H-1B Visa ‘Elimination’ Bill: Here’s what can change for foreign workers in America

What would Greene’s Bill actually change?

Greene’s proposed Bill would eliminate the H-1B visa program, which she claims, in a video posted on X, “has been riddled with fraud and abuse and has been displacing American workers for decades.”

However, there’s a narrow exception: the proposed Bill would allow up to 10,000 visas annually for doctors and nurses providing life-saving care to Americans. But even this exemption isn’t permanent; it would be phased out over 10 years to allow time to develop what Greene calls “our own pipeline of American doctors and physicians.”

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Blocking the path to citizenship

Currently, H-1B workers can apply for permanent residency through their employers and eventually pursue US citizenship. Greene’s proposed Bill would sever this connection entirely.

The legislation would “take away the pathway to citizenship, forcing visa holders to return home when their visa expires.”

This represents a return to the original concept of temporary work visas, where workers would come, provide specialised skills, and then leave.

What’s the rationale? Greene argues these visas were intended to address speciality occupational needs at specific times, not to provide a permanent immigration pathway. “People should not be allowed to come and live here forever,” she states.

What it says about medical education in the US

Perhaps the most controversial provision targets medical education. The proposed Bill would prohibit Medicare-funded residency programs from admitting non-citizen medical students.

Greene points to stark numbers to justify this: Last year alone, over 9,000 American medical school graduates couldn’t secure residency placements, while in 2023, more than 5,000 foreign-born doctors received residency spots, she claims in the video.

But here’s where it gets complicated: how would this interact with the temporary medical exemption allowing 10,000 doctor and nurse visas? The proposed Bill would essentially create a two-tier system, where foreign doctors could work temporarily but couldn’t train in American residency programs.

Changes Trump administration announced in 2025

Greene’s proposed Bill comes at a time when the immigration landscape in the US is already facing dramatic action under the Trump administration. Earlier this year, in September 2025, President Trump signed a proclamation imposing a $1,00,000 application fee for new H-1B visa petitions filed after September 21, 2025.

Who’s hit hardest? The biggest tech companies and top banks in the US have been hit particularly hard, with Amazon reportedly sponsoring over 10,000 H-1B workers in fiscal year 2025, followed by Microsoft, Meta, Apple, Google, JPMorgan Chase, and Walmart.

Overhaul of the lottery system

The administration also proposed changing the H-1B lottery selection process to favour higher-skilled and better-paid workers by creating wage tiers, with workers in the highest wage category being entered into the selection pool four times compared to once for the lowest category.

The $1,00,000 fee created immediate chaos. In the aftermath of the fee announcement, families were separated as H-1B visa holders scrambled to reach the United States before the fee went into effect, fearing they would be locked out of the country.

Though the White House later clarified the fee wouldn’t apply to existing visa holders, the confusion had already caused panic, with some workers cancelling plans to visit their home countries, believing even a vacation was too risky.

What makes Greene’s Bill different?

The Trump administration’s approach, while aggressive, maintains the H-1B program in modified form. The $1,00,000 fee and wage-tier lottery system do not eliminate the program – they try to reshape it, making it accessible primarily to employers hiring truly high-skilled, high-paid workers.

Greene’s Bill takes a fundamentally different approach: complete elimination (with the temporary medical exception).

Her rationale centres on an “America First” philosophy that views the program as inherently flawed rather than in need of correction. “It’s time to put American citizens first instead of foreigners first,” she argues, adding that “Americans deserve a future. They deserve a chance.”

Is the medical exemption sustainable?

The 10-year phase-out of the medical exemption reveals the Bill’s ultimate goal: complete self-sufficiency. But is this realistic?

The United States already faces a significant physician shortage, particularly in rural and underserved areas. Greene claims her Bill would “help mitigate the shortage of doctors and nurses in our country,” serving as an “off-ramp from our reliance on foreign workers.”

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But critics might ask: if 9,000 American medical graduates couldn’t find residency spots, isn’t the bottleneck in training capacity rather than visa availability? And if so, would eliminating H-1B visas for doctors actually solve the problem, or would it simply create a decade-long medical crisis while the “pipeline” Greene envisions is being built?

What happens next?

Over 70 per cent of H-1B visa holders are Indian citizens, and India’s Ministry of External Affairs has warned that the Trump administration’s measures will have “humanitarian consequences by way of the disruption caused for families.”

Greene’s proposed Bill faces an uncertain future in Congress. While it represents the most aggressive approach to H-1B reform, if tabled, it would need to navigate committee hearings, floor votes, and potential presidential consideration.

Meanwhile, the Trump administration’s $1,00,000 fee and lottery reforms are already in effect or moving forward, though they face legal challenges. A coalition of labour unions, healthcare providers, educational institutes, and religious organisations has filed suit against the administration over the constitutionality of the fee order, arguing that the president lacks authority to unilaterally change a system created by Congress.