Colorado hospitals recruit foreign workers for hard-to-fill jobs. That won’t be an option with Trump’s new $100,000 fee. ...Middle East

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In a tight health care labor market, sponsoring foreign workers helped Community Hospital in Grand Junction to hire enough nurses to avoid burning its people out. But it may not have that option as the federal fee increases to $100,000 per worker.

The hospital sponsored 13 people under the H-1B visa program, according to the most recent data from U.S. Citizenship and Immigration Services. Most are nurses, primarily from the Philippines, though the hospital also employs three doctors and a registered dietician under the program, said Amy Jordan, chief human resources officer. About 20 more people are in the queue for visa sponsorship.

The H-1B visa allows American employers to hire foreign workers with at least a bachelor’s degree, typically when they can’t find U.S.-based applicants. The program requires the employer to pay the “prevailing wage” for the job category, though critics argue it limits incentives to offer higher pay to attract American workers.

In September, the Trump administration announced it would increase the application fee, which varies by the employer’s sector and the applicant’s country, to $100,000. Its policy allows the Department of Homeland Security to make exceptions when no American workers are available to take a job and leaving it unfilled would harm national interests, though employers are still sorting out what that might mean in practice.

Typically, a lottery of applicants takes place in March to determine who gets visas, which the federal government limits to 65,000 people with at least a bachelor’s degree and 20,000 with at least a master’s. Both employer groups and states have filed lawsuits challenging the policy, so courts could pause the fee increase.

In the first case, a federal judge in the District of Columbia ruled for the government, finding Congress gave the executive branch broad discretion in regulating who can enter the country and under what circumstances. The U.S. Chamber of Commerce, which filed the suit alongside a group representing universities, said it intends to appeal.

Over the decade that Community Hospital has sponsored visas, the fees have averaged out to a few hundred dollars per applicant, CEO Chris Thomas said.

Altogether, though, it costs the hospital $15,000 to $20,000 per worker because of the need to hire immigration lawyers and other related costs — comparable to the signing bonuses and moving allowance needed to recruit a domestic worker, he said.

Right now, the math works out because having more people on staff reduces the need to pay overtime or to hire expensive temporary workers, while preventing turnover because nurses aren’t overworked, Thomas said.

But it wouldn’t make sense if the hospital had to pay $100,000 for every sponsored employee on top of the other recruiting costs, he said.

“If they put a $100,000 fee on this, this program is dead at Community Hospital,” he said. “We’d be going from $20,000 to $120,000.”

Colorado Attorney General Phil Weiser sued to block the administration from increasing the fee, alleging the move was contrary to Congress’ intent and that officials skipped necessary processes in making the change. Nineteen other Democratic-led states also filed suit.

The increased fee will apply to new applicants who aren’t currently living in the United States, meaning that employers don’t have to pay it when they hire someone already here on a visa to study or work for a different company.

The federal data showed health care workers make up a sliver of visa holders in Colorado, accounting for 91 out of 2,765 sponsored people in 2025. The largest share of sponsored workers fell into the umbrella “professional, scientific and technical services” category.

Out of 47 companies listed as in the health sector with reported H-1B employees, all but four had fewer than five people sponsored.

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The exceptions were Community Hospital; UCHealth, with nine; CommonSpirit Health, with eight working in its Colorado locations; and DaVita, with six in the state.

H-1B employees constitute a tiny fraction of the roughly 37,000 people working across UCHealth, spokesman Dan Weaver said. The system sponsors employees for particularly hard-to-fill jobs, such as some laboratory positions, he said.

CommonSpirit said its records showed only two H-1B employees. DaVita didn’t respond to questions about its sponsored employees or whether it would continue to recruit overseas with a $100,000 fee.

H-1B workers are a minority of Community Hospital’s 1,400 employees, and hiring them doesn’t replace other recruiting strategies, such as partnerships with nursing schools, Thomas said.

But hospitals need to use all options to serve patients while keeping workloads sustainable, he said.

“This is another tool for Amy (Jordan) and the HR department to keep us staffed,” he said.

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