By Chris Musillo

The Fairness for High-Skilled Immigrants Act (H.R. 1044), co-sponsored by Reps. Zoe Lofgren (D-CA), Ken Buck (R-CO), and 200+ bipartisan members and the companion Senate bill S. 386 sponsored by Sens. Mike Lee (R-UT) and Kamala Harris (D-CA) with 15+ co-sponsors) would amend the Immigration and Nationality Act by eliminating per-country caps for employment-based immigrant visas, aspires to a worthy goal: a more equitable immigration system. However, this proposal as it is drafted, would inadvertently devastate access to health care in the United States by restricting the immigration and hiring of foreign-educated registered nurses.

It is not law but could become law in 2019. In order to become law, the bill would need to pass both houses of the US Congress and be signed by the President. It is likely at least several months before Congress takes any action on the bill.

The law allows for 140,000 Employment-Based visas per year, of which 80,080 are used by EB-2 and EB-3. The Fairness Act does not change these numbers. It just re-orders the queue in which the numbers are claimed. As of April 2018, there were approximately 550,000 EB-2 and EB-3 Indian immigrants and their spouses and minor children waiting for green cards. Additionally, there are 25,000 Chinese and 21,000 Philippine immigrants and their spouses and minor children also waiting for green cards. No other countries have material retrogressions. In total the visa backlog for EB-2 and EB-3 is about 596,000.

At a run rate of 80,080 per year and a backlog of 596,000, there will be a permanent EB-2, EB-3 retrogression of 7.45 years (596,000 / 80,080 = 7.45). No hospital is going to sponsor a nurse today who is not going to arrive for 7.45 years.

Unlike IT workers, nurses are ineligible for H-1B visas. Therefore, while IT professionals are able to work inside the US while awaiting their retrogression, nurses and other healthcare occupations would need to wait outside the US for 7+ years.

The Fairness for High-Skilled Immigrants Act has a worthwhile aim: eliminating the incredibly long backlog for Indian EB2 and EB3 applicants. Musillo Unkenholt is in favor of the bill, provided that it is modified in a way to allow nurses to continue to come to the US. As it is currently structured, the Fairness for High-Skilled Immigrants Act would eliminate nurse immigration into the US.