ACP Leads Charge for Immigrants' Role in Health Care Delivery System

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Advocacy continues for legislation allowing international medical graduates to remain in the U.S. and contribute to health care workforce

Oct. 21, 2022 (ACP) — The American College of Physicians is working with lawmakers to foster the important role of immigrants in the U.S. health care system as it relates to reducing the shortage of U.S. physicians and expanding access to care for patients in underserved areas.

“Immigrants who are international medical graduates (IMGs) play an integral role in the delivery of care to patients across this nation, both under the J1 training and H-1B work visa programs,” said Renee Butkus, ACP director of health policy. J-1 and H-1B visas are two types of temporary nonimmigrant visas that allow foreign nationals to live and work in the United States.

“IMGs are more likely to practice in underserved areas and become primary care physicians, making them critical to addressing current and future physician workforce shortages,” she added.

IMGs also contribute to much-needed diversity in the physician workforce, which is necessary to care for an increasingly diverse patient population. “Adherence to care improves when patients experience greater comfort and higher levels of patient satisfaction with care from physicians who look like them,” Butkus said.

Time is of the essence. There will be a shortage of 17,800 to 48,000 primary care physicians by 2034, and in many parts of the country, there already is a shortage, according to the Association of American Medical Colleges.

ACP is urging Congress to pass The Conrad State 30 and Physician Access Reauthorization Act (H.R. 3541, S. 1810), which would extend the authorization for the federal Conrad 30 waiver program that allows J-1 IMGs trained in the United States to remain in the country after completing their residency if they practice in an underserved area for three years. This bill also allows spouses of doctors in this program to work in the United States.

ACP also supports The Healthcare Workforce Resilience Act (H.R. 2255, S. 1024), which would recapture 40,000 unused visas and use them to provide additional green cards to 15,000 physicians and 25,000 professional nurses. The visas would not count toward the annual limit and would be recaptured from a pool of more than 200,000 unused employment-based visas.

Another piece of legislation that ACP supports in this advocacy area is the Dream and Promise Act of 2021 (H.R. 6), which would provide a pathway to U.S. citizenship for undocumented individuals who were brought to the United States when they were children. Without the full protections afforded to them by the Dream and Promise Act, these students and physicians could potentially be forced to discontinue their studies or their medical practice and may be deported.

ACP is pleased with the Biden administration's new regulations that protect the ability of immigrants to access health care without threat of deportation or family separation.

“We were pleased to see that the Biden administration reversed the previous administration's interpretation of the definition of public charge, which would have expanded the number of programs that the federal government would consider in public charge determinations to include Medicaid, the Medicare Part D Low-Income Subsidy Program, the Supplemental Nutrition Assistance Program and potentially the Children's Health Insurance Program, among others,” Butkus explained. “This would have discouraged immigrants and their families from seeking health care and other vital public assistance and posed a risk to the health of millions of children and families.”

The bottom line is that the use of health care, nutrition or housing assistance programs will not be considered in any immigration decisions, Butkus said.

“ACP reaffirms that immigration policy should not interfere with the patient-physician relationship and that health policy should not foster discrimination against any patient, regardless of immigration status,” said Dr. Ryan D. Mire, president of ACP. “Policies that magnify fear in seeking health care are detrimental to public health.”

These are crucial advocacy issues that affect all physicians, and everyone can play a role in pushing the needle forward, Butkus noted. “Offering support for immigrants, ensuring an adequate workforce to meet our nation's health care needs and ensuring access to care for all are longstanding priorities for the College,” Butkus said. “We will continue to engage our members whenever possible through grassroots efforts and our Annual Leadership Day.”

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