End H-1B Now Act

Summary

Phases out the H‑1B temporary skilled worker visa program by cutting the annual numerical cap gradually from FY2026 and setting the cap to zero after FY2035, and narrows who can qualify by removing fashion models from eligible occupations. Also stops Medicare from counting or paying for residency (GME) programs that train noncitizen "aliens" for cost reporting periods beginning on or after enactment, which will remove Medicare support for those programs immediately in the next applicable cost reporting period.

• Phases down the annual H‑1B visa cap from 10,000 in FY2026 to 1,000 in FY2035, then sets the cap to zero for all subsequent fiscal years.
• Removes fashion models from H‑1B(b) eligibility and deletes related 'distinguished merit and ability' and dual‑intent language for that category.
• Prevents Medicare from counting or paying for any GME residency program that trains noncitizen 'aliens' for cost reporting periods beginning on or after enactment.
• H‑1B changes begin FY2026 and fully eliminate new H‑1B numerical allocations after FY2035, creating a multi‑year phaseout.
• Medicare GME change takes effect immediately for the first applicable cost reporting period after enactment, producing near‑term funding shifts for affected residency programs.
• Employers, universities, and hospitals that rely on H‑1B hires or on Medicare‑funded residents could face staffing shortages and financial impacts.
• Implementation will require regulatory updates from USCIS, DHS, DOL, and CMS and could prompt litigation over statutory interpretation.
• The bill contains an insertion point in one immigration provision with no substantive text, creating potential ambiguity that may require clarification.