The Trump administration's Department of Homeland Security has proposed a steep $70,000 fee for schools recommending international students for Optional Practical Training (OPT) — a temporary work program for F-1 visa holders that must align with their field of study. An additional 24-month STEM extension would cost another $30,000. While schools would technically foot the bill, the rule allows costs to be passed on to students or employers.

The American Hospital Association flagged the proposal as a potential major disruption, noting that OPT is a key pipeline for international nurses, physicians, pharmacists, and other healthcare professionals. Immigration experts agree, predicting the fees would "chill" foreign student enrollment and deter employers from sponsoring new graduates — especially in a sector already stretched thin by labor shortages.

By the Numbers

• $70,000 — proposed fee per OPT school recommendation
• $30,000 — additional fee for a STEM 24-month extension
• $100,000 — previously proposed (and court-vacated) H-1B supplemental fee
• $103,265 — another pending H-1B petition fee proposal
• Nov. 9 — deadline for public comments on the proposed rule

Why it matters: Healthcare providers are already grappling with persistent workforce shortages, and international graduates have long helped fill critical gaps. If enacted, this fee could further narrow an already tight talent pipeline — with real consequences for patient care.