The Trump administration has proposed another new visa fee that would likely limit hospitals and other healthcare employers’ access to foreign-born skilled workers.
In a proposed rule unveiled Oct. 7, the Department of Homeland Security outlined plans to bring new fees for Optional Practical Training (OPT), a type of temporary employment for nonimmigrant students with an F-1 visa. OPT must be directly related to the student’s major area of study and recommended by their educational institution
An initial recommendation for OPT from a student’s school would be subject to a $70,000 fee, per the proposed rule, and additional recommendations for the same student (such as an additional 24-month extension for science, technology, engineering or mathematics fields) would run $30,000.
DHS said the planned policy change will help Americans better compete in the job market, and is in line with President Donald Trump’s executive orders directing such policies. It’s also a “response to fraud and abuse identified” in the program, DHS said while describing “schemes to exploit current regulations, including problematic worksite and ‘pay-to-stay’ visa schemes.”
“Optional Practical Training was never meant to be a back door into the American workforce, a subsidy for cheap labor, or a prize for those who game the system,” a DHS spokesperson said in a statement alongside the proposed rule’s announcement.
The American Hospital Association, in an online notice highlighting the proposal, said it “could have significant implications for hospitals and health systems that rely on international graduates, including nurses, physicians, pharmacists and other healthcare professionals, as OPT often serves as a pathway into the healthcare workforce.”
Brian Bumgardner, business immigration shareholder in Raleigh at Ogletree Deakins, agreed, telling Fierce Healthcare he’d expect such a policy to “chill” enrollment among foreign students.
“I do not foresee that the majority of foreign students who are considering their options, especially for graduate-level studies, would be open and eager to navigate this new proposed fee before they are authorized to work once they have completed their degree programs,” he said.
While schools would be on the hook for the fees, Bumgardner noted that the proposed rule permits the cost to be passed on to students and employers. However, “I don’t anticipate many employers lining up to cover these substantial fees for a new college graduate who would likely be a new hire employee,” he said, also noting such arrangements would introduce ancillary employment, tax and policy issues.
Bumgardner explained that F-1 OPT participants typically fill out analytical, research, technical or clinical roles at hospitals and healthcare systems. Enactment of the fees would likely limit such candidates and increase lead times while schools weigh whether or not to recommend their students.
“It is a big ask to schools, students and employers, one that likely would be a dealbreaker,” he said.
DHS is accepting public comments on its proposed rule through Nov. 9. The proposed fees would not apply to students approved for OPT or recommended by their school before its effective date, though Bumgardner cautioned healthcare employers to consider whether any last-minute approvals could later require the $30,000 extension.
The proposed fees are the latest in a string of policy barriers the Trump administration has sought to impose on the hiring of foreign workers. Last year DHS unveiled a $100,000 supplemental fee for H-1B petition applications, filed by employers for specialized workers. A federal judge vacated that rule in June, and another federal court vacated it in September. An additional H-1B petition fee of $103,265 has also been proposed, and likely to be challenged in court if finalized.
Beyond imposing direct fees, DHS also sought to limit how long nonimmigrant students could remain in the country, replacing the longstanding “duration of status” policy. The change was blocked just hours before its Sept. 15 implementation and is now under appeal.
The Department of Labor has also proposed increasing the prevailing wage floors for those under the H-1B, H-1B1, E-3 and PERM green card programs, which would also reduce the appeal of such workers for tight-margined healthcare employers.
Healthcare provider groups have generally opposed these foreign student and worker policy changes, citing widespread labor shortages in the healthcare industry and, at minimum, requesting that the administration consider exemptions for the field.