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.

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.

• 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.

• "We can't bring in people fast enough to fill the hole that we already have" in the nursing workforce, said Megan Cundari, senior director of federal relations at the American Hospital Association.
• 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.

Some health care lobbies, including AHA, are backing a legislative fix that would reclaim unused green card slots to make available 25,000 additional employment-based visas for nurses.

• Some advocates also say the Biden administration could unilaterally open up another visa program for nurses.

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."

Go deeper

An array of conservative groups is calling on GOP leaders to roll back new Medicare drug pricing negotiations, seeking to elevate the issue on the party's agenda, Axios' Peter Sullivan scooped first on Pro.

Why it matters: Their letter to Speaker Mike Johnson and Senate GOP Leader Mitch McConnell comes ahead of the first presidential debate, and it highlights the political stakes around Democrats' efforts to lower drug prices.

• The groups — including Americans for Prosperity, Americans for Tax Reform and CPAC — portray the Medicare drug price negotiations as heavy-handed and economically ruinous.
• The effort was organized by Ryan Ellis, president of the Center for a Free Economy and a lobbyist for Akin Gump, which has drug industry clients.

The big picture: Repeal will realistically only be on the table if Republicans sweep the House, Senate and White House in November.

• Even if that happens, congressional Republicans, while highly critical of the Inflation Reduction Act that included drug negotiations, have not gone into detail about their plans for next year.
• And while former President Trump abandoned his previous support for negotiations, his campaign hasn't said how he would handle Medicare negotiations if elected.

If you need smart, quick intel on health care policy for your job, get Axios Pro.

Outdoor and even indoor workers in the states being hardest hit by a dangerous heat wave have few if any protections to keep them safe, writes Axios Latino author Astrid Galván.

Why it matters: About 75.8 million people in the U.S. — including millions of Latino laborers — are under heat alerts, with a brutal wave hitting large swaths of the country.

• There were 33,890 work-related heat injuries and illnesses from 2011 to 2020, according to estimates from the Bureau of Labor Statistics.

Zoom in: Republican governors in Florida and Texas banned local governments from mandating heat protections such as breaks for outdoor workers, arguing that federal laws already ban unsafe work conditions.

• Just six states, mostly in the West, have state-level protections in place, per a Bloomberg Law analysis.

OSHA's current standards "don't really have any teeth," says Thomas Kennedy, a spokesperson for the Florida Immigrant Coalition.

• The federal worker safety agency's proposed rules for heat protections are under review at the White House.

Read more

A new AI-meets-biotech company is releasing a tool to help scientists craft entirely new molecules in a process they say mirrors half a billion years of evolution.

The big picture: Researchers are pushing hard to try to use AI to create new molecules in order to engineer better medicines, biofuels and materials.

• AI tools are now being developed in an effort to more quickly determine a protein's structure, generate biological molecules with enhanced functions and design new gene editors.

Driving the news: EvolutionaryScale — a startup founded by several AI researchers who used to work at Meta — is building a language model similar to those that power AI chatbots that can be prompted to design new proteins.

• The largest version of the new generative AI model — called ESM3 — was trained on data from 2.78 billion natural proteins: their amino acid sequences, the 3D atomic structures that arise from those sequences and the resulting functions of the proteins.
• The model then predicts patterns in that data and leverages it to design new proteins with specific functions.

What to watch: Ultimately these tools will need to prove their worth to the pharmaceutical industry and other sectors that have long grappled with slow, expensive development pipelines.

Keep reading

🦟 The CDC is warning about increased dengue risk as cases of the mosquito-borne disease explode in the Americas. (NBC News)

🌍 The recent mpox surge in Africa must be addressed urgently, the World Health Organization warned. (Reuters)

💊 Mail-order pharmacies were supposed to save money, but they're driving up drug costs. (Wall Street Journal)

🏛️ A House Republican proposing a ban on Pentagon funding for IVF called the fertility treatment "morally wrong." (The Hill)