As we approach the presidential election next month, Congress has wrapped up its session and all legislative initiatives have effectively ended. It is possible that Congress will have a “lame duck” session after the election, but the odds are very likely that the new Congress that will be sworn in next year will have to start over again.

And they’ll have a lot of work to do when it comes to health care immigration. Virtually nothing was accomplished this year by Congress. We saw an extension of the Conrad 30 J-1 program until March 6, 2009 and an expansion of J-1 flex slots from 5 to 10 per state. The H-1B cap was not addressed. The severe visa situation for nurses was ignored. Needed physician immigration reforms were left unaddressed.

Fortunately, the situation looks a little more promising for 2009. We will have a sympathetic President no matter which of the two candidates wins. And Democrats will likely make huge gains in Congress. The Democrats have traditionally been the more pro-immigration party and Democrats on the immigration subcommittees in each house of Congress are viewed as in favor of both family and business immigration. There are some exceptions, of course, but the environment should be better.

There is also likely to be a push for more extensive immigration reform, particularly addressing illegal immigration and it is quite possible that legal immigration measures helping health care professionals will be included.

So while it has been a rough year and while there is great uncertainty due to the economic crisis, I am optimistic when it comes to the prospects for health care immigration in 2009.

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