Crisis Averted: Why the $100,000 H-1B Visa Fee Is NOT Your Problem, Nurse

By Lysa Balboa

Disclaimer: The information in this article is based on an analysis of the Presidential Proclamation "Restriction on Entry of Certain Nonimmigrant Workers" signed on September 19, 2025, and subsequent official clarifications from the White House, U.S. Citizenship and Immigration Services (USCIS), and the Department of State. This includes official fact sheets and statements confirming the specific exemption for the "healthcare and engineering industries" and clarifications on the fee's one-time, non-annual nature. The report regarding physicians' exemption is sourced from Reuters, citing a White House spokesperson.
This is not legal advice. Immigration policy is subject to rapid change and interpretation. Foreign-educated nurses and their employers should always consult with qualified immigration counsel to confirm eligibility and the latest official guidance regarding their specific case.
All resources are below the article.

The immigration world was thrown into a panic by a Presidential Proclamation signed on September 19, 2025, suggesting a new $100,000 fee for H-1B visas. However, for nurses, the panic is entirely unwarranted. Nurses are explicitly exempted from this new charge, which is a targeted measure aimed at the tech and outsourcing sectors, not the vital, talent-starved U.S. healthcare system.

 The Healthcare Carve-Out: Why Nurses Are Safe

The core of the matter is a strategic exemption built into the policy itself.

1. Direct Exemption Confirmed

The proclamation explicitly states that the new fee will not apply to visa applications submitted for those working in the "healthcare and engineering industries." This is a direct, unambiguous carve-out that protects the nursing profession from the new financial burden.

2. "National Interest" Waivers Solidified

New reports further reinforce this protection. Following the announcement, White House communications indicated that the fee is subject to "case-by-case exemptions if in the national interest." Reports citing White House spokespersons explicitly mention that physicians may be exempted under this clause. This is a critical signal that the entire medical sector, including highly skilled nurses, is considered in the "national interest," solidifying the policy's intent to avoid disrupting the U.S. healthcare workforce.

H-1B: Only for the Advanced Practice Nurse

For most foreign-educated nurses, the H-1B visa has historically not been the primary path to U.S. work authorization or permanent residency.

  • The H-1B is designated for "specialty occupations" that legally require a minimum of a bachelor's degree.

  • The minimum educational standard for a general Registered Nurse (RN) in the U.S. is often an Associate’s Degree, which typically does not meet the H-1B's requirement.

Preferred Pathway: The EB-3 Visa

The most common and effective pathway for foreign-educated RNs seeking a Green Card is the EB-3 immigrant visa, a route that is completely unaffected by this H-1B proclamation.

H-1B for Advanced Roles (And They Are Fee-Exempt)

The H-1B remains a viable—and now, fee-exempt—option only for nurses in advanced roles where a higher degree is the industry standard:

Nursing Role

H-1B Eligibility

Why it Qualifies

Nurse Practitioner (NP)

Yes

Requires a Master's degree or higher.

Clinical Nurse Specialist (CNS)

Yes

Requires a Bachelor's or Master's degree.

Certified Registered Nurse Anesthetist (CRNA)

Yes

Requires a Master's degree or higher.

Nurse Manager

Yes

Management-level roles generally require a Bachelor's degree or higher.

 

Clarifying the Confusion: What the Fee Actually Is

The initial, confusing rollout of the proclamation caused panic, which is why it's essential to know the facts:

Issue

Initial Claim/Perception

Official Clarification (What is TRUE)

Fee Structure

Annual fee of $100,000

One-time fee of $100,000

Applicability to Current Holders

Applies to all H-1B visa holders

Does not apply to current holders or those seeking renewals/extensions

Affected Population

Anyone with an H-1B visa or seeking one

Applies only to new petitions for individuals outside the U.S. in non-exempt industries

 

Actionable Takeaways for Nurses

The proclamation is a strategic, industry-specific measure that does not target the nursing profession. Your focus should remain on your career path, not on immigration anxieties that don't apply to you.

  1. Relax, the Fee is Not Your Concern: The $100,000 fee is a non-issue for the healthcare field. Your employer can continue to sponsor advanced-practice nurses under the H-1B program without this financial barrier.

  2. EB-3 is Still King: If you are a foreign-educated RN, the EB-3 immigrant visa is your most stable and common path to a Green Card. This new policy does not change that fact.

  3. Consult Legal Counsel: To confirm your most advantageous visa path (EB-3 for most, or the fee-exempt H-1B for advanced roles), always consult with an immigration attorney who can reassure your employer about the robust healthcare exemption.

References:

Trump adds $100,000 annual fee for H-1B visa applications | AP News, accessed on September 22, 2025, https://apnews.com/article/h1b-visa-trump-immigration-8d39699d0b2de3d90936f8076357254e

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Lysa Balboa

NEAC’s Licensing Supervisor, bringing 9 years of expertise in international medical licensing. As a specialist in NCLEX, License Endorsement, and Visa Screen processing, she has helped thousands of healthcare professionals obtain international licensure. Known for her dedication and in-depth knowledge of licensing regulations, Lysa ensures a smooth and hassle-free application process, guiding applicants at every step. She has also played a key role in major initiatives at NEAC, including co-founding the Processing Department. Her commitment to excellence has established her as a trusted expert in the field.

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