Padilla Leads Hearing Examining How Immigrants Can Bolster Depleting Health Care Workforce￼
WASHINGTON, D.C. — Today, U.S. Senator Alex Padilla (D-Calif.), Chairman of the Senate Judiciary Subcommittee on Immigration, Citizenship and Border Safety, convened his fifth hearing of the Subcommittee entitled “Flatlining Care: Why Immigrants Are Crucial to Bolstering Our Health Care Workforce.”
The hearing focused on health care workforce shortages, particularly in rural and medically underserved areas, and the growing crisis of access to the most basic level of medical care in the United States. Our country’s health care workforce shortages are dire, with studies confirming physician demand in the U.S. will continue to grow faster than supply, leading to a projected total physician shortage of up to 124,000 by 2034. Immigrants are a significant part of the health care workforce, but their potential impact is limited by our outdated immigration system that does not adequately address current workforce shortages in the health care industry. Without reforms, we will continue to face critically-severe and worsening shortages that only compromise the health and wellbeing of all Americans.
During the hearing, Senator Padilla heard from Dr. Ram Sanjeev Alur, MD, Hospitalist Physician at Marion Veterans Affairs Medical Center in Illinois; Sarah Peterson, Principal, SPS Immigration PLLC in Minnesota; and Sheriff Urbino “Benny” Martinez of Brooks County, Texas.
Padilla opened the hearing by highlighting the growing shortage of health care workers that is impacting Americans’ access to health care, how our health care system has already depended on immigrants during the COVID-19 pandemic, and made the case for fixing our outdated immigration system, which has allowed this shortage to go unaddressed.
Padilla began his questioning by asking about how limitations on nonimmigrant visas impact doctors and other health care professionals. Dr. Alur discussed how the restrictions impeded the ability of immigrant health care workers to provide services to Americans during the peak of the pandemic. Dr. Alur also spoke to the potential benefits of lifting those restrictions, including enabling health care professions to provide care for more people with a wider breadth of services. During this discussion, Ms. Peterson emphasized how immigrant physicians have already stepped up to fill the gaps in underserved areas and how lifting restrictions would increase access to health care services for that population.
During a second round of questioning, Padilla and Dr. Alur spoke about the disparities in health care access for rural communities, which are often too far from hubs where health care services are available. Dr. Alur also expressed how the stability offered by green cards would improve the lives of his family as well as his patients, who would have more access to his services.
In a final exchange, Padilla and Ms. Peterson spoke about how dealing with issues of immigration and health care shortages are not mutually exclusive. Ms. Peterson emphasized how inaction will only exacerbate the health care shortage problem and become a growing burden on the American people by way of longer wait times, worse health outcomes, and financial burdens.
Padilla closed the committee hearing by raising concerns with Republicans’ continued attempts to detract and conflate the hearing topic with politically motivated border security concerns. He reiterated that the hearing had nothing to do with the border and called on his Republican colleagues to work in good faith on bipartisan solutions that are sitting before the Judiciary Committee to address our health care shortage crisis.
Senator Padilla is a strong advocate and leader for immigration reform. As Chair of the Judiciary Subcommittee on Immigration, Padilla has now led five hearings to highlight the urgency of taking action to fix our outdated and broken immigration system. Padilla is an original cosponsor of the U.S. Citizenship Act of 2021, legislation to overhaul the American immigration system, restore fairness and humanity to the system, strengthen families, boost our economy, and open a pathway to citizenship for millions. He also introduced the Citizenship for Essential Workers Act to create a pathway to citizenship for undocumented essential workers and the bipartisan America’s Children Act to provide a pathway to citizenship for ‘Documented Dreamers,’ children of long-term visa holders who have been waiting for years, and often decades, for a green card.
Additional information on the hearing is available here.
Full transcript of Padilla’s opening remarks, as prepared for delivery, can be found below:
Good morning. Welcome to the fifth hearing of the Senate Judiciary Subcommittee on Immigration, Citizenship, and Border Safety this Congress.
Today we’re here to talk about both the critical role that immigrants play in our nation’s health care system, and the opportunity and obligation we have to confront our nation’s growing shortage of health care workers.
I want to thank all of our witnesses who are here today—not only to speak about their personal experiences, but who have a shared goal of improving care for millions of Americans.
For that same reason I want to thank Chairman Durbin, Ranking Member Cornyn, and all the committee staff who have worked so hard to bring this hearing together.
Today, we have an opportunity to shed light on life-saving solutions to the challenges facing our health care system.
And we have a chance to reshape our immigration laws in ways that better reflect the needs of our population and economy.
Over the last few years, Americans have seen new obstacles to accessing the standard of health care that should be readily available to everyone.
Even before the COVID-19 pandemic, the United States was experiencing some concerning trends:
Our population was aging, with more patients increasing demand for care and more physicians retiring;
Sky high student loan debts were driving prospective health care professionals away from the field;
And hundreds of hospitals in rural or low-income communities were at risk of closing their doors for good after struggling to recruit physicians.
The onset of COVID-19 created an entirely new strain on our workforce—thrusting America’s health care workers onto the frontlines of a crisis, and accelerating burn out in an already fractured system.
Tragically, in the first year of the pandemic, 3,600 health care workers died while serving their communities.
As a result, we are now facing a dangerous shortage of health care workers.
The Association of American Medical Colleges projects the U.S. is facing a shortage of up to 124,000 physicians by 2034.
That means a shortage of up to 48,000 primary care physicians, and up to 77,100 non-primary care physicians.
And 1 million nurses are expected to retire in the next decade.
For over two and a half years of a pandemic, Americans had to put doctor’s appointments and life-saving screenings on hold.
But as COVID becomes endemic, and as we gain the tools to better manage outbreaks, there shouldn’t be any more excuses for delaying Americans lifesaving care simply because we couldn’t invest in our health care workforce.
Luckily, there is a common-sense solution right before us.
There are thousands of highly qualified health care professionals living abroad with dreams of coming to America to study, train in their profession, and ultimately save lives.
We know immigrant health care workers can help to fill this gap and provide critical care to so many communities in need.
How? Because in large part, they already are.
One in every four physicians, and one in every six nurses is an immigrant in the United States.
There are around 34,000 DACA recipients and 11,600 TPS holders working in the health care field.
And with an aging population in desperate need of care, immigrants make up over half of our physicians practicing geriatric medicine, and almost 38 percent of America’s home health aides.
Immigrants write our prescriptions;
They care for us at our bedsides;
They perform highly skilled procedures;
And they’re often the cornerstone for rural and low-income communities—places where sometimes one foreign born physician can be tasked with protecting an entire community.
There’s no reason we can’t turn to them now to confront this crisis.
However, even as we face unprecedented shortages in our health care system, the laws that limit the immigration of highly trained health care workers have gone largely unreformed since the 1990s.
There continue to be backlogs in processing green cards for critical health care workers.
There are annual caps to employment-based visa categories that have not been met and per country caps that should be updated to meet the demand of the health care industry.
And many of the essential workers we relied on at the peak of the COVID-19 pandemic still risk uncertainty with their legal status in America.
In our hour of need, the United States is effectively discouraging immigrants from trying to come to America to join our health care work force.
That needs to change.
The very first bill I introduced in the Senate, co-sponsored by Chairman Durbin and others in this committee, would start to protect many of those workers at risk.
By providing an expedited pathway to citizenship for the over five million essential workers without permanent status, the Citizenship for Essential Workers Act would protect health care workers who risked their lives to keep our communities safe during this pandemic.
I’m also calling on the Senate to pass America’s Children Act and protect “Documented Dreamers”—the children of long-term visa holders who face deportation at the age of 21 without a green card or other immigration status.
Many health care professionals worry about their own children aging out of status or losing status completely if something were to happen to the primary visa holder.
But as we’ll hear today, we need bold, system-wide reforms that incentivize and welcome immigrants into our health care workforce.
And God forbid we force Americans to wait another month, another week, another day to access critical care because we couldn’t come together to fix our immigration system.
I am looking forward to hearing from all of our witnesses today about what they’ve seen firsthand, and about how we can work together to fix this broken system.
Next, I’ll turn it over to Ranking Member Cornyn for his opening statement.