Indian Doctors And Nurses Await Clarity As H-1B Visa Fee Slams The Door On Them

(MENAFN- Live Mint)

As tech workers brace for the impact of Donald Trump's prohibitive H-1B work visa fees, another category of highly skilled Indian professionals awaits clarity: healthcare professionals.

Thousands of medical and paramedical workers, as well as researchers in the life sciences and space, work in the US through H-1B visas . Indian physicians, physical therapists and medical researchers eyeing employment in the US are now left in limbo as the order does not clarify whether they are covered under the new rules. Some are exploring different pathways, such as the H-4 dependent or J-1 visa. All these people did not wish to be quoted.

“Unlike the pandemic-related travel ban, when the US government had indicated what visas and or travel would be authorized as national interest exceptions, this time there is no such indication," Poorvi Chothani, Immigration Attorney and Managing Partner, LawQuest.

Also Read | Airfares to US spike amid H-1B visa confusio

"Hence, academics and healthcare professionals, including nurses, occupational and physio therapists, etc., will have to wait for more clarity," said Chothani.“As of now, their employers will have to pay $100,000 when filing a new H-1B petition as well."

One in five immigrant doctors in the US is of Indian origin, according to a 2024 analysis of data from the Migration Policy Institute (MPI) and the US Bureau of Labour Statistics by Remitly. India was the second-largest origin country for nurses in the US after the Philippines. Overall, at 1.76 lakh, Indian healthcare workers made up 7% of the total immigrant healthcare professional population, it said.

Late on Friday, US President Donald Trump signed an executive order requiring companies to pay $100,000 for every new foreign worker on an H-1B visa . White House Press Secretary Karoline Leavitt clarified on Saturday that the fee is not an annual fee and would not impact those who already hold H-1B visas and are currently outside of the country.

Individuals employed by higher education institutions, non-profits engaged in research, and those involved in clinical training have previously been exempt from paying the fees.

Also Read | Mint Explainer: What spooked the Trump administration on H-1B visas

H-1B visas allow companies to sponsor foreign workers with specialised skills, such as those in STEM (science, technology, engineering and mathematics) fields and healthcare, to work in the US. Information technology employees will face the maximum impact as they corner the maximum number of such visas. But healthcare professionals will not escape, unless the rules are eased for them.

“The quantum of H-1B in this (healthcare) category will be less...there will certainly be an impact, but not as much as for tech workers," Bhanu Prakash Kalmath S J, partner and healthcare industry leader at Grant Thornton Bharat, told Mint.

Aditya Narayan Mishra, MD and CEO of recruitment firm CIEL HR, said, "As of now, the healthcare professionals will come under the same rules as the IT executives who fall under H-1B visa. Until more clarity is available on who all fall under the "welfare" bracket, the employment visas for healthcare workers going to US are in cold storage."

US employers were certified to fill approximately 10,500 H-1B physician positions in 2017, according to a study published on JAMA Network. It analyzed 2016 H-1B visa data from the US Office of Foreign Labor Certification. Applicants to the H-1B program represented 1.4% of the active physician workforce in the country that year.

Restricting the entry of immigrant healthcare professionals could put a severe strain on the US's already strained healthcare system, experts said.

Also Read | Trump's H-1B visa fee hike: the death of onsit

Thousands of physicians on H-1B visas serve in underserved areas in the US, and the healthcare system would“collapse in some time" if they leave, Dr Satheesh Kathula, president of the American Association of Physicians of Indian Origin (AAPI), told PTI in an interview last year.

According to Biplab Lenin, partner (pharma, healthcare & life sciences) at law firm Cyril Amarchand Mangaldas, told Mint,“If teaching hospitals or mid-sized institutions suddenly have to bear such a steep fee, many may think twice before sponsoring international physicians."

To be sure, in FY24, 23,560 H-1B visa applications filed were exempted from paying the mandated fee as the employer was an institution of higher education, according to the US Citizenship and Immigration Services FY24 annual report on H-1B petitions.

Close to 19,000 applications were exempted because the employer was a nonprofit or an entity affiliated with an institution of higher education; 6,598 because the employer was a non-profit research or government organization; and over 10,000 because the employer was a nonprofit entity engaged in clinical training.

Rise of GCCs

Immigrant pharmaceutical and life sciences researchers working for big pharma companies and biotechs could also find their entry restricted unless they are exempted from the fee hike.

However, Kalmath of Grant Thornton Bharat said this could lead to the growth of global capability centres (GCCs) domestically.

India has already grown as a hub for life science GCCs in the past five years, according to a report by EY India. Of the top 50 global life sciences companies, 23 already operate GCCs in India. While pharma GCCs handle over 60% of enabling functions like finance, HR, supply chain, and IT, they are also increasingly taking on critical mandates across functions like regulatory affairs, medical, and commercial, the report said.

The country's talent pool is vast: over 2.7 million professionals in the life sciences sector. Every year, 2 million STEM graduates and more than 110,000 medical graduates enter the workforce.

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