Half Of West Michigan H-1B Visa Holders Are Health Care Workers

West Michigan health care providers are panicking over President Trump's $ 100,000 H-1B visa fee.  Turns out they are heavily dependent upon H-1B visa holders.  Cheap, nonimmigrant foreign labor allows them suppress wages across the industry

The statement “Let’s be honest, our social security payments impact everybody.” towards the end of this story is a lie.  Most countries from which H-1B visa holders arrive have tax treaties with the United States, which relieve their citizens from paying U.S. income based taxes, including Social Security and Federal Insurance Contributions Act (FICA, Medicare) taxes.  Those H-1B visa holders not relieved by tax treaties are eligible for Social Security and Medicare on the same basis as U.S. citizen workers.  They can collect their benefits here, or back in the old country:

https://www.woodtv.com/news/grand-rapids/chilling-effect-west-michigan-employers-worried-by-changing-visa-guidelines/

https://www.uscis.gov/tools/reports-and-studies/immigration-and-citizenship-data

https://www.irs.gov/pub/irs-lbi/table-3-list-of-tax-treaties.pdf

‘Chilling effect:’ West Michigan employers worried by changing visa guidelines
By Katherine Wilkison - January 31, 2026

GRAND RAPIDS, Mich. (WOOD) — President Donald Trump’s administration hiked the cost of a program designed to bring highly-educated workers to the United States by tens of thousands of dollars, leading to uncertainty and chaos for the hundreds of thousands of visa holders already working in the country, including thousands in Michigan.

A Sept. 19 presidential order increased the cost of the H-1B — a temporary, nonimmigrant visa designed to bring people with “specialty occupations” to the U.S. — petition fee from an average of $2,000 to $5,000 depending on the size of an employer to a flat fee of $100,000 for most new applicants applying from outside the country.

“When the proclamation was first issued, much chaos ensued,” Grand Rapids-based immigration attorney Susan Im said. “Because of the ambiguity in the language and then the subsequent guidance that came out from the various agencies, some of it conflicting, there was so much confusion.”

Historically, H-1B visas have been awarded through a lottery system, with 65,000 new visas available per year for works of all education levels, plus an additional 20,000 visas for people with master’s or doctoral degrees. The new system set to launch Feb. 27 aims to “implement a weighted selection process that will increase the probability that H-1B visas are allocated to higher-skilled and higher-paid aliens,” U.S. Citizenship and Immigration spokesperson Matthew Tragesser said in a December 2025 statement.

In 2025, Ford Motor Company, General Motors, the University of Michigan, IT company Atos Syntel Inc. and automotive manufacturer FCA US LLC were the top recipients in Michigan, accounting for more than 2,500 new employees. A News 8 analysis of U.S. Citizenship and Immigration Services data found that 2,030 new, amended or continued H-1B visa petitions were approved for West Michigan workers in 2025.

While H-1B workers have long been seen as the lifeblood of tech companies in Silicon Valley, proponents say they also serve as a vital source of health care workers and educators in rural and underserved communities.

VISA HOLDERS IN WEST MICHIGAN: DOCTORS AND EDUCATORS

In West Michigan, nearly half of the 2,030 employees who filed for a new, amended or renewed H-1B visas in 2025 work in health care. Physical and occupational therapists make up the greatest numbers, 449 and 440 respectively.

Pine Rest Christian Mental Health Services Chief Operating Officer Bob Nykamp estimates that the metro Grand Rapids-based provider employs six to 10 H-1B visa holders at any given time. These employees largely fill subspecialty positions that he says Pine Rest would otherwise struggle to fill.

“We use the visa system to find world-class clinicians that really is the bar that we’ve set. So now they may be in another country, but they could have received all of their medical education and specialized medical education in the United States, so we are looking at the cream of the crop,” Nykamp explained. “We have identified subspecialty physicians who bring unique skill sets to West Michigan and to our patient population that we’ve needed, or our community needed.”

While noncitizens who are educated in the U.S. can apply for a change of visa status while still in the country, which would allow them to bypass the fee, if they return to their home countries, they become ineligible for that waiver.

Nykamp said he worries about how the $100,000 fee will affect the next hiring cycle.

“If there’s $100,000 fee attached to any position, whether that’s physician or nonphysician specialist, we’re going to have to take a really hard look at: can we afford that? Because we’re also trying to be economical and not have huge inflationary costs to the patients that we serve,” he explained.

While many of the region’s H-1B health care workers are based in Kent County — about 376 — many more work in more rural counties that often struggle to attract medical staff, including Barry, Berrien and Muskegon counties.

An analysis by the Michigan Health Endowment Fund found that nearly all health care roles are expected to see shortages within the next 10 years. At the same time, 65 of Michigan’s 83 counties are considered “Primary Care Health Professional Shortage Areas.”

Nykamp sees the changes to the H-1B process as a further threat to communities that struggle with a lack of access to health care, as well as those who require highly specialized care.

“It could reduce access to care,” he said. “If we don’t have certain subspecialty physicians, we might not be able to implement a new program that we want to implement. That’s a gap in care in our community. So that means patients are going to either have to travel farther or wait longer to receive that specialized care.”

Many in the education field share Nykamp’s concerns. Changes to the H-1B process are coming as many Michigan school districts are struggling to keep teachers in classrooms and fill open positions. Hundreds of districts across the country, particularly in rural areas, have turned to foreign-born teachers amid hiring shortages. The National Education Association found that public K-12 districts employed over 2,300 H-1B visa holders in 2025.

Nearly every college in West Michigan employs at least one H-1B worker, as do multiple public school districts. In 2025, at least 82 educators were employed in West Michigan under H-1B visas, primarily at the postsecondary level, though at least 20 were employed at elementary schools and six at middle schools, according to USCIS data.

At least one district that currently employs an H-1B visa holder told News 8 it would be “cautious” about future hiring due to the fees.

INTERNATIONAL COMPETITION

Many visa holders reacted to the news of Trump’s executive order and the new fee with anxiety and concern. Foreign-born students who come to the U.S. to study on F-1 student visas often hope to amend that visa into a longer-term visa, like an H-1B, after graduation. That path now seems less certain even if the $100,000 fee does not necessarily apply to them.

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Charles Elwood works in the artificial intelligence and technology fields in Holland, where he has struggled to attract and maintain qualified workers. Recently, he lost a University of Pittsburgh-educated protégé who chose to return to his home country amid what the intern called rising anti-immigrant sentiment and visa uncertainties.

“It was so disheartening to watch him go through this. Because you could tell he had the American dream. He wanted to stay here, he wanted to learn, and he wanted to do AI. He was so interested, and … to kind of watch that switch where he kind of gave up,” Elwood said. “Just to watch it all vanish … that one hit me hard. To watch somebody’s young dreams kind of just change.”

More than 85% of H-1B visa holders come from Asian countries, with the greatest numbers coming from India and China. Elwood, who is a dual Thai-U.S. citizen, said that he has seen some countries in Southeast Asia making a push to bring their American-educated citizens home to work amid visa uncertainties.

“If we lose all these people, if they come and they go to school at GVSU and they get a data science and an AI degree, and then they feel like they don’t belong and they don’t see representation and they leave, I mean, that concerns me. Five years down the road, what does that do for our region?” Elwood said about highly-trained immigrants from Asian countries.

Im, the immigration attorney, said many employers she works with agree that limiting the H-1B program will affect their ability to grow and innovate.

“I can’t emphasize enough also the number of employers that have expressed to me how this proclamation is going to stifle their growth, their innovation. And they know this because they have seen the benefits of hiring international talent in the past. And they have those folks on board right now, actively contributing,” Im said. “I feel that the downsides of this presidential proclamation and the $100,000 fee and the chilling effect is pretty devastating.”

FEDERAL SKEPTICISM

Trump’s suspicion of the H-1B program has been longstanding, stretching back to his first term, when he sought to tighten foreign worker visa requirements to “protect American workers.”

“For too long, this program has been misused as an inexpensive labor program, replacing American jobs in the process,” an October 2020 statement from the Trump White House website says.

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Im disagreed with that characterization. She said she has worked with companies across the country to bring international workers to the U.S. to fill specialized positions for which they say they could not find qualified Americans. While she acknowledged that there are unscrupulous businesses looking to subvert the system, she said most employers and visa holders are well-intentioned.

“Our West Michigan clients … they’re not relying on the H-1B program to fill their entire workforce. They are looking to supplement their workforce with H-1B workers where they can’t hire enough U.S. workers, enough qualified and willing U.S. workers to take that job,” she told News 8.

The Trump administration has also said that the program has been exploited by U.S. employers “who were primarily seeking to import foreign workers at lower wages than they would pay American workers.”

The federal H-1B data tracks pay both by annual salary and hourly wages. In the analysis, News 8 converted the hourly wages to an average yearly income for a direct comparison. That revealed that the median H-1B visa holder in West Michigan made over $75,900 in 2025. A 2025 state report found the median income for a Michigan worker with at least a bachelor’s degree and at least five years of experience to be $66,600 — 13% lower than among H-1B holders.

The highest paid H-1B workers in West Michigan are physicians, with the highest paid being an Advantage Health cardiologist making more than $580,000 per year. The lowest paid worker, according to the USCIS data, is a Cornerstone University assistant track and field coach making under $25,000. Of the 2,030 people who applied for a new, continued or amended H-1B visa in 2025, 67 made under $50,000 per year.

“The story we hear now is that immigrants are detractors and are takers of our economy, rather than contributors to our economy. We contribute to federal social programs,” Bing Goei, a Grand Rapids business owner and immigrant, said. “Let’s be honest, our social security payments impact everybody.”

Goei, who was born in Indonesia and moved to the U.S. at age 12, said he sees the administration’s rhetoric as dangerous — and economically unsound.

In 2021, immigrants in Kent County paid $318.8 million in federal taxes and $173.9 million in state and local taxes, according to the American Immigration Council. They also contributed more than $190 million to Social Security and $47 million to Medicare. H-1B visa holders are not eligible to receive Social Security or Medicare because they are not legal permanent residents.

Goei and his wife founded Eastern Floral, a flower shop and delivery business that operates across West Michigan. While he has since retired and passed the business to his daughter, he said he employed hundreds of people over his decades-long career.

“My story is not unusual in terms of what has been done with immigrants here in West Michigan,” Goei said. “There’s a lot of economic contributions that the immigrant population has contributed to the state of Michigan, as well as to Kent County and Ottawa County. … A significant number of immigrants are entrepreneurs and business owners.”

Everyone who spoke with News 8 said they worry what the outcome of reducing foreign-born workers in the U.S. may be and what may be lost if visa holders are forced to leave or never allowed in to begin with.

Im said she is concerned that American policymakers have lost sight of what H-1B workers and other immigrants contribute to local economies. She reflected on what some of her past clients have done since gaining permanent residence status or becoming citizens.

“(They are) successful business owners that have hired and employ dozens, sometimes hundreds, of U.S. workers. Because of their contribution, we have more jobs for U.S. workers. Because of their research, because of their brilliance, their innovations, their different perspectives, they are enriching our workforces. They are driving our innovation,” Im said.