline for physicians and other health care workers remains strong. We look forward to working with you to protect patients’ access to care.

Sincerely,

Academic Pediatric Association
Alliance for Headache Disorders Advocacy
Ambulatory Surgery Center Association
American Academy of Addiction Psychiatry
American Academy of Family Physicians
American Academy of Home Care Medicine
American Academy of Neurology
American Academy of Pediatrics
American Academy of Physical Medicine and Rehabilitation
American Brain Coalition
American College of Cardiology
American College of Obstetricians and Gynecologists
American College of Physicians
American College of Radiology
American College of Rheumatology
American Gastroenterological Association
American Geriatrics Society
American Headache Society
American Medical Association
American Pediatric Society
American Psychiatric Association
American Society for Clinical Pathology
American Society of Anesthesiologists
Association for Advancing Physician and Provider Recruitment
Association of Academic Leaders of Neurology (formerly AUPN)
Association of American Medical Colleges
Association of Medical School Pediatric Department Chairs
College of American Pathologists
Dysphonia International
Dystonia Medical Research Foundation
Hope for HIE
Infectious Diseases Society of America
International Bipolar Foundation
M-CM Network
Miles for Migraine
National Rural Health Association
North American Neuro-Ophthalmology Society
Pediatric Policy Council
Physicians for American Healthcare Access
Project IMG
Society for Adolescent Health and Medicine
Society for Pediatric Research
Society of Hospital Medicine
The American Society of Neuroradiology
The National Association of Rural Health Clinics
The Society for Cardiovascular Angiography and Interventions
The Society of Thoracic Surgeons