Republican Leaders Push Bill to Import Nurses, Not Train Americans

BIRMINGHAM, ENGLAND - MARCH 16: A nurse uses a wireless electronic tablet to order medicin
Christopher Furlong/Getty Images
Neil Munro

Republican and Democrat legislators want to help hospital chains import at least 25,000 extra foreign nurses, even though tens of thousands of Americans are being denied places in underfunded nursing schools.

“If there’s one thing I hear from my hospitals in Texas, it’s the shortage of nurses because of the burnout factor associated with COVID-19 and the like,” Texas Republican Sen. John Cornyn said at a March 15 hearing. “Now hospitals are having to pay incredible multiples of what they ordinarily would pay to nurses to contract with companies that basically will provide the [travel] nurses.”

The foreign nurses should get U.S. nursing jobs because not enough Americans are interested in nursing careers, said a statement from Rep. Tom Cole (R-OK). “Federal resources are scarce and inadequate to finance an expansion of our medical training system,” he said in a February 25 statement to Breitbart News.

“The number of Americans interested in pursuing health care professions has unfortunately not kept pace with the growing demand … [so] allowing skilled, foreign medical professionals to practice in the U.S. is a suitable alternative,” Cole’s statement said. “While I wish more Americans were choosing to pursue education and professions in the health care field, the reality is that our country has a serious labor shortage and simply cannot fulfill the demand,” he said.

Democrats are also calling for more nurses, even though they are also talking up the need to train more Americans.

“We have an urgent nursing shortage in the state of Wisconsin, in hospital settings, in clinical settings, and nursing home settings,” Sen. Tammy Baldwin (D-WI) said at a February 10 hearing in the Senate. “At the same time, there are eligible students who are turned away from potential training because of the shortage of nursing faculty.”

“Just in Colorado, we’re facing an estimated shortage of 10,000 nurses over the next five years,” Sen. John  Hickenlooper (D-CO) said. “If we are serious … We should make it easier for those without college degrees, for working parents, and for those without previous experience, to break into early-stage healthcare jobs.”

Democrats are hoping they can use the nurse bill and a bill that would help H-1B contract workers win the huge prize of citizenship for their children to win a critical bloc of about 12 GOP Senators for passage of a pro-migration bill.

The Democrats need the 12 or more Republicans to reach the 60-votes threshold needed to get any immigration bill through the Senate to President Biden’s desk. So far, GOP opposition has blocked several efforts by Democrats to pass a massive immigration-expansion bill in 2021 and this year.

In his March 15 hearing, Cornyn touted his work with Democrats to draft the Senate’s version of Cole’s Healthcare Workforce Resilience Act.

Cornyn and Sen. Richard Durbin (D-IL), the Democrats’ top immigration advocate, agreed to negotiate an immigration bill. “You may have seen history in the making,” Durbin said.

“The question is: is there anything we can do on the subject of immigration that can win 60 votes in the Senate?” Durbin asked Politico on March 20. “We’re going to test that.”

For now, 13 GOP Senators — and at least 12 Democrat Senators — are sponsoring the new bill that would import at least 25,000 foreign nurses for stable careers that would otherwise go to young Americans. The Healthcare Workforce Resilience Act would create green cards for at least 25,000 foreign nurses.

The “workforce resilience” bill is sponsored by Cornyn (R-TX) and Sen. Todd Young (R-IN).

The bill is co-sponsored by GOP Sens. Kevin Cramer (R-ND), Rob Portman (R-OH), Joni Ernst (R-IA), Bill Cassidy (R-LA), John Bo0zman (R-AR), Roy Blunt (R-MO), John Thune (R-SD), Mike Rounds (R-SD), Thom Tillis (R-NC), Susan Collins (R-ME). and Rand Paul (R-KY). The senators’ states include roughly 4 million high-school students.

Tillis is also pushing a Democratic-backed bill to fast-track the award of green cards to Indian visa workers. Naturalized Indians overwhelmingly vote for pro-immigration Democrat candidates, in part because the Democrats support the transfer of jobs from American graduates to Indian visa workers.

“I just specifically discussed the recapture there seems to be a general consensus on it,” Tillis told Latinorebels.com March 22. “I mean, there are going to be some that would be opposed to it … It’s only down to two [judciary committee] members that would even object to it,” said Tillis, who was reelected in 2020 with support from President Donald Trump.

Cole’s 25,000-nurse outsourcing bill in the House is also backed by GOP legislators who have championed prior immigration bills favored by businesses. They include Rep. Don Bacon (R-NE), Rep. Brian Fitzpatrick (R-PA), Rep. Billy Long (R-MO), and Rep. Mariannette Miller-Meeks (R-IA).

Meanwhile, Republican and Democratic legislators have done little to accelerate the training of American nurses for the routine nursing jobs now going to the foreign nurses favored by healthcare companies, despite the vast evidence of the sector-wide burnout and resignations caused by the coronavirus crash, and the huge share of older nurses who are heading towards retirement.

The Hechinger Report outlined the federal failure in December:

LONG BEACH, Calif. — At a time when the Covid-19 pandemic has exposed a growing shortage of nurses, it should have been good news that there were more than 1,200 applicants to enter the associate degree program in nursing at Long Beach City College. But the community college took only 32 of them.

…

U.S. universities and colleges last year rejected 80,407 qualified applicants for bachelor’s and graduate degrees in nursing, blaming a lack of faculty, classroom space and clinical opportunities in hospitals. That doesn’t include the number turned away by community colleges, which educate a large number of beginning nurses.

At Cape Fear Community College in North Carolina, “we always have well over 400 applicants” for just 80 spots, Brenda Holland, the college’s nursing chief told WHQR.com.

“Hospitals have failed to hire and support enough nurses to weather crises,” Sarah DiGregorio said in an op-ed for the Washington Post. Nursing schools are “rejecting tens of thousands of qualified candidates because there aren’t enough instructors to teach them [in part because] nurse educators are paid a fraction of what they could make working clinically.”

“If the industry — and our lawmakers — truly want to address the staffing crises, they will need to start at the root of the problem: our collective failure to value caring,” DiGregorio wrote.

Industry groups want to import many foreign nurses.

U.S. investors prefer foreign nurses because most will work long hours without complaint in a rational exchange for the company-provided deferred bonus of green cards, citizenship, and chain migration. “I’m doing it for my daughter, for the sake of her future, so that she can also move here and then get a better life,” Alex-Jane Hermio-Nees, a Filipino nurse with a job in Arizona, told NBC News Now. “My daughter is still back home. I miss her a lot and also my mom.”

In 1996, healthcare lobbyists persuaded Congress to create a hidden pipeline for hospitals to import their own nurses and therapists, similar to the special H-1B white-collar pipeline created for the Fortune 500. In 2018 the nation had roughly 3.3 million registered nurses (RNs), each of whom has earned a nursing degree.

That number includes 512,000 immigrant nurses, or 15 percent of the labor force, according to 2018 data reported by the pro-migration Migration Policy Institute.

Overall, the immigrant share of RNs jumped from 11 percent in 2000 to 15 percent in 2015, according to a report by the Institute for Immigration Research at George Mason University in Virginia. The immigrant share of all nurses, psychiatric, and home health aides has jumped from 17 percent in 2000 up to 24 percent in 2015, and their numbers almost doubled, from 591,000 in 2000 to 1.1 million in 2015.

The Migration Policy Institute report says 1.5 million immigrants hold skilled jobs as “health-care practitioners and technical occupations,” and that another 1.138 million immigrants hold “health-care support” jobs.

Immigrants hold larger shares of registered nursing jobs in several states — “Nevada (36 percent), California (35 percent), Maryland (30 percent), and New York (29 percent)” — the Migration Policy Institute said. Only about 37 percent of the nurses came from Central and South America.

The foreign nurses are imported via a variety of little-recognized visa programs. For example, a November 2021 letter from the medical industry reported that 134,558 nurses waited for green-card processing at the U.S. embassy in Manila in President Barack Obama’s second term. But that number fell to 94,816 in President Donald Trump’s four years.

Hospital managers burn through their nursing workforce, regardless of the damage done to nurses and patients, DiGregorio wrote:

Employing more nurses per patient is safer for patients, and it makes nurses less likely to burn-out and quit. But hiring and supporting a large nursing staff is expensive, and many hospitals have been unwilling to do it. Travel nurses are expensive, too, but they are a short-term expense; they don’t get benefits or job security.

The flood of foreign labor cuts jobs and wages for American nurses — and minimizes the political pressure to train more young Americans for nursing careers.

The inflation-adjusted wages for registered nurses rose by only 4 percent from 2010 to 2020, according to data from the Bureau of Labor Statistics. During the same period, the nation’s biggest hospital chain saw its stock price rise from $33 to almost $240 per share, delivering a $60 billion gain for the shareholders, which include former GOP Senator Bill Frist.

In most of the nation, nurses earn between $60,000 and $70,000, but in many states they earn less, according to job-search site Ziprecruiter.

In Florida, for example, the average salary was $54,530, said Ziprecruiter. The Bureau of Labor Statistics reports that nurses on the coasts are paid higher wages, while nurses in a zone including  states from Alabama to West Virginia and South Dakota to Oklahoma, earn much less. Nurses in Connecticut, Massachusetts, and Hawaii earn around $75,000, but they also have to pay higher housing costs.

Wall Street converts nurses’ wage losses into gains for investors. In general, healthcare stock values rise by $12 billion when wages can be cut by $1 billion.

Amid the coronavirus crash, nurses have gone on strike to protest their wages and staffing levels. On November 15, for example, Kaiser Permanente dropped plans for wage cuts after 32,000 nurses were about to strike in November, the Associated Press reported:

Agreement on the four-year contract includes annual wage increases, while maintaining health benefits for employees, and new staffing language to continue to protect employees and patients, the statement said.

“This agreement will mean patients will continue to receive the best care, and Alliance members will have the best jobs,” said Hal Ruddick, executive director of the alliance. “This contract protects our patients, provides safe staffing, and guarantees fair wages and benefits for every Alliance member.”

Unsurprisingly, the American Hospital Association (AHA) used the February 10 hearing to ask Sen. Baldwin and Sen. Hickenlooper for more foreign nurses:

Our workforce challenges are a national emergency that demand immediate attention from all levels of government and workable solutions. These include recruiting, revitalizing and diversifying the health care workforce by  …. Boosting [federal] support for [U.S.] nursing schools and faculty … Expediting visas for all highly trained foreign health care workers … Pursuing visa relief for foreign-trained nurses.

In 2021, the AHA also was quick to applaud the House and Senates bill introduced by Cole and other Republicans and Democrats. The bill “would expedite the visa authorization process for highly-trained [foreign] nurses, who could support hospitals facing staffing shortages,” said the association.

But the goal of boosting training U.S. students for the jobs is not mentioned in the AHA’s lobbying priorities for 2022. Instead, in 58th place, the AHA merely calls for legislators to “Address nursing shortages and burnout by reauthorizing nursing workforce development programs to support recruitment, retention and advanced education for nurses and other allied health professionals.”

Rep. Cole’s May 2020 bill was also backed by the U.S. Chamber of Commerce and the Koch political network, both of which routinely champion the inflow of more workers, consumers, and renters.

Cole is an influential GOP leader and a cheerleader for immigration. “We are a nation built largely and impressively by immigrants,” his website says.

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