The U.S. H-1B visa for highly-skilled immigrant labor and the accompanying H-4 visa for their dependents leads to structural constraints that exclude dependents from the labor force. Identifying H-1B recipients from the U.S. Census and American Community Surveys, we find that—despite the labor force exclusion—the vast majority of married H-1B recipients is accompanied by their spouses. This is particularly the case for male H-1B recipients, making wives rather than husbands carry most of the burden. Using a matched sample of married immigrants with work authorization, we estimate counterfactual labor force participation probabilities and wages for the sample of dependent H-4 spouses. We find that the policy-imposed labor force exclusion of H-4 spouses leads to substantial losses of spouses’ earnings and annual aggregate productivity loss of over US$2.1 billion.