Visa freeze worsens America's nursing shortage
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Longstanding caps on green cards for foreign-educated nurses are limiting one potential fix for America's stark shortage of health care workers.
Why it matters: As burned-out nurses leave the field, many hospitals and nursing homes have sought to recruit nurses from abroad to help fill vacancies estimated at nearly 200,000 per year.
- But backlogs for visa applications have slowed the pipeline of international nurses, who account for 16% of the country's nursing workforce.
Driving the news: The State Department this month cut off employment-based visas, known as EB-3, for nurses and other skilled workers through the rest of the fiscal year that ends in September. It enacted a similar freeze last year.
- In most cases, only those who applied for green cards before December 2021 will be eligible for visa interviews over the next three months.
- More than 10,000 foreign nurses are affected by the current freeze, said Chris Musillo, general counsel of the American Association of International Healthcare Recruitment.
State of play: About 40,000 of these visas are available each year — a cap that's been unchanged since the category was created in 1990.
- "The backup just keeps getting more and more serious as we go forward," said Megan Cundari, senior director of federal relations at the American Hospital Association.
- "We can't bring in people fast enough to fill the hole that we already have" in the nursing workforce, she said. The freeze "has a compounding effect" on staffing struggles across the health care system.
- A couple years ago, nurses from certain countries could start working in the U.S. within 18 months of starting their green card process, she said. Now, the process takes closer to two and a half years.
A broad coalition of health care lobbies, including AHA and the American Organization for Nursing Leadership, are supporting a bipartisan bill that would open up 25,000 employment-based visas for nurses by reclaiming unused green cards.
- The bill hasn't moved since it was introduced in November, and there's little expectation this Congress will take up immigration legislation.
- This is "probably the least controversial aspect of immigration there is, but even then it's a tough topic to push forward," said Marc Topoleski, a managing attorney at law firm Ellis Porter.
The Biden administration could also expand nurses' eligibility for another type of visa without Congress, some advocates say.
- Those visas, known as H-1Bs, are reserved for jobs that require at least a bachelor's degree. But they have their own limitations, which include allowing only for temporary residence.
The other side: Congress shouldn't expand nurse visas without also creating a plan to make U.S. nursing jobs more sustainable, said Cheryl Peterson, senior vice president of nursing programs at the American Nurses Association.
- "We're going to always hit the cap because we fail to do what we need to do here in the United States to make sure we have a sustainable nursing workforce," Peterson said.
The bottom line: International nurses aren't a "silver bullet" to solving the workforce crisis, said Erica DeBoer, chief nursing officer at rural health system Sanford Health.
- But "streamlining the immigration system for health care workers would help us tap into a global talent pool and bolster our nursing workforce — especially in rural areas where the nursing shortage is more acute."
- Sanford Health expected 120 internationally educated nurses to start at the health system this year, but DeBoer said about a quarter have been delayed because of the visa freeze.
This story was corrected to reflect Cheryl Peterson is the senior vice president of nursing programs at the American Nurses Association (not director of nursing practice and policy).
