Trump's $100,000 H-1B visa fee threatens rural schools and hospitals and why it could devastate essential services

The Trump administration’s announcement of a new $100,000 fee on H-1B visa applications is raising concerns about its impact on rural schools and hospitals across the US. The fee targets employers hiring skilled immigrant workers under the H-1B visa, a programme widely used in sectors like education and healthcare. Rural communities, already struggling with staff shortages, fear that the increased cost could make it impossible to fill vital positions.

Superintendents and healthcare officials in small towns warn that this fee hike could force them to reduce services or hire uncertified workers, threatening the quality of education and healthcare. Many of these areas rely heavily on immigrant teachers and doctors, who fill roles that locals are either unavailable or unwilling to take.

Rural schools rely on immigrant teachers to fill vacancies
Rob Coverdale, superintendent of the Crow Creek Tribal School in South Dakota, explained the crucial role of H-1B visa holders in his district. When he began his role in 2023, 15 teaching positions remained vacant. He filled those vacancies with Filipino teachers, most arriving on H-1B visas. “We’ve hired the H-1B teachers because we quite simply didn’t have other applicants for those positions,” Coverdale said, as reported by the Associated Press. “They’re filling jobs that otherwise just simply we would not get filled.”

Rural schools like Crow Creek face unique challenges, including isolation and lower wages, making recruitment difficult. Stephan, the town where Crow Creek is located, is nearly an hour’s drive from the nearest Walmart or clothes store, adding to the challenge. Teachers like Mary Joy Ponce-Torres, who moved from the Philippines with 24 years of experience, find themselves adjusting to these conditions while providing essential education.

The new $100,000 visa fee, announced on September 19, is designed to discourage companies from replacing American workers with cheaper overseas talent. However, the White House has clarified that existing visa holders are exempt and has provided an exemption form for some employers. Despite this, the cost could be prohibitive for rural districts with tight budgets. Melissa Sadorf, executive director of the National Rural Education Association, said, “Attaching that price tag to a single hire... it just simply puts that position out of reach for rural budgets,” as quoted by the Associated Press.

Hospitals and health care providers face similar challenges
The healthcare sector also relies heavily on immigrant workers. The American Medical Association (AMA) projects a shortage of 87,000 physicians in the next decade, a gap worsened in rural areas. About one-quarter of the nation’s doctors are international medical graduates, many of whom come to the US on H-1B visas.

Bobby Mukkamala, AMA president and a doctor from Flint, Michigan, warned of the fee’s impact. “It’s just going to be terrible for the physician shortage, particularly in rural areas,” he said, as reported by the Associated Press. Many new doctors prefer larger cities, leaving rural communities dependent on international graduates.

Healthcare providers worry the new visa fee will strain already tight budgets and could force hospitals to cut services or reduce staffing. Allison Roberts, vice president of human resources at Prairie Lakes Healthcare System in South Dakota, said the fee “is going to really take your smaller, rural health care institutions out of the picture,” as quoted by the Associated Press.

Visa options and the broader impact on rural communities
While H-1B visas offer a pathway to permanent residency, J-1 visas used for short-term cultural exchanges are not subject to the new fee. However, J-1s do not provide the stability rural schools and hospitals seek because of their temporary nature. George Shipley, superintendent at Bison Schools in South Dakota, noted the importance of permanent hires: “The H-1B opens that possibility. It is super important... to actually transition from the J-1 visas to the H-1B,” as reported by the Associated Press.

The fee increase is part of the Trump administration’s attempt to prioritise American workers, but critics say it overlooks the critical roles immigrant workers play, especially in underserved rural areas. A coalition of healthcare providers, religious groups, and educators has filed a lawsuit challenging the fee, citing the harm it would cause to essential services.

Without immigrant workers, rural schools might be forced to combine classes, hire uncertified teachers, or reduce course offerings. Hospitals could face longer patient wait times and have to close departments. The new visa fee threatens to widen gaps in education and healthcare where communities can least afford it.