Bloggings On Immigration Law And Policy
by Greg Siskind
Editor's note: Here are the latest entries from Greg Siskind's blog.
March 22, 2010
THE REVERSE BRAIN DRAIN
SON OF THE YEARI
GRAHAM BACKTRACKS ON THREAT TO WALK AWAY FROM IMMIGRATION REFORM
Last week Lindsay Graham indicated that if Democrats passed health care reform using reconciliation, that would spell the end of immigration reform. Now he is reversing that position. Graham was interviewed on Univision that he is still on board.
THE NEXT EINSTEIN
NY Times columnist Tom Friedman has another great article reminding Americans why immigration is in our self-interest. In his latest piece he talks about how most of the finalists for the Intel science prize for high school kids (the most prestigious honor a young American science student can seek) are immigrants or children of immigrants. Albert Einstein is probably the most successful immigrant in the sciences we have ever welcomed to our shores. But you never know who will one day give him a run at the title.
200,000 MARCH FOR COMPREHENSIVE IMMIGRATION REFORM
President Obama reconfirmed his commitment to reform and expressed his support for the Schumer-Graham framework. The President did, however, caution that CIR "won't happen overnight."
The rally was also addressed by Luis Gutierrez, the leading pro-immigration Congressman from Illinois, the Reverend Jesse Jackson and Senator Robert Menendez (D-NJ)
WILL USCIS SABOTAGE THE NEW HEALTH CARE BILL?
This evening Congress passed historic legislation extending health coverage to more than 30 million more Americans. That’s the equivalent of adding the population of the entire country of Canada to the insurance rolls. This is going to be a monumental challenge for many reasons one of which is the fact that the country already has a severe physician shortage. According to Reuters:
growing shortage of primary care doctors could place a major burden on the U.S.
healthcare system if President
As healthcare legislation works its way through the U.S. Congress, most of the focus has turned to how to finance a reform that could cost $1 trillion in the next 10 years and aims to cover most of the 46 million uninsured Americans.
Less attention has been paid to what might happen if millions of new patients join a healthcare system that is unprepared and unequipped to handle the load.
The United States already has a shortage of between 5,000 and 13,000 primary care doctors, according to the Robert Graham Center. Add millions of previously uninsured people and the shortfall will balloon to as many as 50,000 doctors.
So why in the world is US Citizenship and Immigration Services enacting a series of policy changes to make it more difficult for foreign-born, American-trained doctors to get visas to remain in the US after receiving the US taxpayer-subsidized graduate medical education at teaching hospitals around the US.
More than 25% of the doctors in training in the US are international medical graduates. Immigration policies that tend to drive these doctors out of the country rather than encouraging them to remain can have a dramatic impact on Americans access to health care.
What are those policies? Here’s an incomplete list that gives you and idea:
1. The January 2010 Neufeld memorandum that essentially bars the use of H-1Bs by doctors who are not directly employed by hospitals and health care facilities. Most doctors have traditionally been employed by groups or self-employed and many states actually mandate this.
2. USCIS is taking draconian interpretations of H-1B cap exemption requests by physicians working at non-profit institutions affiliated with universities and research institutions. USCIS has a great deal of discretion here but chooses to take a restrictive view that drastically limits employment opportunities for many doctors.
3. More than a quarter of international medical graduates are Indian nationals who face green card backlogs of 5 to 10 years longer than almost every other nationality. As I blogged yesterday, USCIS has the ability to enact policies to alleviate the backlogs including changing the way “filing” is interpreted and not counting spouses and kids in the green card tally.
USCIS routinely excludes physician graduate
medical education from benefits it extends to those pursuing graduate degrees
in the US. For example, the bonus cap of 20,000 H-1B visas is interpreted in
such a way that US-educated doctors are excluded. And USCIS has not created a “cap
5. Until the AAO stepped in, USCIS recently took the position that the MBBS medical degree – the degree used in more than 40 countries including India and the United Kingdom – was not an advanced degree and all such doctors should be relegated to a low employment-based green card preference level with waits of nearly ten years.
There are many other issues I could include in the list. USCIS should see itself as playing a critical role in helping to implement this momentous legislation. It needs to identify every policy that serves to curb the supply of doctors (and other health professionals) and embrace the “yes we can” philosophy of this Administration to reverse course and be a part of the solution.
The situation for other health care professionals is also severe and will only get worse as a result of the new legislation. Despite the economic downturn, the nursing shortage in the US persists with a gap of 50,000. That number was expected to increase significantly in years to come even before the new legislation was passed. And the shortage of other health care professionals - physical therapists, pharmacists, medical technologists, etc. The problems noted for doctors apply here as well, but can be even more severe. For example, USCIS takes extremely conservative views on which jobs qualify for H-1Bs and has generally rejected most nurse positions as being below H-1B caliber and ignored its own memorandum from 2002 on the subject.
Congress, of course, could do a lot to improve the situation as well. North Dakota Democratic Senator Kent Conrad’s S.682 bill which would make a number of improvements to physician immigration rules. The bill creates H-1B cap exemption opportunities for doctors going to the worst shortage areas and also creates green card cap exemptions to reward such service.
On the nurse front, HR 2536, the Emergency Nursing Supply Relief Act, introduced by Congressman Robert Wexler (D-FL) would immediately help relieve the bottleneck that has caused a five to ten year wait to bring in nurses to the US. That legislation is sorely needed and needs to be strengthened to include a broad exemption from green card caps for nurses and other allied health professionals until we have a domestic pipeline of workers that can meet our needs.
Many on both sides of the immigration debate will be tempted to say we should roll these bills in to a comprehensive immigration reform bill. That's fine, but these bills need to be put on a separate track independent of broader immigration legislation. They are health care bills more than immigration bills and we can no longer afford to wait for these crucial issues to be addressed. The time to act is now.
THE IMMIGRANT DIVIDEND
Readers have been sending me the best links. Here's one from the latest issue of Newsweek:
THE MEHTA-ENDELMAN PLAN
A few of you have written to me telling me about an interesting set of ideas proposed by my friends Gary Endelman and Cyrus Mehta, both fellow immigration lawyers. I've praised the plan in the comments, but it is worth bumping up to its own post. The proposal has three major components:
1. Interpreting the INA in a way that would allow for a more liberal reading of when a case is "filed" for purposes of being able to file an adjustment application when a green card category is backlogged.
2. The President should use his parole authority to allow persons in long queues for green cards to be able to obtain employment and travel authorization while they wait without having to have an adjustment application pending.
3. Not including spouses and children in the employment-based green card quotas in order to ensure that the numbers are actually counted for immigrant workers.
Hopefully these ideas will gain some traction.
WILL ANTIS SEND THE NEXT BIG THING TO ASIA?
A kind reader sent me a link to a new Business Week article that discusses a fast emerging trend in American business schools - taking jobs in Asia rather than in the US. One of the biggest targets - young Asian immigrant students in the US being lured back home:
The Center for American Progress has published a new report showing that this is what it would cost to rid the country of the estimated 10,000,000 illegally present immigrants in the US.
POLL: IMMIGRATION CRUCIAL ISSUE TO MOST HISPANIC VOTERS
Those who follow immigration politics closely know that the finding in a new America's Voice Bendixen poll of 1,100 Hispanic voters that more than 3/4 consider immigration to be a major issue for them is true. But for many anti-immigrant members of Congress, there's a case of wishful thinking going on - that Hispanic voters only consider immigration a minor issue and will vote on other issues instead. Or an even less realistic assumption that Latino voters actually feel the same way as them and want to see immigration reform fail. That thinking failed miserably in 2006 and 2008 as Hispanics defected en masse from the GOP to the Democrats. The only way this trend is likely to be reversed is if the Democrats fumble and somehow make it appear that they are no better on immigration issues.
PRESIDENT PRAISES SCHUMER-GRAHAM FRAMEWORK
SCHUMER AND GRAHAM INTRODUCE CIR TO THE PUBLIC
We still don't have the official summary of the Senate comprehensive immigration reform bill, but Senator Charles Schumer, the chair of the Senate Immigration Subcommittee and Senator Lindsey Graham (R-SC) have written a joint op-ed piece that will appear in tomorrow morning's Washington Post that describes the major provisions of the CIR bill they will shortly introduce in the Senate.
The bill will look similar to previous bills, but we now learn that it will have some new features. They include the introduction of the controversial new national identification card (a biometric social security card). The legalization program will now include community service in additional to other penalties. And those receiving advanced degrees from US universities will be exempt from green card caps.
There WILL be a guest worker program in the bill, though it is hard to tell exactly how it will work with this limited description:
Look for more details to emerge in the coming days.
Greg Siskind is a partner in Siskind Susser's Memphis, Tennessee, office. After graduating magna cum laude from Vanderbilt University, he received his Juris Doctorate from the University of Chicago. Mr. Siskind is a member of AILA, a board member of the Hebrew Immigrant Aid Society, and a member of the ABA, where he serves on the LPM Publishing Board as Marketing Vice Chairman. He is the author of several books, including the J Visa Guidebook and The Lawyer's Guide to Marketing on the Internet. Mr. Siskind practices all areas of immigration law, specializing in immigration matters of the health care and technology industries. He can be reached by email at email@example.com
The opinions expressed in this article do not necessarily reflect the opinion of ILW.COM.