Carper, Blunt Rochester Join Klobuchar, Schneider, Colleagues to Urge Administration to Increase Number of Doctors in Rural and Other Medically Underserved Areas

The recently announced suspension of premium processing for employment-based visa petitions by U.S. Citizenship and Immigration Services (USCIS) would exacerbate physician shortages during the COVID-19 pandemic, particularly in rural areas that depend on doctors who participate in the Conrad 30 J-1 visa waiver program 

In a letter to USCIS Acting Director Cuccinelli, Members call on USCIS to address its administrative needs without sacrificing access to health care in underserved areas during a pandemic

WASHINGTON D.C. – Today, U.S. Senator Tom Carper and Representative Lisa Blunt Rochester (both D-Del.) joined Senator Amy Klobuchar (D-Minn.) and Representative Brad Schneider (D-Ill.) along with colleagues in both the House and the Senate, to write to U.S. Citizenship and Immigration Services (USCIS) urging the Administration to resume premium processing for physicians seeking employment-based visas. Doctors on these visas increase access to health care, especially rural areas, through the Conrad 30 program, which allows foreign medical school graduates who have been trained in the United States to stay in the country as long as they serve underserved areas. On March 20, USCIS announced its suspension of premium processing due to the coronavirus (COVID-19) pandemic.

“On March 20, U.S. Citizenship and Immigration Services (USCIS) announced the immediate and temporary suspension of premium processing for all Form I-129 and I-140 petitions due to the coronavirus (COVID-19) pandemic. We are deeply concerned that this suspension will exacerbate physician shortages, particularly in rural areas, and at the leading academic and research organizations that depend on health care provided by physicians who graduated from foreign medical schools,” the members wrote.

“This processing freeze will undoubtedly prevent these physicians from practicing in underserved areas, and at providers of high-complexity care, leaving hospitals in these areas more shortly staffed than before this national health crisis began. We ask that you follow your past practice and continue to offer premium processing for physicians seeking employment-based visas—including for resident physicians serving in teaching hospitals—in order to help ensure that rural and underserved areas can continue to receive quality and continuity of care in this time of extraordinary need.”

In addition to Carper and Klobuchar, the letter was signed by Senators Susan Collins (R-ME), Tina Smith (D-MN.), Jacky Rosen (D-NV), Ron Wyden (D-OR), Angus King (I-ME), Tammy Baldwin (D-WI), Ed Markey (D-MA), Richard Blumenthal (D-CT), Tom Udall (D-NM), Martin Heinrich (D-NM), Chuck Schumer (D-NY), Catherine Cortez Masto (D-NV), Kamala Harris (D-CA), Patrick Leahy (D-VT), Tina Smith (D-MN), Dick Durbin (D-IL), Elizabeth Warren (D-MA), Kevin Cramer (R-ND), Maggie Hassan (D-NH), Tammy Duckworth (D-IL), Dianne Feinstein (D-CA).

In addition to Blunt Rochester and Schneider, the letter was signed by Representatives Abby Finkenauer (D-IA-01), Tom Cole (R-OK-04), Terri Sewell (D-AL-07), Angie Craig (D-MN-02), Cindy Axne (D-IA-03), Mark Pocan (D-WI-02), Tom O’Halleran (D-AZ-01), Raja Krishnamoorthi (D-IL-08), Xochitl Torres Small (D-NM-02), Sylvia Garcia (D-TX-29), and Darren Soto (D-FL-09).

Currently, many doctors from other countries training in the United States are required to return to their home country for two years after their training has ended before they can apply for another visa or green card. The Conrad 30 program allows doctors to stay in the United States without having to return home if they agree to practice in an underserved area for three years. The “30” refers to the number of doctors per state that can participate in the program.

In March 2019, Klobuchar and Senators Susan Collins (R-ME) and Jacky Rosen (D-NV) introduced legislation to extend the Conrad 30 program until 2021, which would improve the process for obtaining a visa, and allow for the program to be expanded beyond 30 slots if certain thresholds are met, while protecting small states’ slots. The Conrad State 30 & Physician Access Act also allows the spouses of doctors to work and provides worker protections to prevent the doctors from being mistreated. A version of the bill was included as an amendment in the comprehensive immigration bill that passed the Senate in 2013. The legislation has received the endorsement of the American Medical Association, the American Hospital Association and the Association of American Medical Colleges.

“Ensuring that underserved and under-resourced communities have ample access to physicians is a chronic challenge in normal times, and the COVID-19 pandemic is expected to exacerbate this issue. Physicians practicing in underserved communities either via an H-1B visa or as part of the Conrad State 30 program play a key role in providing much needed health care to vulnerable populations. We applaud Senator Klobuchar, Representative Schneider and the other bipartisan, bicameral cosigners for seeking to rectify this problem stemming from the pandemic,” said Patrice A. Harris, M.D., president of the American Medical Association.

“The American Hospital Association supports this effort because it will increase the number of physicians on the front lines providing care to patients during the ongoing public health emergency,” the American Hospital Association said.

Full text of the letter can be found HERE and below:

Dear Acting Director Cuccinelli:

We write to express our concerns about recent actions taken by U.S. Citizenship and Immigration Services (USCIS) that may impair access to health care in underserved areas during the current unprecedented public health crisis. On March 20, U.S. Citizenship and Immigration Services (USCIS) announced the immediate and temporary suspension of premium processing for all Form I-129 and I-140 petitions due to the coronavirus (COVID-19) pandemic. We are deeply concerned that this suspension will exacerbate physician shortages, particularly in rural areas, and at the leading academic and research organizations that depend on health care provided by physicians who graduated from foreign medical schools.

This processing freeze will undoubtedly prevent these physicians from practicing in underserved areas, and at providers of high-complexity care, leaving hospitals in these areas more shortly staffed than before this national health crisis began. We ask that you follow your past practice and continue to offer premium processing for physicians seeking employment-based visas—including for resident physicians serving in teaching hospitals—in order to help ensure that rural and underserved areas can continue to receive quality and continuity of care in this time of extraordinary need.

Although 20 percent of the population resides in rural areas, fewer than 11 percent of physicians in the U.S. practice there. As a result, over 20 million rural Americans live in federally designated health professional shortage areas (HPSAs) that have a provider-to-patient ratio of 1 to 3,500 or less. Even in times when health care providers do not face serious shortages of medical equipment and supplies, too many rural Americans do not have adequate access to health care—and physicians in particular. 

Since 1994, the Conrad State 30 program has been instrumental in helping to meet the health care needs of rural communities by making it easier to retain foreign physicians who have just completed their medical training in the United States. After completing medical residencies in the United States, most foreign doctors are required to return to their home countries for two years before they are able to return to the United States to work in medical facilities. Under the Conrad State 30 program, in exchange for three years of service in an underserved area, foreign doctors receive a waiver of the home return requirement and rural communities get the expertise and treatment they desperately need. Since its inception, the Conrad State 30 waiver program has supplied over 15,000 physicians to these underserved communities. According to the American Hospital Association, the Conrad State 30 program has been a “boon” to rural health care.

The foreseeable effects of suspending premium processing of employment-based petitions are obvious. If physicians cannot work, hospitals will not be able to care for more patients. With rural areas already experiencing a physician shortage, they will be disproportionately affected by the coming wave of COVID-19 infections. The Conrad State 30 program has helped address chronic physician shortages in rural America and other underserved areas for over two decades. Programs like this were built for times like these. USCIS can address its administrative needs and maintain the safety of its own staff without sacrificing access to health care in underserved areas.

We appreciate your attention to these important concerns.

Sincerely,