The PROTECT Act of 2026 makes significant changes to how companies can hire foreign workers through the H-1B visa program. Right now, companies can bring in skilled workers from other countries when they claim they can't find Americans to do the job. This bill tightens those rules and makes the program more expensive for most employers, but creates an important exception for healthcare workers.

The main changes affect wages and where workers can be placed. Companies must now pay H-1B workers at least $100,000 per year (adjusted for inflation each year), or whatever they paid an American worker doing the same job in the past two years—whichever is higher. If a company wants to send an H-1B worker to work at a client's office (called a third-party worksite), the visa is only valid for one year instead of the usual longer period, and the work assignment must be clearly defined and expected to last the full employment period. When the government reviews H-1B applications, it will approve those offering higher pay first, regardless of when the application was submitted.

Healthcare workers—including doctors, nurses, therapists, pharmacists, and other direct patient care professionals—get special treatment. They're exempt from certain visa fees and surcharges that other H-1B workers must pay. However, employers still need to prove they made a genuine effort to hire American workers first and couldn't find qualified candidates. The Department of Homeland Security will set up rules for how companies must document their recruitment efforts.