Openers

Dear Readers:  

These are not the easiest times to advise clients on health care immigration matters. There are numerous crises happening simultaneously and little evidence Congress has the will to solve the problems.  

First we have a black out on nursing immigration that began early this year and continues with no immediate solution in site. Green card backlogs for nurses run several years and the lack of a non-immigrant visa means that very few nurses are now entering the country. The Senate passed a measure as part of a budget bill that would have temporarily resolved the issue by allocating 61,000 additional green cards for nurses. But the measure was stripped out of the final bill. The odds of a measure passing soon are probably no better than 50-50. In the mean time, patients around the US are facing a severe nursing shortage and the lack of foreign nurses is actually increasing mortality rates.  

On the doctor front, the news is only a little better. The doctors can still get to the US on J-1 and H-1B visas to train in residency and fellowship programs. But remaining in the US after those programs end is getting more challenging.  

First, those training on H-1Bs are finding that the massive demand for H-1B visas means the only opportunities available upon conclusion of their programs are at university hospitals or non-profit facilities associated with universities. Even work in a physician shortage area is not enough for many.  

For those on J-1s, the Conrad 30 waiver program expires in eight months and it is no sure bet that the program will be extended in the current political environment.  

The green card situation isn’t much better. The EB-2 category for India is backlogged several years. That group constitutes by far the largest number of immigrant doctors – near 30%.  

While foreign health care workers are relatively popular politically, the current poisoned atmosphere in the Capitol is a serious issue. In short, immigration is a radioactive issue and no one wants to push these bills even when they do not involve illegal immigration.  

In some ways, the popularity of these groups works against them. Last summer, separate immigration bills for doctors and nurses were not allowed to proceed on their own because they are considered "sweeteners" to get tougher measures on illegal immigration passed. And even though comprehensive reform is dead, some in Congress refuse to let those bills move unless action is taken on less popular measures like the DREAM Act for unauthorized immigrants who entered as children and AgJobs for unauthorized agricultural workers.  

Part of the problem is also the calendar. Right now, the legislative calendar is dominated by appropriations bills that must pass for the government to continue operating. Attempts at getting immigration bills added to these bills have not been successful despite repeated efforts. The measures must pass with 60 votes in the Senate and if any controversial measures pass, all of the less controversial items are potentially subject to being stripped out in order to avoid a fight.  

So for now, the measures may have to pass as standalone bills and they must find a place on the legislative calendar. And that may mean we have to wait until 2008.  

Hopefully, by the time our next newsletter is out, we’ll have something positive to report.  

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We remind readers that we do not charge employers and recruiters of health care employees for consultations and that policy extends to individual physicians as well. Please feel free to call our office at 901-682-6455 to arrange for an appointment with me or one of my colleagues.  

Kind regards, 

Greg Siskind

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