H-1B Fee Exemption: Who Lobbied Congress in Q3 2026

Doctors’ groups and hospitals used their latest federal lobbying reports to press Congress and DHS for an H-1B fee exemption, while universities and industry groups reported lobbying on the same visa, disclosures filed with Congress show. The reports, which cover July through September 2026 and were due Oct. 20, list both the $100,000 H-1B payment and a separate proposed $103,265 fee among the issues lobbied, and several medical organizations ask outright for health care workers to be carved out.

Courts in Massachusetts and California have stopped collection of the $100,000 payment created by President Trump’s Sept. 19, 2025 proclamation, and the government is appealing both rulings. A third challenge, in which a Washington, D.C., judge upheld the fee, is before the D.C. Circuit on the U.S. Chamber of Commerce’s appeal, putting the payment before three federal appeals courts.

The volume of activity has stayed high since the proclamation. A search of the Senate’s Lobbying Disclosure Act database for reports that mention “H-1B” in their lobbying issues returns 70 results for the third quarter of 2026, against 44 for the same quarter of 2025, the period in which the proclamation was signed. That is about 59 percent more, a calculation from the database results. The count has stayed between 70 and 78 for four straight quarters.

Lobbying report period	Results mentioning “H-1B”
Q3 2025 (July-Sept. 2025)	44
Q4 2025 (Oct.-Dec. 2025)	74
Q1 2026 (Jan.-March 2026)	78
Q2 2026 (April-June 2026)	74
Q3 2026 (July-Sept. 2026)	70

Source: Senate Lobbying Disclosure Act database (lda.gov), search of specific lobbying issues for “H-1B,” by report period, run Oct. 27, 2026. Results include amended reports, so one organization can appear more than once. The Q3 2026 figure may change as late or amended reports arrive.

What the H-1B fee exemption requests actually say

Medical groups are the most specific. The American Society of Anesthesiologists listed an “Exemption for Physicians from New H-1B Visa Policy and $100,000 Fee.” The American Psychiatric Association reported a letter to the DHS secretary seeking a physician exemption. The Medical Group Management Association, which represents physician practices, went further, asking that all health care workers be exempted from the proposed $103,265 fee. The Mount Sinai Hospital in New York and the American College of Physicians both cited H.R. 7961, the H-1Bs for Physicians and the Healthcare Workforce Act.

That bill, introduced March 17 by Rep. Mike Lawler (R-N.Y.) with Reps. Sanford Bishop (D-Ga.), María Elvira Salazar (R-Fla.) and Yvette Clarke (D-N.Y.), would exempt anyone employed or offered a job in the “health care workforce,” as the Affordable Care Act defines it, and cap their fees at the ordinary statutory level. Despite its title, it reaches well beyond physicians. It sits in the House Judiciary Committee, and like every bill it dies if Congress does not pass it before the current session ends in January 2027.

Universities framed their requests more broadly. Columbia University’s own report lists “H1B Visa Fees” next to caps on graduate student loans, with $200,000 in total lobbying spending for the quarter across all issues. The University of Florida listed H-1B and Optional Practical Training issues even as the state’s university system has frozen new H-1B sponsorship at its public campuses until Jan. 5, 2027. Google, the semiconductor group SEMI and the Retail Industry Leaders Association also reported H-1B issues, as did the United Auto Workers, whose report does not state a position.

Why physician practices have more at stake in the DHS rule

The two fees do not fall on the same employers. DHS’s proposal, by its own terms, applies to cap-subject petitions, the ones that go through the annual lottery. Universities, their affiliated nonprofits and nonprofit or government research organizations are exempt from the cap under 8 U.S.C. 1184(g)(5), so as written the rule would miss most academic hiring. Physician groups and community hospitals with no university affiliation generally are cap-subject, and the Medical Group Management Association’s request, aimed squarely at the proposed rule, fits that pattern.

The practical effect is that the court cases and the rulemaking could leave different winners and losers. If the appeals courts end the proclamation payment for good but DHS finalizes its rule, the cost would move toward cap-subject employers, many of them outside academic medicine, in specialties that already lean heavily on foreign-trained doctors.

The next markers are a final DHS rule, rulings from the First, Ninth and D.C. Circuits, and fourth-quarter lobbying reports due Jan. 20, 2027, which will show whether the exemption push is gaining ground or fading as the Congress winds down. Employers already filing without the payment under the court orders are receiving some approvals, but that relief lasts only as long as the orders do.

This article is for general information and is not legal advice.

Sources

Vasanth Vaidyanathan, Esq.

Administrator

Vasanth Vaidyanathan is an immigration attorney with over 20 years of experience focused exclusively on U.S. immigration and nationality law. He holds a LL.M. from California Western School of Law, San Deigo and advises individuals and businesses on employment and family-based immigration matters, including H-1B, PERM, EB categories, and adjustment of status. He has also been a featured speaker at immigration seminars across the U.S. To reach Vasanth visit: https://www.vnathan.com/

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