President-Elect Joe Biden will inherit an immigration landscape that has changed dramatically in the four years of the Trump Administration. Under its “Buy American, Hire American” directive, the Trump Administration changed the way federal immigration laws are interpreted and enforced, leading to increased scrutiny of every conceivable aspect of legal immigration, from obtaining U.S. citizenship to coming to the United States as a foreign student. In this series, we will look closely at how different facets of healthcare immigration could be impacted under President-Elect Biden’s Administration.
Healthcare immigration has been relatively unscathed by President Trump’s “Buy American, Hire American” initiative. While petition adjudication for medical professionals has been subject to increased scrutiny and longer timelines, federal visa programs for foreign physicians remain a valuable staffing tool for healthcare providers in medically underserved and rural areas. The biggest changes to healthcare immigration under President-Elect Biden will be streamlined green card and naturalization processes and could also include expansion of the Conrad 30 Waiver program. Additionally, a focus on addressing labor availability could also see increased opportunities for non-professional medical care.
Removal of Country Quotas will Aid Retention Efforts
When an employer sponsors a foreign employee for permanent resident status or a “green card,” they are showing their commitment to the long-term success of the employee. For healthcare providers, the cost of the petition process is minor compared to the costs associated with onboarding a new physician and physician turnover, so most hospitals and healthcare institutions factor sponsorship through various employment-based permanent residence categories into their long-term retention strategies.
Under the Trump Administration, priority dates for different visa categories and nationalities experienced monthly fluctuation, leaving physicians from countries such as India and China waiting for a green card for years. President-Elect Joe Biden’s immigration platform calls for the expansion of employment-based visa programs and the elimination of quotas based on nationality, which will benefit physicians and medical staff from countries with long green card backlogs.
Expansion of Conrad 30 Program
The Conrad Visa Waiver Program provides 30 visa waivers for each state, allowing healthcare facilities in rural and underserved areas to use healthcare immigration to hire foreign medical graduates of U.S. residency programs. In return for working in these medically underserved areas for three years, foreign physicians can waive the two- year Home Residency Requirement tied to the J-1 training visa.
While the Conrad 30 Visa Waiver Program has had bipartisan support in Congress, expansion was never a priority for the Trump Administration. President-Elect Biden should advocate for immigration policy that provides additional visas to states that fill their quotas quickly, or creates alternate programs for physicians to stay in the United States after completing their training in U.S. medical schools.
Return to Obama-era Policy Enforcement will Streamline Petition Adjudication
Many of the President Trump’s most disruptive policies were issued via Executive Order, and while they didn’t change immigration law, they changed the way existing policies were enforced. The resulting uptick in Request for Evidence notices and denials left no industry untouched. FordMurray attorneys advocated on behalf of renowned surgeons and medical school graduates alike, who were subjected to overzealous enforcement of what should have been routine petitions of highly skilled medical providers.
We look forward to returning to an era of fair enforcement and petition adjudication under President-Elect Biden. Foreign physicians, especially recent medical school graduates, serve invaluable roles in rural and underserved communities. Especially in the time of COVID-19, visa petitions should be processed in a way to minimize disruption to our healthcare systems and frontline physicians.
Increased Opportunities for Residential Medical Providers
President-Elect Biden’s immigration platform calls for expansion of temporary visa programs to respond to market demands. The outline states, “Employers should be able to supply data showing a lack of labor availability and the harm that would result if temporary workers were unavailable. This flexibility, coupled with strong safeguards that require employers to pay a fair calculation of the prevailing wage and ensure the right of all workers to join a union and exercise their labor rights, will help meet the needs of domestic employers, sustain higher wages for American workers and foreign workers alike, incentivize workers and employers to operate within legal channels, prevent exploitation of temporary workers, and boost local economies.”
We consult with healthcare providers regularly who cannot access foreign talent through existing visa programs but are unable to fill vital positions in areas such as home healthcare and elder care. With the burgeoning needs of the aging Baby Boomer generation, special visa categories for Licensed Practical Nurses and Certified Nursing Assistants could go a long way in meeting the needs of today’s healthcare providers.
FordMurray offers complimentary consultations to healthcare institutions who want to stem staffing shortages with foreign-born physicians, nurses and allied health professionals.