Fred Hutchinson Cancer Center and the University of Washington's medical institutions have paused sponsoring H-1B foreign worker visas as the new $100,000 fee announced last month by President Donald Trump creates broad uncertainty among health care organizations across the state.
Fred Hutch spokesperson Claire Hudson confirmed the pause this week, attributing it to the rapidly changing federal situation around employer sponsorship of immigrant workers." The halt applies only to new potential hires, she said. The cancer center declined to make an official available for an interview.
Up until now, Fred Hutch has been one of the state's top health care employers of H-1B visa holders. Over the last five years, the world-renowned clinical and research institution has had 181 such visa applications approved, according to U.S. Citizenship and Immigration Services data.
The University of Washington halted H-1B petitions in all academic and medical arenas — including UW and Harborview medical centers — days after Trump's Sept. 19 announcement of the $100,000 fee. UW initially said the pause, which affects only new applications, would last until Oct. 8 as it sought clarity about how the new federal rules apply to higher education, then extended it until Oct. 15.
With only one day to go before the pause was due to end, university officials said Tuesday they didn't know whether it would be continued. "We have been looking through the cases that we have in the pipeline and trying to identify workarounds," said Ursula Owen, UW's international scholars operations manager.
The university has made job offers to about 20 people needing H-1B sponsorship, roughly three-quarters of whom would work for UW Medicine, according to Owen.
Federal figures don't separate UW Medicine's H-1B visa approvals from those of the university as a whole. Owen estimated at least half of the more than 300 UW employees with such visas currently work on the medical side, whether as clinicians or researchers.
In the state overall, federal figures show "health care and social assistance providers" had more than 2,200 H-1B visas approved in the last five years.
That number isn't huge compared to the tech sector. Microsoft, for instance, received about 5,200 in just the last fiscal year, ending in September. But the H-1B visa is nevertheless a "vital recruitment tool" for health care organizations, said Jacqueline Barton True, vice president of advocacy and rural health for the Washington State Hospital Association.
Since Trump's announcement of the new fee, "hospitals across the gamut — from small, rural to large urban systems — have expressed concern because they utilize these visas," Barton True added. She also noted the $100,000 charge, to be paid by employers, is untenable to many organizations strapped for funding amid state and federal cuts to Medicaid and reimbursement rates for public employees.
Heightening the alarm is a shortage of health care workers in Washington. The state is projected to have 6,000 fewer doctors than it needs by 2030, according to one estimate.
"If you've tried to get in to see your primary care doctor now, the wait times are really long and it's because we have a shortage," said Dr. Bridget Bush, president of the Washington Medical Association. "We don't have enough physicians to take care of everybody that's moving here, and that's across the entire state."
The H-1B program, created in 1990, allows companies to sponsor foreign workers in specialty occupations for visas that can generally be extended to up to six years. Employers need to prove a job has been hard to fill and are supposed to pay at least the average market wage.
Trump has said that's not happening. "American workers are being replaced with lower-paid foreign labor, creating an economic and national security threat to the nation," reads a White House fact sheet.
At the same time, the fact sheet says the administration will allow "case-by-case exemptions if in the national interest."
A coalition of academic, health care, labor and religious groups have filed a legal challenge in California to the H-1B shake-up.
"The H-1B visa program is a critical pathway to hiring educators and healthcare workers — two categories in high demand in the U.S. — who comprise 10% of all H-1B workers," the coalition's complaint says.
As the case proceeds, the American Medical Association and a dozens of other medical societies have written a letter urging the administration to make a blanket exemption for physicians. That has not so far been granted.
The Trump administration has not made clear its criteria for exemptions or the process for requesting one. When asked, a White House spokesperson offered no details beyond the fact sheet.
Absent further guidance, organizations are trying to read the tea leaves. UW's Owen said she has heard some universities are submitting material attesting to a national interest with visa petitions. That's an option UW is exploring, Owen said.
She said UW may also sponsor other types of visas in place of H-1B, such as the J-1 "exchange visitor" visa, often used for teaching, research and advanced professional training. The Trump administration has proposed modifying that program by setting a four-year cap on the length of visas but the change would not be as dramatic as with the H-1B program.
As it gathers information, UW has also heard that the administration is not requiring a $100,000 fee for some H-1B applications, specifically for foreign workers already in the U.S. who are applying for a change in status. That could be, for example, someone currently holding a visa allowing them to study or pursue advanced training.
"USCIS hasn't announced this clarification," Owen said, but that appears to be what the agency is doing.
John McReynolds, CEO of North Valley Hospital in the north-central Washington town on Tonasket, is hoping a physician exemption will come through. The H-1B visa, he said, "has been a helpful tool for us to get people to a rural area."
Canada offers a potential pool of doctors for North Valley since the border is only 30 minutes away, he said. A Canadian with an H-1B visa serves as the hospital's only general surgeon, and is an important addition to the facility's small staff, which has 10 doctors.
The hospital is in the process of recruiting a family practice physician, also a Canadian, who would need an H-1B visa. "Like all rural hospitals we're really struggling just to continue operations," he said, eyeing the $100,000 fee with trepidation.
Still, he said, the hospital will probably go through with hiring its newest recruit even if it has to pay the fee. "It would be more expensive to start the process over and get another recruiter involved," plus paying traveling doctors to fill in until someone is permanently hired, he said.
If no physician exemption comes through, he doubts North Valley could make the same kind of choice again. Referring to the fee, he said, "I think this will be a major deterrent.
Seattle Times staff reporter Alexandra Yoon-Hendricks contributed to this report.
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