By now, everyone has heard of the H1 implications and fees, and it seems largely headlines have been relating to tech giants and their executives who came here on a J1/H1.
What is getting less publicity is the significant number of healthcare workers who are in America on a Visa, and that the already existing shortage of care will increase over the next year.
Immigrants make up 27% of doctors, 22% of nursing assistants, and 16% of registered nurses in the U.S. today.
Focusing on the Physician specifically, here are some quick stats that relate to our Arizona Healthcare System:
- One in four physicians in practice are currently, or was at one point, on a J1 or H1 visa/waiver.
- In Arizona today, the state meets only about 39 percent of its primary care physician needs. Meaning over half of the state is actively needing more primary care providers.
- By 2030, Arizona will need nearly 1,941 additional primary care doctors to keep up with population growth and aging.
These numbers tell us that Arizona is already in a precarious position. For business leaders who rely on a healthy workforce, employee recruiting in competitive markets, and stable community health systems, any further disruption to doctor recruitment is not just a policy issue; it is a strategic risk.
What is a J1 / H1 Visa?
The J1 visa is a cultural exchange visa that allows international medical graduates to complete U.S. residency training. Doctors on a J1 typically must return to their home country for two years after training, unless they obtain a waiver by committing to serve in underserved areas.
The H1B visa allows foreign professionals to work in the U.S. long-term in specialty roles, including physicians. Many doctors transition from a J1 to an H1B after training, which gives them stability and a path to permanent residency.
Together, these visas form a crucial pipeline that brings international physicians into the U.S. healthcare system, particularly in rural and underserved communities.
The $100,000 Supplemental Fee:
In September 2025, a presidential proclamation added a $100,000 fee to new H-1B visa applications.
Previously, Physicians coming to Arizona on an H1 would cost around $2,000 – $5,000 plus attorney fees, usually coming to around $10,000 in total.
Small and rural hospitals often operate with very tight budgets, and adding this cost can make hiring a physician unfeasible. Some hospitals are already reconsidering whether they can afford to sponsor doctors, pausing offers, or relying only on J-1 hires (the number of J-1s allowed has also been significantly decreased), who may not stay beyond their required service.
Because the transition from J-1 to H-1B is so carefully balanced, a change like this could disrupt the entire physician pipeline.
What It Means for Arizona Businesses:
Since this will initially only be in effect for one year, most facilities are likely to pause H1B visa sponsorship during that time. The hope is that either an exception will be made for the healthcare sector or that the order will expire after the first year.
Until then, demand for physicians in the state will increase, widening the existing gap and shortage of candidates.
Residency programs are also expected to see a noticeable drop in total physician enrollment in 2025 and 2026.
Rural healthcare facilities are likely to be hit the hardest, as they rely heavily on physicians on visas. With already limited budgets and existing shortages, the $100,000 fee will be impossible for most of these facilities to absorb.
Arizona is not immune to the national forces reshaping medicine. But as a rapidly growing, competitive state, we have both more to lose and more to gain. If the healthcare talent pipeline snaps, the ripple effects will touch not only patients but also employees, capacity, attraction, and economic growth.
Written by Stefan Van Der Heyden, President, HealthOp
