Trump's $100,000 H-1B visa fee threatens rural schools and hospitals
reliant on immigrant workers
[October 09, 2025]
By SARAH RAZA
SIOUX FALLS, S.D. (AP) — When Rob Coverdale started his job in 2023 as
superintendent of the K-12 Crow Creek Tribal School in South Dakota,
there were 15 unfilled teaching positions.
Within nine months, he had filled those vacancies with Filipino
teachers, the majority of whom arrived on the H-1B, a visa for skilled
workers in specialty occupations.
“We’ve hired the H-1B teachers because we quite simply didn’t have other
applicants for those positions," Coverdale said. “So they're certainly
not taking jobs from Americans. They're filling jobs that otherwise just
simply we would not get filled.”
Now a new $100,000 fee for H-1B visa applications spells trouble for
those like Coverdale in rural parts of the country who rely on
immigrants to fill vacancies in skilled professions like education and
health care.
The Trump administration announced the fee on Sept. 19, arguing that
employers were replacing American workers with cheaper talent from
overseas. Since then, the White House has said the fee won't apply to
existing visa holders and offered a form to request exemptions from the
charge.
H-1Bs are primarily associated with tech workers from India. Big tech
companies are the biggest user of the visa, and nearly three-quarters of
those approved are from India. But there are critical workers, like
teachers and doctors, who fall outside that category.
Over the last decade, the U.S. has faced a shortage in those and other
sectors. One in eight public school positions are vacant or filled by
uncertified teachers, and the American Medical Association projects a
shortage of 87,000 physicians in the next decade. The shortages are
often worse in small, rural communities that struggle to fill jobs due
to lower wages and often lack basic necessities like shopping and home
rental options.
H-1B and J-1 visas provide communities an option to hire immigrants with
advanced training and certification. The J-1s are short-term visas for
cultural exchange programs that aren't subject to the new fee but,
unlike the H-1B, don't offer a pathway to permanent residency.
While large companies may be able to absorb the new fee, that's not an
option for most rural communities, said Melissa Sadorf, executive
director of the National Rural Education Association.
“It really is potentially the cost of the salary and benefits of one
teacher, maybe even two, depending on the state,” she said. “Attaching
that price tag to a single hire, it just simply puts that position out
of reach for rural budgets.”
A coalition of health care providers, religious groups and educators
filed a lawsuit on Friday to stop the H-1B fee, saying it would harm
hospitals, churches, schools and industries that rely on the visa. The
Department of Homeland Security declined to comment and referred a query
to its website.
Filling classrooms where Americans won't go
Coverdale said spots like Stephan, where Crow Creek is based, struggle
to attract workers in part because of their isolation. Stephan is nearly
an hour's drive from the nearest Walmart or any place that sells
clothes, he said.
“The more remote you are, the more challenging it is for your staff
members to get to your school and serve your kids,” he said.
Among Coverdale's hires is Mary Joy Ponce-Torres, who had 24 years of
teaching experience in the Philippines and now teaches history at Crow
Creek. It was a cultural adjustment, but Ponce-Torres said she's made
friends and Stephan is now a second home.
“I came from a private school,” she said. “When I came here, I saw it
was more like a rural area ... but maybe I was also looking for the same
vibe, the same atmosphere where I can just take my time, take things in
a much slower pace.”
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In this photo provided by South Dakota News Watch, Rob Coverdale,
superintendent of the Crow Creek Tribal School District in Stephan,
S.D., poses for a photo in his office, Feb. 7, 2025. (Bart Pfankuch/South
Dakota News Watch via AP)
 Many immigrants like Ponce-Torres
leave their family behind to pursue the experience and higher wages
that a U.S. job can provide.
Sean Rickert, superintendent of the Pima Unified School District in
Pima, Arizona, said he would stop seeking H-1B teachers if the new
fee is imposed. “I just plain don’t have the money,” he said.
Though schools can also use J-1 visas to bring in immigrant
teachers, it increases turnover because it is shorter term.
“It's so important that we find permanent people, people who can buy
homes, who can become part of our community,” said George Shipley,
superintendent at Bison Schools in the town of Bison, South Dakota.
“So the H-1B opens that possibility. It is super important, in my
opinion, to actually transition from the J-1 visas to the H-1B.”
Without enough staff, schools may hire uncertified teachers, combine
classes, increase caseloads for special education managers or drop
some course offerings. Shipley said any future shortage of teachers
in Bison would force some classes to move online.
The rural reliance on immigrant teachers is concentrated on
harder-to-fill specialties, Sadorf said.
“It’s a lot more difficult to find a high school advanced math
teacher that’s qualified than it is to fill a second or third grade
elementary class position,” she said.
Closing gaps in the nation's doctor shortage
The fee could be a “huge problem” for health care, said Bobby
Mukkamala, president of the American Medical Association and a
doctor in Flint, Michigan. Without enough doctors, patients will
have to drive farther and wait longer for care.
One-quarter of the nation's physicians are international medical
graduates, according to the AMA.
“It’s just going to be terrible for the physician shortage,
particularly in rural areas,” said Mukkamala, whose parents came to
the U.S. as international medical graduates. “The people that do
graduate from here, who want to practice medicine, obviously have a
choice and they’re going to pick Detroit, they’re going to pick
Chicago, New York, Los Angeles, San Francisco. ... This is kind of
where everybody goes.”
Leading medical societies have called on the Trump administration
and lawmakers to grant exemptions from the fee to immigrant health
care workers.
“Given the staffing and financial challenges our hospitals are
already facing, the increased petition fees outlined in the
September 19 Proclamation would likely prevent many of them from
continuing to recruit essential health care staff and could force a
reduction in the services they are able to provide,” the American
Hospital Association said in a statement.
Allison Roberts, vice president of human resources at Prairie Lakes
Healthcare System in Watertown, South Dakota, said the change could
be dire for health care in rural America.
“If we end up not being exempt, the variation between what it is now
and that $100,000 fee is going to really take your smaller, rural
health care institutions out of the picture,” she said.
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