Trump administration proposes wage increase for H-1B visa holders

In March, DOL proposed a new rule that would increase the minimum pay for workers who come into the country through the H-1B visa program, as well as several other visa categories. Depending on a worker's experience, their minimum pay could increase by 21% to 33%.

Previously, DOL proposed a similar rule in 2021 during President Donald Trump's first term. However, it was later dropped by the Biden administration.

In a press release, DOL said the new wage rule is a necessary step to modernize the skilled worker visa programs. According to the agency, prevailing wage levels have historically been set too low below market rates that American workers would receive, particularly for early-career and entry-level workers.

"This proposed rule will help ensure that employers pay foreign workers wages that reflect the real market value of their labor, in addition to protecting the wages and job opportunities of American workers," said Secretary of Labor Lori Chavez-DeRemer. "The continued abuse of the H-1B program by certain bad actors will no longer be tolerated."

The Trump administration has also introduced other changes to the H1-B visa program to combat what it has called "systemic abuse." Last September, Trump issued an executive order implementing a $100,000 fee for any new H-1B visa petitions, which will be implemented with the 2026 cycle.

How could the H-1B wage increase impact healthcare?

According to Brian Bumgardner, shareholder at Ogletree Deakins, the new wage rule is "another brick in the wall" in terms of additional costs for employers sponsoring H1-B visas. Depending on experience, employers may have to pay tens of thousands of additional dollars to H1-B workers. 

Recent Advisory Board data also shows encouraging signs of stabilization in the domestic labor market, particularly among nursing roles, where time‑to‑fill and vacancy rates have largely returned to 2019 baselines. 

However, Advisory Board's Vidal Seegobin noted that this surface-level stability masks underlying fragility in the healthcare workforce.

"Intent to leave remains elevated, and policy changes that increase the cost or complexity of H‑1B visas risk disproportionately affecting providers — especially rural hospitals and other safety-net organizations — that depend on internationally sourced clinicians to maintain access and stay financially viable," Seegobin said.

"As the industry faces a wave of retirements — nearly half of nurses report intent to leave the bedside within three years, and many plan to exit the profession altogether — strategy is becoming more complex and more consequential," Seegobin said. "In response, we expect these firms' value propositions to mature, with expanded capabilities to navigate visa pathways, manage regulatory requirements, and assume immigration-related risk on behalf of provider organizations. These offerings will be critical: as every macro force points toward sustained shortages of bedside clinicians, health systems will need diversified, adaptable talent strategies, and immigration will remain an essential — and constructive — part of that solution."

Overall, the new H-1B wage rule "has the potential to significantly limit the sector's ability to provide timely and quality health care services to those in need, both now and in the future," said Dana Ritchie, associate VP of the American Health Care Association and National Center for Assisted Living.