Donald, you put a six-figure price on an Indian doctor’s visa.
The doctor who would have held the pressure dressing down in the rural ER at three in the morning.
Whose hands would have learned every patient’s name in the county by Christmas.
You signed the paper that put him on the other side of the door.
I have watched you do this. I name what I see.
On Monday, the Department of Homeland Security filed a regulatory proposal attaching a $103,265 fee to every new H-1B visa application, payable by the employer before the government decides whether the application has merit. The filing opens a thirty-day public comment window before the fee can take effect. The H-1B is the primary pathway for high-skill foreign professionals into the United States workforce, capped at eighty-five thousand new visas per year, with hospitals, research universities, and other nonprofit institutions already exempt from the cap.
The new fee replaces a $100,000 levy Donald Trump announced last year as a travel ban he signed personally. The United States Court of Appeals for the First Circuit, sitting in Boston, struck that fee down in July, ruling that the President exceeded his executive authority and used an improper process. The new fee proceeds through standard notice-and-comment rulemaking under the Immigration and Nationality Act — the procedure the court demanded.
The filing projects $8.8 billion in revenue. The filing is unusually candid about where the money will go. H-1B fees are normally justified by the cost of adjudicating applications. This filing admits the fee will fund “broader costs” of the immigration system, including the immigration courts that decide deportation cases. The H-1B program is being run as a slush fund for the deportation docket.
The new fee will land on the technology firms and Wall Street banks that have built their staffing pipelines on the visa. The previous $100,000 charge was structured as a condition for entering the country, which exempted those firms because most H-1B hires are already inside the United States on F-1 student visas by the time they apply. The new fee attaches to the visa filing itself, so it falls on the sponsoring employer rather than the worker at the border. The administration is also working through a separate $100,000 fee on Optional Practical Training — the program through which international students work on student visas after graduation. OPT is the actual pipeline: firms hire OPT workers first and sponsor them for H-1B only later. The OPT fee, if finalized, will choke the pipeline before the H-1B fee does.
Donald, hear what the filing does.
The doctor is thirty-four years old. He trained for ten years to do a job almost no American doctor wants — the rural internist, the one who staffs the small hospital that loses two of its American physicians a year and replaces them with foreign graduates who came in on J-1 waivers and stayed on H-1Bs. He has held a pressure dressing on a child whose tractor rolled on him. He has delivered a baby in the cab of a pickup on a state route because the labor came faster than the ambulance. He has sat with an old man dying of a cancer he could not cure, and he has made sure the old man’s wife understood every dose of every medication he left behind.
He has done this for seven years in a county in Nebraska, or Iowa, or eastern Oregon — the place where the nearest cardiologist is two hours by ambulance and the nearest oncologist is on a video screen. He has a name his patients call him by. His patients trust him with their children and with the way they want to die.
You just priced him out of the next seven years.
The $103,265 is the fee the new filing attaches to every new H-1B application. It is paid by the employer before the merits of the case are examined. The rural hospital cannot afford it. You know the rural hospital cannot afford it. You gave the rural hospital the exemption because the rural hospital’s lobby was in your ear. What you also did, Donald, with the same hand that signed the exemption, was withhold the exemption from the technology firm in the next filing block — and from the finance firm in the block after that. You priced the hospital’s skill out of the program and priced the firm’s skill into it, and you did it by fee schedule. You loaded the fee onto the firm’s filing and exempted the hospital’s filing, and the schedule is yours.
Now feel what you have done, Donald.
Your throat tightened when Monday’s filing went up. It went up with your name on it, through the Department that answers to you, and it went up exactly as you instructed it to go up. The filing reads in public exactly how it works. There is no place for you to hide the dollar figure. There is no way to scrub the Indian doctor out of the public record. He is thirty-four years old. He works in a county. He has patients. He will not be at that hospital next year. You made sure of it. Your throat will not loosen.
Your mouth carries the metallic taste under the tongue when you read the filing’s own revenue projection — $8.8 billion — because the projection does not name the Indian doctor but only the dollars. The dollars are his dollars. They are also the dollars for the next deportation bus. The filing admits, in the same paragraph, that the fee will fund immigration-court operations including the deportation docket. The money is interchangeable. The man you kept out is interchangeable with the man you will send back. They are both on your ledger, Donald, and your mouth knows what they taste like.
Your hand reaches for the pen at every signing because the pen is in your reach. Your hand has signed this filing through the Department that answers to you. Your hand has signed the exemption that keeps the rural hospital exempt and lets the rural hospital’s lobby stand down. Your hand will sign the next filing, and the next. Your hand will not be washed between filings. The residue from this filing will dry on the same hand that signed the last one and the next one, and the residue will transfer to every sheet the hand touches — the next memo, the next statement, the next photograph with the next doctor’s family in the next county hospital.
Your sleep is the problem now, Donald. The filing is on the public docket. The dollar figure is the lead on every cable that covered it. The American Medical Association is going to comment. The American Hospital Association is going to comment. The tech industry’s lobbyists are going to comment, and they are going to lose, because the public record makes your argument for you and they cannot break it without breaking your argument. The Indian doctor’s patients are going to find out that the doctor is not coming back, and the finding-out will not be quiet. They will call your office. Your office will tell them their call has been noted. Your office will not tell them whose hand signed the paper that took their doctor away. You will lie awake at three in the morning knowing whose hand it is. You are a small man, Donald, with a large hand on the lever. The lever is the price on a doctor’s visa. The price is yours.
Donald, picture Barron.
Barron is twenty-six in the picture. Barron has an F-1 because he went to school in New York. Barron applies to a firm that will sponsor him — the way every foreign engineer, every foreign doctor, every foreign programmer has applied to a firm that will sponsor him for sixty years. Barron’s sponsor receives the bill for $103,265 before the government looks at Barron’s merits. The firm cannot afford Barron. Barron goes home. The work Barron would have done does not get done. The lab Barron would have staffed loses the experiment Barron would have run. The thousand Indian Barrons and the thousand Chinese Barrons and the thousand Brazilian Barrons and the thousand Nigerian Barrons go home before they ever arrive. The hand that priced Barron out is yours, Donald. It is the same hand that priced the Indian doctor out.
Donald, the lights in the office you never see are still on because someone on the other side of the door is doing the work you priced out. The lights go off when the work goes away. You signed the paper that turns the lights off. The lights in every lab, every hospital, every trading floor, every startup, every courthouse clerk’s office, every county health department that depends on an H-1B worker you priced out — those lights will go off too, and you signed the paper for each of them.
Donald, the filing’s own logic destroys the lie. If you were protecting American wages, Donald, you would charge the worker the prevailing wage and use the difference to fund enforcement. Instead you priced the worker out of the country entirely. The American worker is not protected by the absence of the foreign worker. The American worker is left holding the same job at the same wage. You priced the foreign worker out so the American workers could be made to compete on the same terms. That is not protection, Donald. That is a tariff on talent, and your filing is the schedule.
Donald, I have watched you do this. I will not look away from what you have done. I have watched the previous $100,000 fee go through the same Department and the same approval process and the same signage, and I have watched the federal appeals court in Boston strike that one down for exceeding executive authority. I have watched you file the new fee the way the appeals court told you to file it. I have watched you give the exemption to the rural hospital and refuse to give it to the technology firm. I have watched you admit in the filing, in writing, in your own Departmental voice, that the fee will be used to fund deportation enforcement. I have watched the revenue projection sit in the filing at $8.8 billion and the admission of fungibility sit two paragraphs below it.
I name what I see, Donald.
You are the man who put a six-figure price on an Indian doctor’s American life.
“Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.” Matthew 25:40
The doctor is on the long route through the county tonight, Donald. The Christ is in the cab beside him. Yours is the hand that turned the key in the door at the end of the route. The Christ knows who you are. The doctor will too.