NBC News medical analyst Dr. Vin Gupta warned of the consequences that President Donald Trump’s imposed $100,000 annual visa fee for highly skilled foreign workers could have on those seeking health care in the U.S., especially those living in Republican states.

“This is going to have significant impacts, not just in the short term, but very much in the medium term here and that’s the irony of a lot of these policies, they’ll impact red states, and it’s not going to be felt immediately,” Gupta said in a Friday interview with MeidasTouch.

The president on Friday signed a proclamation imposing a $100,000 annual fee for H-1B visas meant for highly skilled foreign workers who fill difficult-to-hire jobs in the U.S., sometimes for a below-annual wage. Per Axios, the fee could be paid by either the visa holder or their corporate sponsor.

Prior to Friday’s proclamation, the average H-1B visa administrative fees totaled around $1,500, according to the BBC.

Gupta told MeidasTouch’s Ben Meiselas that “we need foreign medical graduates, across the spectrum, wherever they’re coming from, to care for an aging society.”