Doesn't it take an act of congress to make any serious headway here?
Personally, I was an H1B a 4.5 years before Trump convinced it was time to leave. I was in the bay area and handsomely overpaid. I have no personal experience of it being abused, but I'm obviously privileged, having worked at reputable tech companies and coming from reasonable wealthy european country. (I was never as scared of loosing job or healthcare as my American co-workers, because I would just move home, and have access to healthcare if I lost my job)
But I will say, that the lottery aspect of the H1B adds a lot of uncertainty that might discourage me from living in SF again. So lifting the caps and/or stemming abuse might be a good idea.