Hospitals, Foreign Health-Care Workers Press Congress for Action

Bloomberg Law

November 19, 2021 5:30 am

The Covid-19 pandemic has fueled unprecedented demand for skilled health-care professionals—and the demand will only continue after the U.S. emerges from the pandemic.

Without training thousands of new American-born doctors and nurses, the clearest way to fill gaps in the health-care workforce is hiring talent from abroad, experts say.

Hospital groups have lobbied Congress for the past 18 months to address a shortage of nurses and physicians by offering green cards to tens of thousands of foreign health-care workers, among a number of proposed legislative options. While that legislation hasn’t advanced, industry groups and immigration advocates are eyeing a major social spending package backed by the White House to lower barriers for those international workers to come to the U.S.

Legislation (S. 1024) backed by more than 20 trade groups including the American Hospital Association and American Medical Association would designate 25,000 unused green cards for nurses and 15,000 for physicians. While a limited number of education exchange or high-skilled work visas are available for professionals like medical doctors, those short-term options aren’t available to nurses.

The bipartisan green card bill would also exempt dependent family members from counting toward green card limits. It hasn’t received committee consideration after being introduced with bipartisan support the past two years.

Advocates hoped the bill would move on its own or be attached to one of the pandemic relief packages passed last year, said Dan Kosten, assistant vice president of policy and advocacy at the National Immigration Forum.

“For some reason it did not and we’re a little mystified as to why,” he said.


Immigration advocates have targeted a major social spending package backed by President Joe Biden to advance pathways to permanent legal status for millions of immigrants in the U.S.

The Senate parliamentarian has ruled proposed legalization measures for undocumented immigrants don’t clear chamber rules for the reconciliation process, which Democrats plan to use to pass the White House spending plan. But green card recapture provisions, which would make thousands of expired visas available, are seen to have stronger prospects for inclusion. Recent versions of House reconciliation text have included language to restore unused green cards in addition to offering protections for undocumented immigrants short of legalization.

If passed, many of those green cards would likely benefit foreign medical workers, advocates say. That legislation wouldn’t address immediate challenges like bottlenecks at U.S. consulates slowing visa approvals for travel to the U.S., said Bruce Morrison, a former congressman and lobbyist for the American Hospital Association.

But Robyn Begley, CEO for the American Organization for Nursing Leadership, said the bill would “expedite the visa optimization process for highly trained nurses.”

Underemployed Workers

While healthcare groups pushed for green card fixes over the past 18 months, several states dropped barriers like licensure requirements that have kept foreign-educated workers on the sidelines. Eight states, including New Jersey and New York, enacted emergency orders during the pandemic to allow those healthcare workers to get off the sidelines, including issuing temporary medical licenses.

Most underemployed foreign health-care workers are women, with training in nursing and bilingual skills, making them highly valuable to in the health-care field, said Michael Fix, a senior fellow at the Migration Policy Institute.

Legislation (H.R. 4179) passed as an amendment to the National Defense Authorization Act (H.R. 4350) would direct the Department of Labor to study factors limiting employment opportunities for immigrants in the U.S. Supporters hope to see a similar measure (S. 3157) attached to the defense reauthorization bill in the Senate.

“There’s growing recognition something needs to be done to address brain waste associated with those coming into the U.S. with advanced degrees, including in the health sector,” Kosten said.