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Pending Bills May Drive Care Access in Underserved Regions

The legislation would extend the Conrad State 30 Waiver program to drive care access in medically underserved areas.

A new bill would extend programs to drive care access in underserved areas.

By Sara Heath

- Both houses of Congress have introduced companion bills to extend the Conrad State 30 Waiver program through 2021, according to multiple sources. The Conrad State 30 Waiver program drives care access allows state legislatures to extend visa waivers to foreign clinicians to practice in federally-designated medically-underserved regions.

The program, originally slated to expire on April 28, 2017, currently hangs in the balance. Both the Senate and the House of Representatives have yet to pass the bills.

Started in 1994, the Conrad State 30 Waiver program sought to reduce clinician shortages by extending visas for international students following their medical education.

Clinicians from other countries working or attending medical school in America on a J-1 visa typically must return home once that visa expires. These individuals must wait in their native countries prior to applying for another US visa.

The Conrad State 30 Waiver program allows these doctors to stay in America if they commit to practicing in federally-designated medically-underserved areas.

Pressing clinician shortage issues have many policymakers rethinking this expiration date. The US is expected to face a 100,000-physician shortage by 2030.

The US needs these international doctors, according to Representative Brad Schneider (D-IL). Asking international medical students to leave the US following their education is counterproductive, Schneider explained in a statement.

“The American medical education system attracts top international talent and produces the best-trained graduates in the world,” Schneider said.

“It makes no sense to force these highly-skilled new doctors out of the country at a time when many of our communities struggle to attract medical professionals,” he continued. “Extending the Conrad 30 visa waiver program is a commonsense step toward ensuring all Americans have access to quality health care providers.”

The House bill’s other co-sponsor, Darrell Issa (R-CA), explained that the legislation can help rural communities and patients who need better access to healthcare across the country.

“The bill we’ve introduced extends and improves the Conrad 30 program to provide care where it’s needed most,” Issa noted. “If signed into law, the bill would be a big win for small and rural areas, underserved communities within larger states like California, and the patients who will have improved access to world class care where they live.” 

The House bill also serves as companion legislation to a Senate bill. Earlier this month, Senators Amy Klobuchar (D-MN), Susan Collins (R-ME), and Heidi Heitkamp (D-ND) introduced S.898, which also extends the Conrad State 30 Waiver program.

“Rural communities in Minnesota and across the country are short on doctors, and they rely on the Conrad 30 program to fill the gaps,” Klobuchar said in a statement. “Over the last 15 years, the Conrad 30 program has brought more than 15,000 physicians to underserved areas.”

For Klobuchar, offering paths to citizenship for American-educated clinicians and requiring them to work in areas suffering from doctor shortages is a matter of common sense.

“It doesn’t make sense to force doctors that we educate and train right here in the U.S. to leave our country once their residency is over,” she pointed out.

The bills have already garnered support from several notable professional medical societies, including the American Medical Association (AMA), American Hospital Association (AHA), and the Association of American Medical Colleges.

“J-1 visa waivers play a significant role in placing physicians in communities that face healthcare access challenges,” the AMA said in a public statement. “Many communities, including rural and low-income urban areas, struggle to attract physicians to meet their patient needs. This legislation will help ensure continued access to care in medically underserved communities across the U.S.”

AHA Executive Vice President Tom Nickels concurred, saying in a letter of support that healthcare access is a critical issue for the nation.

“More than 20 million Americans live in areas where there is a shortage of physicians,” Nickels said. “Our nation’s rural and inner city hospitals struggle to recruit and retain physicians, and the supply of primary care providers in such areas is steadily declining. In many areas of the country, a Conrad State 30 physician is the only source of primary health care.”

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