November 14, 2017

Uncapping High-Value Immigration Categories Could Save Lives and Create Jobs



Well-targeted immigration policies provide a unique opportunity for the United States to remedy shortages in the labor market, as well as grow the economy. The medical field is one such area facing labor shortages, and allowing more foreign medical professionals to work in the United States offers a practical solution. Expanding entrepreneurship and job creation are ideas lawmakers frequently tout, and expanding high-skill immigration provides an effective avenue for lawmakers to achieve both.

Particularly with respect to physicians and nurses, the United States faces a massive shortage of medical professionals. This trend is likely to worsen as the U.S. population continues to age and the demand for medical services rises. By increasing the number of foreign medical professionals authorized to work in the United States, stresses on the existing medical workforce can be reduced.

There are currently two visas available to qualified medical professionals, the H-1B and the J-1. Despite being branded as a “tech visa,” a wide variety of professionals utilize the H-1B program, as I have previously written. In FY 2016, over 14,000 medical and health professionals were authorized to work using H-1B visas, including over 7,000 physicians and surgeons. A recent study from George Mason University found that 28 percent of U.S. physicians and surgeons were foreign-born, along with 15 percent of registered nurses. A 2013 study by the National Foundation for American Policy found that 42 percent of cancer researchers at the top seven cancer research centers in the United States were foreign-born. These professionals help provide vital services to patients throughout the United States, including in rural and underserved areas.

Unfortunately for American healthcare consumers, the number of foreign medical professionals who can be admitted annually to the United States is limited by the statutory cap on H-1B visas (not all of which are issued to medical professionals) of 65,000, plus an additional 20,000 visas reserved for individuals with advanced degrees. Greatly expanding the number of H-1B visas made available each year would help ease the strain on the existing medical workforce by allowing for the entry of more medical professionals. Legislative proposals like Utah Sen. Orrin Hatch’s I-Squared Act, which would double or even triple the number of H-1B visas made available each year, would help achieve this objective.

The other way foreign medical professionals can enter the United States is through the J-1 exchange visa physician program. This program allows foreign medical students to study at participating medical schools in the United States. In 2016, over 2,600 medical students participated in the J-1 program. J-1 visa holders are also eligible to apply for programs like Conrad 30, which serves rural and underserved health care systems. Normally, J-1 visa holders must return to their home country for at least two years after completing their course of study. The Conrad waiver allows them to stay longer, as well as apply for permanent immigration benefits. As the Niskanen Center’s Kristie De Peña has written, making programs like Conrad 30 permanent would help combat health care shortages and make the J-1 physician program an even more attractive option for foreign medical students.

Entrepreneurship is another area that can be helped with well-targeted immigration reform. Economic research suggests that new-firm growth is the primary driver of job creation, which makes the promotion of entrepreneurship an economic imperative for the United States. The Kauffman Foundation, which conducts research on entrepreneurship in the United States, has found that new-firm formation is half of what it was a generation ago. The Kauffman Foundation has studied immigrant entrepreneurship extensively, and their findings are striking: Immigrants are two times more likely than a native individual is to start a business, and  creating a start-up visa could generate between 500,000 and 1.6 million jobs.

These are businesses that provide employment opportunities for Americans, as well as offer more choices of goods and services to consumers. Establishing a start-up visa program, like the one laid out in Arizona Rep. Kyrsten Sinema’s Jobs in America Act, would create thousands of jobs for American workers and promote capital investment in the United States. Incentivizing potential immigrant entrepreneurs to start a business in the United States over other countries is a winning policy for the entrepreneur, and a winning policy for American workers.

As noted by the Chicago Council, the science, technology, engineering, and math (STEM) sector is growing quickly, driven in part by the presence of skilled immigrants with advanced degrees. Allowing immigrant students pursuing STEM degrees to remain in the United States on a long-term basis after completing their education would be hugely beneficial for the continued growth of STEM sector businesses. In August 2016, when the Chicago Council report was published, 60 percent of start-ups valued at over $1 billion were founded by immigrants or their children, worth $81 billion in total. A report by New American Economy found that over 40 percent of the 2010 Fortune 500 companies were founded by immigrants or their children.

Improving medical care, growing the economy, and creating jobs are objectives all lawmakers can support. Uncapping high-value immigration is a powerful mechanism to achieve these objectives and improve the lives of all Americans.