Last fall, President Donald Trump’s executive order raising the fee for H-1B visas to $100,000 — like many of his immigration policies — led to near-immediate chaos. Thousands of workers who had flown overseas to renew their visas ended up stranded abroad. Details about who would be affected only emerged after the fact. Six months later, the disorder from the initial announcement has mostly subsided. The H-1B registration season for the next fiscal year has just begun. With H-1B applications open until March 19th, it’s unclear what effect, if any, the new rules will have on hiring, immigration, and the workforce, but experts are warning the effects will reverberate far beyond the tech industry.

Trump’s transition team was divided between a nativist bloc led by longtime adviser Stephen Miller and the president’s powerful new tech allies, Elon Musk and Vivek Ramaswamy chief among them. These factions were split on the subject of H-1B visas, which let skilled foreign workers come to the US to fill specific jobs. The visa category is most commonly associated with Big Tech, and for good reason: Amazon, Meta, and Microsoft are the three biggest employers of H-1B workers. Musk’s ouster and the dissolution of his Department of Government Efficiency were the death knell for the tech-MAGA alliance, setting the stage for the H-1B fee hike.

But while H-1Bs might bring to mind lucrative software engineering jobs, the policy change has affected other industries more drastically. In fact, firms like Amazon can easily absorb the cost of the increased fees and have figured out workarounds to paying it. Instead, the H-1B fee increase is disproportionately affecting rural schools and hospitals already plagued by labor shortages. Put simply, Trump’s attempt to punish Big Tech is actually hurting underfunded schools and hospitals, many of them in deep-red rural districts that supported his candidacy.

There are two major changes: the fee hike, which generated the most attention, and a new prioritization system that favors high-earning applicants. Since there are more petitioners than there are open slots, H-1B visas are issued by lottery. But now, new applications will be weighted by income, and those with higher-paying jobs will have better odds of getting a visa. Applicants will now be divided into four wage levels: Those at Level 1 will be entered into the lottery one time, while those at Level 4 receive four entries. Immigration attorneys say that under this system, a tech worker earning a high salary would likely be prioritized over a teacher who earns less money. US Citizenship and Immigration Services, the federal agency that handles H-1B and other visa applications, did not respond to The Verge’s request for comment.

Margaret Stock, an Anchorage-based immigration lawyer, says the fee increase is already affecting public schools in her state. “We have a big labor shortage in Alaska,” she said, and that shortage extends to the school system. Stock represents several school districts that have hired foreign teachers on H-1B visas. The teachers, Stock said, are hired under union contracts that determine their salaries.

Partly because teachers are so hard to come by, Alaska is one of the highest-paying states for teachers. Some counties even offer signing bonuses and moving allowances. But these resources can only go so far. “The state doesn’t have the money to pay $100,000 per teacher for an H-1B worker,” Stock said. “It would be millions of dollars they’d be paying the federal government for teachers.”

Alaska has nearly 600 international teachers, 341 of whom are on H-1B visas, according to the Alaska Council of School Administrators. That’s a tiny percentage of the total H-1B workforce — per Pew, 400,000 applications were approved in 2024, the majority of which were renewals — but makes a huge difference in Alaska, the most sparsely populated US state. Alaska’s international teachers largely come from the Philippines, Ghana, and India — countries with large English-speaking populations. Last year, before the fee hike, the Nome, Bering Strait, and Kenai Peninsula school districts even organized a recruiting trip to the Philippines.

Stock said the fee increase won’t just affect prospective immigrants.

“Alaska is losing population, and one of the reasons we’re losing population is because people don’t want to live here when they can’t put their kids in a good school,” she said. “If the class sizes are too big, or there are no teachers, or there’s no activities, or there’s no healthcare, then people won’t want to live here. It’s not just an H-1B issue. There’s downstream effects on the whole economy.”

State and federal officials are hoping to receive exemptions for the fee increase. After the fee increase was announced, the administration clarified that the Department of Homeland Security will grant exceptions in “extraordinarily rare” circumstances where hiring foreign workers “is in the national interest,” and only when American workers aren’t available to fill those roles. Exemptions will only be granted in cases where the employer’s inability to pay “would significantly undermine the interests of the United States.”

The only way to apply for exemptions is via email, and Stock hasn’t heard of any being granted.

The fee hike also affects Alaska Native corporations, 13 regional companies across the state whose shareholders are Indigenous Alaskans. These companies, Stock said, often hire H-1B workers for specialized roles. “I know of an H-1B worker who’s working on hazardous waste management related to military bases in Alaska,” Stock said. “There are all kinds of workers: engineers, healthcare workers, doctors, teachers at the university and in public schools. In Alaska, most H-1B workers are not tech workers.”

Alaska isn’t the only state facing a dire labor shortage. Rural clinics across the country have increasingly relied on immigrant workers. Since the fee change was announced, some jobs have gone unfilled entirely. Last September, the National Rural Health Association and National Association of Rural Health Clinics asked the Trump administration to implement a “blanket exception for healthcare providers.” They didn’t hear back. (The National Rural Health Association did not respond to The Verge’s request for comment.)

Global Nurse Force, a nurse recruiting firm, sued the Trump administration over the fee hike last October. It’s one of three federal lawsuits that have been filed since the change went into effect.

In a February hearing in the Global Nurse Force case, government attorneys said about 70 employers have paid the fee so far. The low number of applicants, the administration claims, proves that the increase “is not a tax because it’s not raising revenue.” It could also signal that employers have figured out ways to get around paying the fee.

Fariba Faiz, an immigration attorney based in San Francisco, said the fee has changed companies’ hiring practices — but it hasn’t stopped them from hiring immigrant workers. “What we are seeing in practice is a shift in employer strategy rather than a complete abandonment of the H-1B program,” Faiz said.

The $100,000 fee only applies to first-time petitioners applying from outside the United States. Someone in the US on a student visa who applies for an H-1B, for example, wouldn’t be subject to the increased fee. This workaround means that some companies “are prioritizing cases that can be filed as stateside changes of status,” Faiz said, while others are hiring foreign workers remotely rather than bringing them into the country.

“The practical effect is that companies are adjusting hiring models to avoid the fee rather than eliminating the need for highly skilled workers,” Faiz said. “In many cases, the talent is still being hired, the job however is simply no longer located in the United States.”

Even with these workarounds, the Trump administration’s broader immigration policies have made some companies more hesitant to hire immigrant workers. Some employers don’t understand the new regulations.

“The questions that I’ve answered about the $100,000 tax, so to speak, have been endless,” said Matt Maiona, a Boston-based immigration attorney. Maiona said he often speaks to clients who don’t realize there are ways to get around the fee. “But it’s not necessarily the $100,000 that’s making companies not want to hire; it’s the environment, it’s the economy, and it’s the uncertainty of how their employees may or may not get into the country even if they’re doing everything right.”

Beyond going after so-called “criminal aliens,” the Trump administration is also cracking down on nearly all forms of legal immigration. The administration recently reduced the length of asylum seekers’ work permits to 18 months. Before the change, asylum seekers’ work authorizations lasted five years. The administration also announced last August that it’s reviewing the records of all visa holders — including those with H-1Bs — for any violations that could render them deportable. Since December, H-1B applicants have also been subject to enhanced vetting, and petitioners who have worked in content moderation may have their requests denied.

“The $100,000 is something you can get an answer on,” Maiona said. “You can call an immigration attorney and we’ll say, ‘We don’t really think you have anything to worry about. It looks fine, you’re in good shape.’ But the other things we can’t really promise. That’s really what’s driving a lot more of this. It’s that fear.”