Updates to Immigration Laws Would Address Midwest Health Care Shortages

March 23, 2016
With the Midwest relying increasingly on foreign-born health care professionals to fill critical labor gaps, a new study by the Chicago Council on Global Affairs finds that urgent immigration reforms are needed to ensure the future vitality of the health care sector. Updating visa allocations for foreign-born graduates from U.S. medical schools, removing H-1B visa quotas and caps for health care professionals, and streamlining credentialing processes for foreign-born professionals would help the United States, and the Midwest in particular, mitigate acute shortages of health care workers just as the aging baby boomer population is expected to demand increasing resources.

The health care sector, which is fundamental to the Midwest’s economy and livability, is under strain:
  • The U.S. Census Bureau projects a 36 percent growth in the number of Americans over age 65 in the next decade, with nearly 1/3 of all physicians retiring because they fall in that age demographic. Meanwhile, the number of individuals needing health care is increasing as an estimated 20 percent of Americans will be 65 or older and on Medicare in the next 15 years.
  • U.S.-born medical school graduates are not going to fill the gaps because they often pursue careers in lucrative specialties and relocate to coastal cities, causing severe shortages of critical primary care, pediatric and family medicine physicians in the rural Midwest.
  • Foreign-born health care professionals who have completed their training overseas face complicated, inconsistent reaccreditation processes in the United States, leaving many unable to practice in their fields.
The study also notes the inability of undocumented immigrants to access health insurance under current laws, further straining the health care sector by using expensive emergency room care instead of preventative care.

A continued political stalemate on immigration reform means these issues will only grow in urgency. The report argues that Congress should work urgently with the next Administration to update policies to:
  • Issue visas according to labor force demands.
  • Remove H-1B visa quotas and caps on high-skilled doctors and surgeons.
  • Streamline credentialing challenges for foreign-born professionals.
  • Allow undocumented individuals to access some forms of insurance.
  • Train health care professionals to provide linguistically and culturally competent care to diverse populations.
“In election cycles, rhetoric around immigration tends to simplify,” said study author Nicole Fisher. “But when the dust settles, Congress and the new president will need to address our growing reliance on foreign-born health care professionals. The best thing they can do is update our immigration policies to prepare for the inevitable labor shortages we will face in this sector.”

Health care contributes significantly to the Midwest economy. Midwestern hospitals alone employ nearly 1.3 million people, and in Missouri, Nebraska and North Dakota, the health care sector is the No. 1 employer in the state. Education and health care services generate $51 billion in wages across the 12-state region, according to the Bureau of Labor Statistics. Currently, 25 percent of all physicians and surgeons in the Midwest are born outside of the country.

“Reforms to immigration policies are not about partisan politics. They are needed to respond to current demographic, economic and social realities,” said Council on Global Affairs Immigration Director Juliana Kerr. “Without immediate and sustainable updates, the health care sector, the Midwest economy and peoples’ lives will be at stake.”

This report is part of the Council’s immigration initiative, which focuses on the important economic contributions immigrants make to Chicago, the Midwest and the nation. Through a series of publications and events, and a network of regional leaders, the Council provides analysis and policy recommendations to inform the immigration debate and bridge the partisan divide.

Generous support for The Chicago Council on Global Affairs’ immigration studies is provided by the John D. and Catherine T. MacArthur Foundation.

Read the full report here.

About the Author
Nicole Fisher is the founder and CEO of HHR Strategies, a healthcare- and human-rights-focused advising firm started in the Midwest. She is also a senior policy adviser on Capitol Hill and expert on health economics, technology and reform, specifically as they impact vulnerable populations. Fisher runs the nonprofit Global Brain Health Coalition and is pursuing a doctoral degree in health policy at the University of North Carolina. Her writing has appeared in numerous journals and publications, and her talks can be found on the United Nations website and various news outlets.