A Legislative Threat to Patient Care and How to Fix It

The Fairness for High-Skilled Immigrants Act (H.R. 392) and the companion Senate bill (S. 281), which would amend the Immigration and Nationality Act by eliminating per-country caps for employment-based immigrant visas, aspires to a worthy goal: a more equitable immigration system.   But this proposal is neither fair nor farsighted, as it would inadvertently devastate access to health care in the United States by restricting the immigration and hiring of foreign-educated registered nurses

H.R. 392 would result in a catastrophic disruption of health care services in the United States.

Already, critical shortages for physicians, registered nurses, physical therapists, and occupational therapists exists in the United States. Based on current graduation and immigration trends, more than a third of the Bureau of Labor Statistics’ projected 1 million job openings for nurses will go unfilled by the year 2022. The U.S. Health Resources and Service Administration (HRSA) projects an even greater shortage, and this is during a period when the nationwide demand for care is rising rapidly.

As written, H.R. 392 would prioritize Indian nationals above all other green card applicants. But few nurses are Indian nationals, so as a practical matter this legislation would result in an immediate retrogression in the availability of foreign-educated nurses from countries like the Philippines, Kenya, Nigeria, Jamaica, and the United Kingdom.

America’s nursing crisis is felt most acutely in rural and underserved communities, including those battling the opioid epidemic. Any disruption in the flow of foreign-educated health care practitioners will only harm these populations by restricting their access to medical care.

There is a better way.

The Emergency Nursing Supply Relief Act (H.R. 3351) would thoughtfully mitigate the problems borne of the Fairness for High-Skilled Immigrants Act by specially apportioning employment-based immigration third preference category (EB-3) visas for nurses and other care professionals in critical need categories.

Immigration for healthcare professionals differs sharply from immigration by other sectors, like technology. Recruitment of foreign-educated healthcare professionals meet patient care needs in confirmed shortage occupations.

Because the immigrant visas set aside under H.R. 3351 have all been deemed so-called shortage occupations by the Department of Labor, there will be no adverse impact on US workers.

Congress must act to consolidate these proposals.

While H.R. 392 and H.R. 3351 have been moving independently of each other, there is no substantive or procedural reason why these two bills cannot be merged.

Americans’ access to health care will be severely restricted unless and until the Emergency Nursing Supply Relief Act is incorporated into the Fairness for High-Skilled Immigrants Act as a technical amendment.

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One Comment

  1. Here is my take on this Indian Trojan Horse. H.R.392 – Fairness for High-Skilled Immigrants Act of 2017 is being pushed by a certain Indian Advocacy Group (IV Immigration Voice) for Congressional approval before the end of year 2018.

    H.R.392 has a nicely disguised friendly title called “Fairness for High-Skilled Immigrants Act”. However make no mistake – this bill is designed to give a huge advantage to foreign temporary STEM IT workers from India and will strip deserving US citizens of their jobs. This bill encourages much faster processing of green cards to STEM and especially IT and medical visa workers from India and will encourage a huge inflow of these workers from India. The current green card backlog is now preventing these foreign workers from obtaining a green card and thus US Citizenship. Game Over for your IT or Medical job.

    Currently STEM and IT workers from India and China are in fair queue for Green Cards based on 7% per country per year limit. This 7% limit protects diversity of US population. The change in the law on this bill is designed to destroy the 7% per country limit per year for green cards. It basically allows an open door for many more foreign workers; especially Indians to join the US market as soon as possible. This is serious bad news for American medical workers losing more jobs.

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