Visa fee adds to rural hospital challenges

Rural hospitals dependent on foreign-born professional workers to fill critical positions must pay $100,000 for the Trump administration’s new H-1B visa fee. Bekki Holzkamm, who oversees a lab at West River Health Services in Hettinger, a North Dakota town of about 1,000 people, has been unable to hire an American-born technician. She says even lab technician interns at the hospital are uninterested in the position because they prefer the higher salaries available in cities. The visa fee equates to what some rural hospitals would pay for two lab technician salaries in a year. Before the executive order, hospitals paid around $5,000 for an H-1B visa. The government approved around 19,000 H-1B visa applications in the health and social assistance sector during the 2025 federal fiscal year. (KFF news article, 12/9/25)