H1B visas may be a disaster for USA in terms of hiring tech workers medical and care staff from abroad

24th September 2025

While the visa charge of £100,000 is not automatically a “disaster,” but recent policy changes (especially the big fee hike and new restrictions) make serious harm much more likely to tech hiring, and to healthcare/care staffing unless policymakers carve out exemptions or other fixes.

What H-1B normally does (benefits).

Watch A Simple Explanation of Trumps possible H1B visa disaster

It fills real shortages in STEM and medicine (many hospitals and clinics rely on foreign-trained doctors and nurses; foreign graduates make up a sizeable share of practicing physicians in underserved areas). That improves access to care and keeps some services running.

Research shows high-skilled immigrants raise productivity, innovation, and welfare overall, even while producing distributional effects (some native wages fall modestly in affected occupations). In other words: economy-level benefits with localized winners/losers.

What recent policy changes do (the risk)

The new administration actions (a one-time ~$100k fee for new H-1B petitions plus other entry limits) are projected to cut thousands of authorisations per month, raise hiring costs dramatically, and deter employers from using the programme for many roles. That’s a big shock to hiring pipelines.

Analysts and industry groups warn this will push firms to offshore roles, delay projects, or pay far more to hire locally — and hospitals warn it could worsen physician and nursing shortages, especially in rural/underserved areas, unless exemptions are introduced.

Evidence from past studies (how big the labour effects are)

Academic work finds the H-1B program does reduce wages modestly for some native workers in the same fields but also increases innovation, employment in complementary roles, and overall productivity. The effects are real but not uniform — size depends on scale of immigration and local labour market.

Sector differences — tech vs healthcare/care staff

Tech: Many tech firms can respond by offshoring, automating, or recruiting from other countries (Canada, EU). Short term pain (slower hiring, higher costs) is likely; long-term damage depends on whether the US retains openness to global talent and invests in domestic STEM pipelines.

Healthcare & care staff: Far less easily offshored — patient care is local. Restrictions on visas will more directly reduce the available workforce, worsening staffing gaps unless exemptions, streamlined licensing, or domestic training scale up. Several healthcare bodies have warned about this exact risk.

So — will it be a disaster?

Possible, but not inevitable. If the policy is applied bluntly (large fee, no sector exemptions, and no parallel domestic training/immigration reforms), expect meaningful damage: fewer foreign hires, some project delays in tech, and real risks to hospital capacity and care provision in many communities.

If policymakers exempt healthcare and caregiving roles, reduce burdens for critical occupations, expand green cards/other visas, and invest in training, the worst outcomes can be mitigated.

Practical implications & options

Companies may offshore or accelerate remote hiring for tech roles; that shifts economic activity out of the U.S.

Hospitals may lobby for exemptions or special routes for doctors/nurses; without them, staffing shortages and service constraints are likely.
Reuters

Policy fixes that help: targeted exemptions, faster credentialing for foreign clinicians, scaled domestic training, and clearer pathways to permanent residency for in-demand workers.