Collins, King Call on Administration to Increase Number of Doctors in Rural and Other Medically Underserved Areas

WASHINTON, D.C. – U.S. Senators Susan Collins (R-Maine) and Angus King (I-Maine), along with colleagues in both the House and the Senate, wrote 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 healthcare, especially in 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 Collins and King, the letter was signed by U.S. Senators Amy Klobuchar (D-Minn.), Jacky Rosen (D-Nev.), Ron Wyden (D-Ore.), Tom Carper (D-Del.), Tammy Baldwin (D-Wis.), Ed Markey (D-Mass.), Richard Blumenthal (D-Conn.), Tom Udall (D-N.M.), Martin Heinrich (D-N.M.), Chuck Schumer (D-N.Y.), Catherine Cortez Masto (D-Nev.), Kamala Harris (D-Calif.), Patrick Leahy (D-V.T.), Tina Smith (D-Minn.), Dick Durbin (D-Ill.), Elizabeth Warren (D-Mass.), Kevin Cramer (R-N.D.), Maggie Hassan (D-N.H.), Tammy Duckworth (D-Ill.), Dianne Feinstein (D-Calif.).

The letter was also signed by U.S. Representatives Brad Schneider (D-Ill.), Abby Finkenauer (D-Iowa), Tom Cole (R-Okla.), Terri Sewell (D-Ala.), Lisa Blunt Rochester (D-Del.), Angie Craig (D-Minn.), Cindy Axne (D-Iowa), Mark Pocan (D-Wis.), Tom O’Halleran (D-Ari.), Raja Krishnamoorthi (D-Ill.), Xochitl Torres Small (D-N.M.), Sylvia Garcia (D-Texas), and Darren Soto (D-Fla.).

Senator Collins, along with Senators Klobuchar and Rosen (D-Nev.), are leading a bipartisan effort to reauthorize the Conrad 30 program through fiscal year 2021. Senator King is a cosponsor of the legislation.

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.

The full letter can be read below or downloaded HERE.

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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.