The Trump administration has unveiled a controversial proposal that introduces a new $70,000 fee for foreign students holding an F-1 visa seeking to participate in Optional Practical Training (OPT). This proposal, announced on October 7, 2026, by the Department of Homeland Security (DHS), aims to impose financial barriers on hiring foreign-born skilled workers in the U.S. healthcare sector.
The regulations will primarily affect hospitals and health systems that rely heavily on international graduates, including crucial personnel such as nurses, physicians, pharmacists, and other healthcare professionals. As noted by the American Hospital Association, this proposed fee structure could significantly constrict access to the healthcare workforce, given that OPT is often a vital pathway for these individuals.
The proposed rules also stipulate that any initial OPT recommendation from a student’s educational institution would be paired with this hefty fee. For students seeking to extend their OPT status specifically in science, technology, engineering, or mathematics (STEM) fields, an additional charge of $30,000 would apply for further extensions.
According to DHS, the rationale for this fee structure centers around improving opportunities for American workers and addressing what the department describes as “fraud and abuse” within the OPT program. DHS spokespersons emphasize that the changes are part of broader measures aligning with President Trump’s executive orders aimed at tightening immigration controls. They claim that OPT was not intended as a “back door” into the U.S. workforce or a means to subsidize low-cost labor.
Experts in business immigration, including Brian Bumgardner, have expressed deep concerns about the effects of this fee on the enrollment of international students. Bumgardner noted that many prospective graduate students may find the new financial barrier discouraging. "I do not foresee that the majority of foreign students who are considering their options... would be open to navigating this new proposed fee before they are authorized to work once they have completed their degree programs," he stated.
Though the schools will initially bear the costs of the proposed fees, they are allowed to shift that financial burden to students and potential employers. However, it is uncertain whether employers will be willing to absorb these costs for recent graduates, who typically require significant training and have not yet built a work history.
DHS is currently inviting public comments regarding this proposed rule until November 9, 2026. It's essential to note that the $70,000 fee would not be applicable to students who have already been approved for OPT or those who received recommendations before the effective implementation of this rule.
Bumgardner also highlighted potential implications for healthcare employers related to delays in candidate approval processes and increased scrutiny when schools determine whether to recommend students. This proposal stands in a series of policy shifts by the Trump administration aimed at limiting foreign worker participation in various sectors, especially amidst ongoing labor shortages for healthcare providers.
The proposed fees add to previous regulatory changes, such as a newly introduced $100,000 supplemental fee for H-1B petition applications aimed at specialized workers, which was subsequently vacated by federal courts earlier this year. Additional regulatory changes have included extending the proposed duration limits for nonimmigrant students, which was also recently blocked.
The Department of Labor has initiated steps to raise wage requirements for H-1B and other visa programs, posing additional challenges for healthcare providers seeking to attract foreign talent. Groups representing healthcare providers continue to express concerns over these evolving policies, advocating for exemptions given the critical workforce shortages faced by the industry.
In summary, the $70,000 fee proposal represents yet another significant regulatory barrier that could shape the future landscape of healthcare employment and international student recruitment in the United States, posing challenges amidst an already strained healthcare system.
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