It has always been true that hiring Indian people in India is cheap as hell, even compared to H1B, but there are a bunch of reasons not to do it.
1) wage inflation is typically double digits, and retention is terrible
2) communication is usually an issue, whether it's because of the time difference, language issues, not ever meeting face to face, or whatever.
3) having worked with off shore staff, they almost all actually just want to work long enough to transfer to the US (or did, before Trump)
4) they typically don't know a lot about American culture. This is a tricky thing to assess until you have seen it. I worked at a major bank that had offshore offices for some back office IT stuff. We had a lot of issues because they didn't really understand credit cards or how Americans used them. So they would often make assumptions that might be logical if you just read about credit cards but made no sense if you'd ever actually had one.
By combining the above, you lose a fair amount of efficiency and there's a fair amount of rework.