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.