As the debate over the spending bill raged over the past few weeks, culminating in a federal government shutdown, two separate announcements from the Trump administration may have flown under the radar, but they are now reverberating through the health care industry. One centered around a dramatic increase in H-1B visa fees, and the other commemorated the launch of a new prescription drug pricing platform, TrumpRx.com.
While both initiatives are framed as efforts to protect American jobs and reduce consumer costs, health care leaders warn they could have unintended consequences for patient care and access.
President Trump's recent declaration that there will be a $100,000 fee for applying for an H-1B visa has drawn criticism from some medical experts and professional societies.
The H-1B visa program has long served as an important pipeline for foreign-trained medical professionals, especially in underserved rural areas where physician shortages are most acute.
Health systems such as Mayo Clinic and St. Jude Children's Research Hospital are among the most frequent users of the H-1B program. These institutions rely on international medical graduates to fill critical roles, especially in specialties and geographic regions where there is a shortage of domestic health care providers.
In the past year, about 17,000 H-1B visas have been issued to medical professionals such as surgeons and new medical school graduates. Additionally, a recent study found that 64 percent of foreign-trained health care providers practice in underserved and rural areas, highlighting the program's importance in addressing health disparities.
The American Medical Association (AMA) and other medical groups have called on the government to exempt health care workers from fee hikes, saying the new costs could discourage hospitals from sponsoring international doctors, worsen current staffing shortages and jeopardize patient care.
Last week, in a separate move, the Trump administration announced TrumpRx.com, a new platform aimed at giving consumers access to low-cost prescription drugs.
Although this announcement generated interest, there are many questions about what this platform will actually do, how it will work, and whether its goals are achievable. For example, it is unclear which drugs will be available through TrumpRx.com or whether consumers will be able to pay for them using insurance.
The administration has positioned the platform as an alternative to traditional pharmacy pricing, allowing consumers to bypass insurance and pharmacy benefit managers (PBMs) and buy drugs directly from manufacturers, but some health care analysts say its impact could be limited without transparency and the ability to work smoothly with existing payer systems.
Initial reaction from industry insiders was mixed. Some see the platform as a step towards increased price competition. Some worry that it could actually slow progress towards more meaningful solutions to the larger prescription drug pricing problem.
Both the H1-B visa and TrumpRx efforts highlight the Trump administration's broader approach to health care policy, which continues to emphasize cost reduction and reliance on the American workforce.
Prior to and during the government shutdown, the government was not shut down at all. We are launching initiatives that could impact the healthcare industry for years to come.
So stay tuned as these policies take shape. Stakeholders across the health care industry will assess the impact not only on budgets but also on the quality and accessibility of care for millions of Americans.
