December 15, 2025: Expiring Marketplace Subsidies, H-1B Visa Fees & a Rural Childcare Success Story

Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital. News sources for this episode: American Hospital Association, “Dueling Senate bills to address health care affordability fail to pass,” December 11, 2025, https://www.aha.org/news/headline/2025-12-11-dueling-senate-bills-address-health-care-affordability-fail-pass. Chris Stein, “Senate rejects dual healthcare bills as Obamacare tax credits expiration nears,” December 11, 2025, https://www.theguardian.com/us-news/2025/dec/11/senate-vote-obamacare-tax-credit-bills, The Guardian. U.S. Department of Health and Human Services, “HHS’ Cleanup of Federal Nursing Home Minimum Staffing Standards Rule Expands Access to Rural and Tribal Health Care,” December 2, 2025, https://www.hhs.gov/press-room/hhs-cleanup-federal-nursing-home-minimum-staffing-standards-rule-expands-access-rural-tribal-health-care.html. Arielle Zionts and Phillip Reese, “Rural Health Providers Could be Collateral Damage from $100k Trump Visa Fee,” December 9, 2025, https://kffhealthnews.org/news/article/h1b-visa-fee-rural-hospitals-foreign-worker-shortages-north-dakota/, KFF Health News. Rick Pollack, “Exempting Health Care Personnel from H-1B Visa Fees Is Good for Patients and Providers,” October 17, 2025, https://www.aha.org/news/perspective/2025-10-17-exempting-health-care-personnel-h-1b-visa-fees-good-patients-and-providers, American Hospital Association. Federation of State Medical Boards, “Physician Licensure in 2024,” 2025, https://www.fsmb.org/u.s.-medical-regulatory-trends-and-actions/u.s.-medical-licensing-and-disciplinary-data/physician-licensure/. Scott Hulver et al., “What Role Do Immigrants Play in the Hospital Workforce?,” June 17, 2025, https://www.kff.org/racial-equity-and-health-policy/what-role-do-immigrants-play-in-the-hospital-workforce/, KFF Health News. Visas & Immigration Team, ”$100,000 H-1B Sponsorship Fee Hits Rural U.S. Hospitals Hard,” December 9, 2025, https://www.visahq.com/news/2025-12-08/us/100000-h-1b-sponsorship-fee-hits-rural-us-hospitals-hard/, Visa HQ. Rural Health Information Hub, “In Rural Communities, Where Child Care Is Often Scarce, Healthcare Organizations Are Finding Creative Ways to Help,” December 10, 2025, https://www.ruralhealthinfo.org/rural-monitor/child-care?utm_source=racupdate&utm_medium=email&utm_campaign=update121025. Rasheed Malik et al., “America’s Child Care Deserts in 2018,” December 6, 2018, https://www.americanprogress.org/article/americas-child-care-deserts-2018/, The Center for American Progress. Jazmin Orozco Rodriguez and KFF Health News, “Child Care Gaps in Rural America Threaten to Undercut Small Communities,” December 27, 2023, https://dailyyonder.com/child-care-gaps-in-rural-america-threaten-to-undercut-small-communities/2023/12/27/, The Daily Yonder. Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.