Doctors and physicians in the United States may soon find themselves exempt from the controversial new $100,000 H-1B visa fee announced by former US President Donald Trump. According to a Reuters report cited on Monday, exemptions may be offered on a “case-by-case basis if in the national interest,” with medical professionals among those likely to benefit.

Bloomberg reporter confirmed on X (formerly Twitter) that White House spokesperson Taylor Rogers acknowledged doctors could fall under the exemption category.

This news comes as a huge relief after Trump’s administration shocked professionals worldwide by unveiling the steep one-time fee for new H-1B visas—a move that immediately triggered panic, especially among Indian workers who make up the bulk of H-1B beneficiaries.

White House Clarification on the $100,000 H-1B Visa Fee

On September 21, the Trump administration clarified that the $100,000 visa fee applies only to new petitions, not existing visa holders. This announcement reassured thousands of professionals already living and working in the US under H-1B visas, many of whom had feared being forced into sudden, unaffordable expenses.

According to the US Citizenship and Immigration Services (USCIS), only petitions filed after the proclamation date—September 21—will attract the new fee. Importantly, H-1B visa holders currently outside the US will not be required to pay this fee to re-enter the country.

Despite this clarification, the hours immediately following Trump’s proclamation saw widespread panic among Indian workers. Many canceled flights at the last minute, while others already in India rushed to return to the US before the order took effect. Immigration attorneys and companies urged H-1B holders and their families abroad to return quickly to avoid being caught by the new rules.

What is the H-1B Visa?

The H-1B visa is a non-immigrant visa that allows US companies to employ foreign workers in specialty occupations requiring advanced technical or theoretical expertise.

• It is especially crucial for the technology sector, with firms like Google, Amazon, and Microsoft depending on it to hire skilled workers from countries such as India and China.

• The visas are valid for three years, with an option to renew for another three years.

• Each year, under a Congressional-mandated cap, the US issues 65,000 H-1B visas plus an additional 20,000 visas for individuals with US master’s or higher degrees.

• Current visa fees range between $2,000 and $5,000, depending on employer size and related costs.

For Indian IT professionals, the H-1B visa has long been a vital route to securing high-paying jobs in the US technology market.

The $100,000 H-1B Shockwave

On Friday, Trump signed a proclamation introducing the $100,000 H-1B visa fee, effective from September 21, 2025, and valid for 12 months unless extended. The order stated:

“The entry into the United States of aliens as nonimmigrants to perform services in a specialty occupation…is restricted, except for those aliens whose petitions are accompanied or supplemented by a payment of $100,000.”

The proclamation directed the Department of Homeland Security (DHS) and the Department of State (DOS) to deny entry to any H-1B worker if the fee is not paid.

Initially, even Commerce Secretary Howard Lutnick described the fee as annual. However, the White House later clarified it was a one-time levy beginning with the March 2026 H-1B lottery.

Still, uncertainty lingers. As Ajay Srivastava, founder of GTRI, said:

“The legal text will decide which is correct, but the signal is unmistakable: Washington is closing the H-1B route.”

Could This Hurt the US More Than India?

For decades, Indian IT firms have relied on H-1B visas to send engineers and consultants to the US, the world’s largest technology market. At first glance, Trump’s move looked like a direct blow to India’s outsourcing industry.

But industry experts believe the fee could actually benefit India’s $60 billion Global Capability Centre (GCC) industry by forcing companies to move more work offshore.

The $100,000 Barrier

According to Motilal Oswal Financial Services, major US tech firms like Amazon, Google, and Meta, along with IT multinationals such as Cognizant and Capgemini, accounted for 57% of all H-1B visas approved in FY24.

If the new fee applied retroactively, each of the top five US firms—averaging 5,700 visas annually since 2009—would face an extra half a billion dollars in costs each year.

Srivastava noted:

“The H-1B fee hike will hurt the US more than India… Faced with this massive fee, firms will accelerate offshoring, doing more work remotely from India.”

Indian IT companies already employ 50–80% local workers in the US, including nearly 100,000 Americans. That means the policy won’t create significantly more American jobs but will make H-1B hiring costlier than hiring US locals.

As Srivastava explained:

“An IT manager earns $120–150K in the US, 40% less on an H-1B and 80% less in India. That means fewer H-1B petitions, less local hiring, higher project costs for US clients and slower innovation, the opposite of what Washington wants.”

Bhaskar Rao, CEO of Digital Sea, told Bloomberg:

“If American companies cannot outsource onshore, they may look to expand their offshore presence in places like India, even with a possible fee hit.”

This makes the GCC model in India even more attractive.

The HIRE Act: Another Challenge for India

Parallel to the visa fee, Trump’s allies in the Senate introduced the Halting International Relocation of Employment (HIRE) bill, proposing a 25% tax on payments to foreign companies for services consumed in the US.

If passed, it could directly impact Indian software exports, a backbone of India’s IT services model.

However, Ganesh Natarajan, chairman of GTT Data Solutions & 5FWorld, dismissed the likelihood:

“I find it very unlikely that this bill can go through in its current format… the first point of resistance will come from American corporate subsets, because every significant corporation in the Fortune 500 has huge investments in India.”

India’s Global Capability Centres: The Silent Revolution

While the visa changes sparked anxiety, they also spotlighted a structural transformation in India’s IT industry: the rise of Global Capability Centres (GCCs).

• Today, India hosts over 1,800 GCCs, employing 1.9 million people.

• By 2030, this is projected to grow to 2.8 million jobs and revenues of $110 billion, up from $64.6 billion in FY24, reflecting a 14% CAGR.

Unlike traditional outsourcing, GCCs are wholly-owned arms of multinational firms, designed not just for cost-cutting but for innovation, R&D, and portfolio ownership.

Companies like Microsoft, Cisco, JPMorgan, Sanofi, and Carl Zeiss are expanding their Indian operations, with two-thirds of the Fortune Global 30 and 174 of the Fortune 500 already running GCCs in India.

As Srivastava said:

“India should seize this moment to transform its IT model, absorb returning talent into building domestic software, cloud and cybersecurity capacity, turning a US protectionist step into a long-term boost for India’s Digital Swaraj Mission.”

Beyond the Metros: Spreading the GCC Wave

Currently, nearly 95% of GCCs are located in six tier-1 cities: Bengaluru, Hyderabad, Pune, Gurugram, Chennai, and Mumbai.

To spread this growth, the Confederation of Indian Industry (CII) introduced a Model State Policy on GCCs, urging tier-2 and tier-3 cities such as Coimbatore, Indore, Bhubaneswar, and Jaipur to attract investment.

CII Director General Chandrajit Banerjee emphasized:

“The extraordinary rise of GCCs in India has been one of the most important developments in our economic journey over the past two decades. But to sustain leadership, states must step up with clear, competitive and innovation-oriented policies.”

By decentralizing growth, India can ensure high-value jobs spread more evenly, preventing talent migration from smaller cities to metros.

A Structural Shift in India’s IT Story

According to Emkay Global (June 2024), fewer than 5% of GCCs now operate as low-cost outposts. Most new centres jump straight to “Stage 3”—driving innovation and R&D.

Examples include:

• Microsoft’s Bengaluru GCC, which develops AI and cloud solutions.

• Goldman Sachs’ centres in Bengaluru and Hyderabad, managing engineering, consumer business, and global partnerships.

This is a sharp break from India’s outsourcing stereotype, positioning the country as a hub for innovation rather than back-office work.

Trump’s Policy: An Unintended Boost for India

The pandemic already accelerated remote work and distributed teams. With India’s 5.5 million IT professionals, companies naturally expanded their offshore presence.

Now, Trump’s H-1B clampdown may serve as the next catalyst. Instead of relocating engineers to California, companies could simply expand their Indian GCCs.

The $200 Billion Prize

According to CII, India’s GCC industry could surpass $200 billion in revenues by 2030, nearly triple its current levels. With Trump’s policies pushing companies to offshore more, that milestone may arrive sooner than expected.

As CII concluded:

“The time has come for India to move decisively from a few metropolitan GCC hubs to a pan-India network of knowledge centres. This will not only strengthen India’s position as the preferred global destination for GCCs but also ensure that the benefits of this sector touch every region of our country.”

The Bottom Line

Trump’s $100,000 visa fee may have been designed to keep jobs in the US, but its unintended consequence may be to accelerate India’s transformation into a global innovation powerhouse.

Instead of restricting opportunities, this move could redirect more high-value work to India’s Global Capability Centres, fueling jobs, innovation, and investment.

In a twist of irony, the policy that sought to curb foreign talent may just have handed India’s $60 billion IT industry its biggest growth opportunity yet.

With inputs from agencies

Image Source: Multiple agencies

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