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

Last Updated: March 23, 2026

What is the latest H-1B Update?

As we covered in the March Legislative Update, after several bipartisan letters from Congress regarding exempting health care workers from the $100,000 H-1B fee, AAPPR worked alongside national medical organizations, including the  American Medical Association and American Hospital Association, to secure the bipartisan introduction of the H-1Bs for Physicians and the Healthcare Workforce Act.

We applaud Reps. Mike Lawler (R-NY), Sanford D. Bishop, Jr. (D-GA), Maria Elvira Salazar (R-FL), and Yvette Clarke (D-NY) for their leadership on this important bipartisan effort.

The legislation would exempt all physicians and other healthcare workers from the new $100,000 H-1B filing fee upon enactment. The legislation defines “healthcare worker” to include, but not be limited to, physicians, nurses, nurse practitioners, primary care providers, preventive medicine physicians, optometrists, ophthalmologists, physician assistants, pharmacists, dentists, dental hygienists, other oral healthcare professionals, and other allied health professionals.

Under the Presidential Proclamation, the Secretary of the Department of Homeland Security (DHS) has the authority to exempt certain individuals, or entire professions, when it is in the national interest. Unfortunately, no physicians or other healthcare workers have been granted exemptions to date.

By introducing this legislation, we are hopeful Congressional support will coalesce around this bill and demonstrate to the Administration that exempting healthcare workers is in the national interest and does not undermine the broader policy goals of the Administration. We are encouraging Members of Congress to cosponsor the legislation. Please reach out if you have any questions.

Outside of this legislative effort, we await an update in the Global Nurse Force litigation. During a hearing last month on a motion for preliminary injunction, the government argued that the new fee is not a tax, while the plaintiffs argued that Congress authorized immigration fees only to cover the costs of administering the programs. We expect an update in the next few weeks.

You can read our previous updates from October 28, 2025, December 22, 2025, and Janurary 6, 2026.

What is the latest J-1 Update?

AAPPR is aware and closely following the hold on HHS Clinical Waivers and its impact on physician recruitment. The HHS Exchange Visitor Program allows foreign-trained physicians on J-1 visas to remain in the United States without returning to their home country for two years, provided they agree to serve in underserved areas. Since fall 2025, the Office of Global Affairs (OGA) at HHS, which is responsible for issuing the recommendation letters necessary to advance waiver applications, paused the process with hundreds of cases now in the backlog. HHS has reportedly stated that changes are being made to the criteria for the clinical waiver program, but no timing for those changes has been shared.

The consequences of this freeze are serious and far-reaching. The waiver process operates on a tight timeline and physicians generally must have their recommendations forwarded to the State Department by mid-March to complete the transition to H-1B status by the typical July 1 start date. It is not clear if physicians whose J-1 status expires before their waiver is processed will have to leave the country, further disrupting their path to employment.

Given the severity of this issue, we are engaging congressional offices to share our concerns with the Administration and urge immediate action to resume processing. If you are experiencing these delays or have any follow-up questions, please reach out and let us know.