Klobuchar’s bill would allow international doctors to remain in the U.S. and provide essential health care in medically underserved areas.
WASHINGTON - At a Senate Judiciary Subcommittee on Immigration, Citizenship, and Border Safety hearing titled, “Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce,” U.S Senator Amy Klobuchar (D-MN) highlighted the need to pass her bipartisan legislation to address doctor shortages. The Conrad State 30 and Physician Access Reauthorization Act, which Klobuchar introduced in May 2021 with Senators Susan Collins (R-ME), Jacky Rosen (D-NV), and Joni Ernst (R-IA), would allow international doctors to remain in the U.S. upon completing their residency to provide essential health care for rural or underserved areas.
“In rural Northwestern Minnesota, there's only one doctor for every 686 people. That is why I took on this bill…to allow for more doctors that are studying at our great medical schools throughout the country to be able to stay for their residency,” said Klobuchar. “Our bill updates and modernizes the [Conrad 30] program by allowing states to bring in more doctors and then additional incentives for doctors to continue serving in an underserved area for up to five years.”
Klobuchar also emphasized that America’s outdated immigration system puts the country at a competitive disadvantage when it comes to recruiting talented doctors: “This is a problem for the U.S…not just we don't keep people here, we're losing them to other countries.”
Minneapolis-based immigration attorney Sarah Peterson underscored that Klobuchar’s legislation will improve health care access in medically underserved communities. “28 percent of these international doctors who go into underserved areas stay there well past their five years,” said Peterson. “We have a shortage, it's documented, and we have the vehicle to immediately address it, which is your bill, Senator Klobuchar.
Klobuchar has long led efforts to address workforce shortages. In July, she and Collins urged the Biden administration to address the current green card, visa, and work permit application backlogs.
In March, Klobuchar joined a bipartisan group of colleagues in urging the Biden administration to quickly increase the number of available H-2B visas for seasonal workers. Following the Senators’ push, the Department of Homeland Security (DHS) and the Department of Labor (DOL) announced in May that a temporary rule had been finalized to authorize an additional 35,000 H-2B visas. Minnesota businesses, including the tourism and forestry sectors, rely on temporary workers during their busiest seasons.
Sen. Klobuchar: Thank you very much, Chairman, and thank you very much for taking on this issue. This is something that I appreciate Senator Tillis, Senator Cornyn, your support for a number of these immigration measures, including the Conrad 30 bill that Senator Collins and I introduced. We now have 26 bipartisan co sponsors, including Senator Ernst, Senator Rosen on this committee: the two of you, as well as Senators Durbin and Coons and Blumenthal, and I thank our witnesses.
I really want to, I don't think our economy can withstand it if we don't move. My state has the lowest, as Ms. Peterson well knows, lowest unemployment rate in the country. We don't have enough workers all the way down the line and some combination. And I've been here your point Senator Cornyn, when we have been able to pass an immigration bill that would have fixed a lot of this. We got it through the Senate with bipartisan support, a comprehensive immigration bill and then unfortunately, it did not pass in the House. I've seen a bill pass in the House and not here. And I'm hoping that third time's the charm and we simply cannot wait.
As pointed out by Senator Durbin, national shortage of as many as 124,000 physicians. In Minneapolis, there's one doctor for every 304 people and you know, we're the land of 10,000 lakes as well as 10,000 medical clinics, as you know, along with Mayo, so many University of Minnesota that we're so proud of, but in rural Northwestern Minnesota, there's only one doctor for every 686 people. That is why I took on Kent Conrad's bill many, many years ago to be able to allow for more doctors that are studying at our great medical clinics, medical schools throughout the country to be able to stay for their residency and the like. And I would like to expand that. The legislation reauthorizes and expands the Conrad 30 program that has brought more than 15,000 doctors to underserved areas, rural and urban in the last 15 years. Ms. Peterson by the way, thank you for graduating with degrees from the University of Minnesota working, I understand, at the law school. Where were you born in Minnesota?
Ms. Peterson: Wisconsin, but lived in Minnesota my entire life.
Sen. Klobuchar: Oh, did you see the Vikings and Packers game?
Ms. Peterson: I did.
Sen. Klobuchar: Okay. Well, you can imagine I was happy with the outcome. All right. My mom came from Wisconsin, so all is good. So could you talk about how in your experience, what role do immigrant doctors who've been trained in the U.S. play in providing essential medical care to rural and underserved communities?
Ms. Peterson: Yeah, thank you, Senator Klobuchar. I mean, I think a statistic that's really telling is that 28 percent of these international doctors who go into underserved areas stay there well past their five years, as compared to 11 percent of U.S. doctors. And I think that's telling because we need to expand our programs to continue to reward and recognize international doctors who are going into these communities, like Dr. Alur, they're building lives. They are staying there long term, a doctor who came to my small town has been there for over 20 years. He's built his life there. And so we have a shortage, it's documented and we have the vehicle to immediately address it, which is your bill, Senator Klobuchar.
Sen. Klobuchar: Okay. Can you talk about why reauthorizing the program would be in your words a “win-win?”
Ms. Peterson: It gives states the ability to control the doctors that they can place. It also encourages and rewards physicians like Dr. Alur to work in underserved areas by helping them get over the H1-B numerical cap, which this year alone, we had over 480,000 people apply for 85,000 numbers. So it also rewards physicians on the green card side of things for going into underserved communities. And these are three very critical components to ensuring that Americans are getting the access to health care they need.
Sen. Klobuchar: I note that recently, the United Kingdom introduced a health care visa program that fast tracks visas for health care workers, not just doctors, and Canada, which is very close to our borders, also offers an expedited pathway to permanent residency for doctors. I note that in Great Britain, they have a Conservative Prime Minister. They had one with Boris Johnson, they have won with Liz Truss, yet they're moving ahead on this. Could you talk about why this is a problem for the U.S. if you want to chime in, doctor, if we lose, not just we don't keep people here, we're losing them to other countries?
Dr. Alur: Thank you, Senator Klobuchar for your leadership. Great question. My personal experience, I've shared my burdens here. If I was to talk to a doctor who is hoping to come here, or who's planning to stay after training, I will tell him it's fantastic to work here. My experience working with the veterans is very rewarding, very satisfying. But if they listen to my family's troubles, and if they have to talk to their family, and then say a doctor has been working here for 11 years, he has been in the country for 15 years, this is the prime of his youth when he can do a lot, should we go here? And I'll leave it to your imagination. What would their family say? As a physician, this is fantastic. As a family, the way the system is currently, how would it help? I want to extend this to say what would happen if people get green cards. I have an example of a pediatrician from my community, who finished his waiver in 2008, went on to build six practices, employ 18 providers, employ 48 employees and serve pediatrics in my community. Thank you.
Sen. Klobuchar: And just to make clear, our bill updates and modernizes the program by allowing states to bring in more doctors, and then additional incentives for doctors to continue serving in an underserved area for up to five years. And I think that also would make a tremendous, tremendous difference. So I just, again, want to thank both of you, want to thank Senator Padilla and Senator Cornyn, for holding this hearing. We can't wait, whether we do a bill that's focused on parts of this. I know that Senator Rounds valiantly tried to do a bill during the, I was part of the group during the Trump administration, and we had a number of Republicans on board and then we were, in my mind, got punched by the administration, with many Republicans having been willing to support it here. This is our chance. We've got to move quickly. And thank you for bringing this, Senator Padilla, to our attention and then Ms. Peterson as well as Dr. Alur. Thank you very much.