The federal government is predicting a nursing shortage in 2025, and we’re already seeing signs of one locally. Around one-fifth of registered nursing positions in Massachusetts home health …
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The federal government is predicting a nursing shortage in 2025, and we’re already seeing signs of one locally. Around one-fifth of registered nursing positions in Massachusetts home health care and nursing homes are unfilled. Massachusetts hospitals spent $1.1 billion last year hiring temporary registered nurses to fill vacancies. Nationally, according to a 2022 survey of nurses, the median age of a registered nurse was 46 years old, and more than one-quarter of all nurses reported that they planned to leave nursing over the next five years.
Yet in July, the U.S. State Department announced that it was effectively freezing visa availability for foreign nurses until the next fiscal year starts in October, cutting off a potential supply of internationally trained nurses who want to work in the United States.
Importing new foreign-trained medical professionals won’t fully solve the nursing shortage. It won’t address challenging job conditions, including understaffing and stress, that lead to turnover. As this board previously argued, Massachusetts also needs to reform its state licensing systems if it wants to welcome more foreign-trained doctors and nurses.
But a bipartisan bill, the Healthcare Workforce Resilience Act, that would allow 25,000 foreign-trained nurses into the United States is a common-sense step that should be an easy political lift. The bill doesn’t increase the number of visas that would be authorized; it lets immigrants use visas that were previously authorized by Congress but went unused for administrative reasons (for example, paperwork wasn’t processed by the end of the fiscal year). The bill also includes 15,000 green cards for doctors, which would likely be used to give permanent residency to foreign-trained doctors already practicing in the US.
Similar bills to “recapture” unused immigration visas were signed by former president Bill Clinton in 2000 and former president George W. Bush in 2005, with the 2005 bill focused specifically on visas for nurses, according to the Niskanen Center, a pro-immigration think tank.
The current bill is sponsored by Sen. Dick Durbin, a Democrat who chairs the Senate Judiciary Committee; Republican Sen. Kevin Cramer; and Democratic Rep. Brad Schneider. It includes Democratic and Republican cosponsors because having an adequate health care workforce affects red and blue states.
One would think much-needed health care professionals should be at the front of the line in the U.S. immigration system. But due to the system’s complexities and caps, even nurses who are fully qualified to work in the United States and have a job offer here get stuck in a green card backlog of around three years, according to the American Association of International Healthcare Recruitment, which supports the bill. (The backlog for Indian and Chinese workers is longer because of country-based visa limits.) The United States caps total employment-based visas at 140,000 a year, and nurses fit into a particular subcategory for workers who have a bachelor’s degree but no master’s degree.
Under this bill, any nurse who obtains a visa would need to have taken the U.S. nurse licensing exam, passed an English exam, and had their education and credentials verified while in their home country. They also must be sponsored by a U.S. employer. Christopher Musillo, general counsel for AAIHR, said a nurse who gets a visa could start working within 30 to 60 days of arriving in the United States.
The situation for physicians is different because they, unlike nurses, can obtain temporary work visas. Musillo said the new visas would likely go to doctors already practicing in the United States on temporary visas who face a years-long backlog to obtain permanent residency.
The Massachusetts Medical Society and Massachusetts chapter of the American College of Physicians came out in support of an earlier version of the bill in 2020. The Massachusetts Health and Hospital Association also supports it. A letter from 52 national organizations representing health care professionals, provider organizations, and patient advocacy groups sent to congressional leaders in February said a shortage of doctors and nurses is already leading to decreased health care access and foreign professionals will “strengthen and provide stability to the US health care system.” As baby boomers age, the demand for health care will grow. A proposal to allow more foreign-trained doctors and nurses to live and practice in the United States should not be blocked by a broader federal debate over immigration. The United States needs these qualified professionals.