Author: Eli Greenspan, Policy Advisor for AAPPR through Foley Hoag, LLP

Last Updated: January 6, 2026

What is the latest?

Just before the holidays, a federal court rejected a request to strike down the Administration’s $100,000 entry fee for H-1B visa holders, upholding the Administration’s authority to condition H-1B visa approval on this payment. U.S. District Judge Beryl Howell found that the President has broad statutory authority to regulate both immigrant and nonimmigrant entry. The Chamber of Commerce, who are leading this particular this case, requested the US Court of Appeals consider this decision and expedite its review, setting up oral arguments for February.

While additional lawsuits remain pending, including one filed by 20 states last month, the ruling marks an early validation of the policy and leaves employers facing increasing questions and pressures for a clear resolution.

We will continue to pursue a clear exemption for health care workers given the uncertainty following this latest court decision and encourage you to reach out with questions or issues as you navigate the H-1B process. You can read our two previous updates from October 28, 2025 and December 22, 2025.

Separately, the Department of Homeland Security last month finalized a rule overhauling the H-1B selection process. Instead of equal odds for all registrants, the new lottery weighs selection by wage level, granting the highest wage tiers more entries and thus better odds. The regulation will apply to the fiscal year 2027 registration period, meaning petitions filed before that date will follow the current lottery rules. The wage-weighted lottery will tilt selection toward higher-paying roles and employers, potentially undermining entry-level or lower-paid clinical positions. While some employers may be cap-exempt and outside the lottery, these pressures will likely shift recruiting strategies and priorities in the new year.

We will cover this change in more detail in the January legislative update but encourage you to reach out with any questions in the meantime.