New Visa Rules Threaten Texas Healthcare Workforce Stability

Health care leaders in Texas are raising alarms over new visa regulations affecting skilled workers, which could exacerbate existing workforce shortages. In a directive issued in March 2025, Governor Greg Abbott instructed public universities and state agencies to halt the processing of new H-1B visa applications. This decision follows a significant increase in application fees by the previous administration, soaring from $5,000 to $100,000. Experts warn these changes may further strain Texas’ healthcare system and its economy.

Dr. Jayesh Shah, president of the Texas Medical Association, expressed concern but urged healthcare providers not to panic. “We are working directly with the governor’s office trying to provide a timely solution,” he stated. Shah emphasized the importance of patience as efforts continue to address the crisis. “We are kind of working for an amicable solution so that the physicians who are here don’t have to go anywhere.”

Understanding the H-1B Visa Program

The H-1B visa program allows U.S. employers to hire foreign workers in high-skilled positions, including physicians, researchers, and engineers. Organizations seeking to employ individuals on H-1B visas must demonstrate that there is a lack of qualified American workers for the job and that the foreign employee will receive a salary comparable to their U.S. counterparts. Each year, Congress allocates 85,000 H-1B visas through a lottery system. Texas is home to more than 10,000 H-1B visa holders, ranking second in the nation.

The Texas Hospital Association (THA) highlighted the ongoing challenges of workforce shortages in healthcare, particularly heightened by the COVID-19 pandemic. A spokesperson noted, “Hospitals have implemented new, innovative routes to fill slots that can’t otherwise be filled by U.S. workers, and visas are one piece of that overall strategy.”

Impact of the Visa Freeze on Healthcare

The freeze on new H-1B visas impacts both new applicants and those renewing their visas. Dr. Shah explained that the uncertainty surrounding the process may lead current physicians to seek employment outside Texas. “Maybe, it’s making a physician feel uneasy who is already here,” he said, noting that some are actively looking for positions in other states.

Governor Abbott’s freeze will remain in effect until the conclusion of the upcoming legislative session and is accompanied by a call to investigate potential abuses of the H-1B program. The THA expressed support for measures aimed at reducing such abuses, which they believe can ultimately connect patients to necessary care.

Challenges for Academic Institutions

The implications of these changes vary across different healthcare facilities. While the freeze affects public universities and state agencies, some private hospitals may still be able to apply for new H-1B visas. For instance, institutions like UT Southwestern Medical Center could face limitations due to their association with public universities.

Stephen Love, president and CEO of the Dallas-Fort Worth Hospital Council, emphasized the critical role that H-1B employees play in maintaining Texas’ stature in medicine and research. He noted that while current H-1B visa holders are not immediately impacted, those whose visas will expire before May 2027 may face challenges when reapplying.

Rural Hospitals at Risk

The changes will likely have a pronounced effect on smaller, rural hospitals, which often rely on foreign-trained physicians to fill gaps in staffing. Love pointed out that many foreign-born doctors serve low-income urban and rural clinics, alleviating physician shortages in underserved areas.

In March 2025, the Texas Legislature enacted the “Doctor Act,” designed to simplify the licensing process for foreign-trained physicians to practice in rural regions. Despite this progress, the new H-1B visa regulations could hinder efforts to attract necessary medical professionals to these critical areas.

The Center for Healthcare Quality and Payment Reform reports that Texas has 156 rural hospitals, with approximately one-third having “less than 10 days cash on hand.” This financial precariousness may prevent them from absorbing the increased application fees associated with the H-1B visa.

Urgent Call for Action

Dr. Shah emphasized the importance of maintaining access to healthcare in Texas and announced that the Texas Medical Association is advocating for a health care exemption to the new state and federal changes. The American Medical Association has similarly requested an exemption for physicians.

With a backlog already causing long wait times for some medical services, the new regulations could exacerbate existing issues. “I just want physicians to know that we are really putting a lot of effort here to make sure that there’s a continuity of care and the physician workforce is preserved in Texas,” Shah assured.

Stephen Love expressed caution regarding the potential impact of these changes on healthcare providers and the industry at large. He urged stakeholders to engage in discussions with state officials to address the challenges ahead. “Let’s wait and see how this plays out,” he stated, underscoring the need for collaboration in preserving the vital research, development, and expertise that Texas healthcare relies on.