[Congressional Record Volume 154, Number 82 (Monday, May 19, 2008)]
[House]
[Pages H4113-H4115]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
EXTENDING PROGRAM RELATING TO WAIVER OF FOREIGN COUNTRY RESIDENCE
REQUIREMENT WITH RESPECT TO INTERNATIONAL MEDICAL GRADUATES
Mr. SCOTT of Virginia. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 5571) to extend for 5 years the program relating to
waiver of the foreign country residence requirement with respect to
international medical graduates, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 5571
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. EXTENSION OF WAIVER PROGRAM.
Section 220(c) of the Immigration and Nationality Technical
Corrections Act of 1994 (8 U.S.C. 1182 note) is amended by
striking ``June 1, 2008'' and inserting ``June 1, 2013''.
SEC. 2. EXPANDING THE FLEXIBILITY OF THE CONRAD STATE 30
PROGRAM.
Section 214(l)(1)(D)(ii) of the Immigration and Nationality
Act (8 U.S.C. 1184(l)(1)(D)(ii)) is amended by striking ``5''
and inserting ``10''.
SEC. 3. SENSE OF CONGRESS.
It is the sense of the Congress that--
(1) Federal programs waiving the 2-year foreign residence
requirement under section 212(e) of the Immigration and
Nationality Act (8 U.S.C. 1182(e)) for physicians are
generally designed to promote the delivery of critically
needed medical services to people in the United States
lacking adequate access to physician care; and
(2) when determining the qualification of a location for
designation as a health professional shortage area, the
Secretary of Health and Human Services should consider the
needs of vulnerable populations in low-income and
impoverished communities, communities with high infant
mortality rates, and communities exhibiting other signs of a
lack of necessary physician services.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Virginia (Mr. Scott) and the gentleman from Iowa (Mr. King) each will
control 20 minutes.
The Chair recognizes the gentleman from Virginia.
General Leave
Mr. SCOTT of Virginia. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days to revise and extend their remarks and
to include extraneous material on the bill under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Virginia?
There was no objection.
Mr. SCOTT of Virginia. Mr. Speaker, I yield myself such time as I may
consume.
Today we take urgent action to prevent a critically important
immigration program from expiring.
No one disputes that there is a health care crisis in this country.
With our
[[Page H4114]]
population aging, there can be no doubt that the demand for health care
will only increase.
The problem is made worse by the fact that many people in communities
across America lack access to health care because of a shortage of
medical professionals, including doctors. H.R. 5571 will reauthorize
the program, the Conrad 30 J Waiver program, that has been successful
in helping medically underserved communities attract highly skilled
physicians. If Congress does not act, the Conrad program will expire on
June 1, 2008.
And how important is this program? Well, to take just one example, a
little more than a year ago, in early May 2007, a powerful tornado tore
through a Kansas prairie, destroying 95 percent of the town of
Greensburg and killing 11 people. Because of the Conrad 30 program,
doctors were available in Greensburg to serve this community in need.
The Conrad 30 program allows States, like Kansas, to recommend that
doctors who have received medical training in the United States on a J-
1 visa and who now want to work in medically underserved areas receive
waivers from the general requirement that doctors first return to their
home countries for 2 years. This is too important a program to let
expire.
I want to commend the gentlewoman from California (Ms. Zoe Lofgren),
the Chair of the Immigration Subcommittee, for her leadership on this
issue. I also want to thank the ranking member of the full committee,
the gentleman from Texas (Mr. Smith); and the gentlewoman from Texas
(Ms. Jackson-Lee) for their efforts to make sure that this bill came to
the floor.
I urge my colleagues to support this important legislation.
Mr. Speaker, I reserve the balance of my time.
Mr. KING of Iowa. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, aliens who participate in medical residencies in the
United States on J exchange program visas must generally leave the U.S.
at the conclusion of their residencies to reside abroad for 2 years
before they can be eligible for permanent residence or status as H-1B
or L visa nonimmigrants. The intent behind this policy to encourage
American-trained foreign doctors to return home to improve health
conditions and advance the medical professions in their native
countries.
In 1994 Congress created a waiver of the 2-year foreign residence
requirement. The waiver was available if requested by State departments
of public health for foreign doctors who committed to practice medicine
for no less than 3 years in a geographic area or areas designated by
the Secretary of Health and Human Services as having a shortage of
health care professionals. The number of foreign doctors who could
receive the waiver was limited to 20 per State.
Congress has extended this waiver on multiple occasions and has also
expanded the numerical limitation on waivers to 30 per State. The
waiver is set to expire on June 1 of this year. In fiscal year 2007,
768 foreign doctors received waivers.
H.R. 5571 will further extend the waiver until June 1, 2013. I
support this bill. The waiver program assists people in rural and
inner-city communities in getting good quality and accessible medical
care. As I look at the problem of access to health care and the way we
have addressed it in this Congress, it gives me a foreboding feeling to
see where we will be in 10 years or so. I think it's an important
piece, a small piece, but an important piece of our health care plan. I
urge its adoption.
Mr. Speaker, I reserve the balance of my time.
Mr. SCOTT of Virginia. Mr. Speaker, I yield such time as she may
consume to the gentlewoman from Texas (Ms. Jackson-Lee).
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)
Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise as well to support the
legislation, H.R. 5571, and to commend the chairwoman of the
Subcommittee on Immigration of the House Judiciary Committee for her
leadership on this issue, Congresswoman Zoe Lofgren. I thank the
manager of the bill, Mr. Scott, for his leadership; our chairman of the
full committee; our ranking member of the full committee; and the
ranking member of the Immigration Subcommittee, Mr. King of Iowa.
This is an embracing and unifying initiative. Why? Because we all
understand the necessity of health care in America. We understand the
importance of providing access to health care no matter where you live.
And I thank Mr. Blake Chisam and my staff, Mr. Arthur Sidney, for
working on language that I proposed to emphasize the importance of the
provision that these doctors receive and should be guided by language
that indicate that they should be utilized in areas that are
underserved, that there are doctors that are not serving the area.
{time} 1630
So that foreign doctors who will benefit from the waiver provisions,
which means eliminating the need for foreign medical doctors to return
to their native land, will be utilized or encouraged to be utilized in
areas around the country. The language in particular reads: It is the
sense of Congress that Federal programs waiving the J-1 home residency
requirement for physicians are generally designed to promote the
delivery of critically needed medical services to Americans lacking
adequate access to physician care, and that when determining the
qualification of location for a waiver petition, the Department of
Health and Human Services should always consider the needs of
vulnerable populations in low-income and impoverished communities,
communities with high infant mortality rates, rural areas, and
communities exhibiting other signs of a lack of necessary physician
services.
In my State of Texas, we have been fighting for this for a very long
time. In the rural parts of Texas, we are lacking in medical services
and physicians. It's very important when these waivers are given that
these physicians are utilized where they can best serve, and that is in
vast number of areas that do not have access to health care.
I support this legislation, H.R. 5571, and I think as it comes to the
floor, it contains all the elements that suggest a benefit that brings
about a burden, but not a burden that is negative but a burden to serve
those who are in desperate need. Many of our country are, and these
physicians can help them. With that, I believe this is an important
bill.
Mr. Speaker, I rise today in support of H.R. 5571, to extend for 5
years the program relating to waiver of the foreign country residence
requirement with respect to international medical graduates. The
purpose of this bill is to extend for 5 years the program relating to a
waiver of the foreign country residence requirement with respect to
international medical graduates. I support this bill.
The Immigration and Nationality Act allows for foreign doctors to
train in the United States under the ``J-1'' visa program, otherwise
known as non-immigrants in the ``Exchange Visitor Program.'' This
Exchange Visitor Program seeks to promote peaceful relations and mutual
understanding with other countries through educational and cultural
exchange programs. Accordingly, many exchange visitors, including
doctors in training, are subject to a requirement that they must return
to their home country to share with their countrymen the knowledge,
experience, and impressions gained during their stay in the United
States. Unless U.S. Customs and Immigration Service approves a waiver
of this requirement, the exchange visitors must depart from the United
States and live in their home country for 2 years before they are
allowed to apply for an immigrant visa, permanent residence, or a new
non-immigrant status.
A waiver of the 2 year foreign residency requirement is available for
doctors who have trained in the United States under the J-1 visa if a
State or an interested Federal agency sponsors the physician exchange
visitor to work in a health manpower shortage area within the State for
3 years as a non-immigrant in H-1B status (temporary worker in
specialty occupation). The Secretary of Health and Human Services
determines which areas have a health manpower shortage.
The availability of this waiver will sunset on June 1, 2008. H.R.
5571 would extend this waiver for 5 years to ensure that areas in the
United States with a shortage of doctors have an option to hire a
doctor with a J-1 visa for 3 years where there is no other doctor
available to fill the job.
I worked with Congresswoman Zoe Lofgren to ensure that the foreign
doctors who will benefit from the waiver provisions, eliminating the
need for the foreign medical doctors to return to their native land,
will be
[[Page H4115]]
required to work in impoverished and underserved inner-city and urban
communities. I believe that this is important because Americans who
need access to medical care, the poor and needy, will benefit. This
would be a tremendous improvement in the U.S. medical system and would
move us closer to garnering access to healthcare for all.
Specifically, I worked to include the following language in the bill:
It is the sense of Congress that Federal programs waiving
the J-1 home residency requirement for physicians are
generally designed to promote the delivery of critically
needed medical services to Americans lacking adequate access
to physician care and that when determining the qualification
of a location for a waiver petition, the Department of Health
and Human Services should always consider the needs of
vulnerable populations in low-income and impoverished
communities, communities with high infant mortality rates,
rural areas, and communities exhibiting other signs of a lack
of necessary physician services.
Across this great Nation the health disparities between minority and
majority populations are staggering. Most major diseases--diabetes,
heart disease, prostate cancer, HIV/AIDS, low-birth-weight babies--all
hit the minority communities harder. Minorities consistently have
decreased access to care, and receive lower quality care, when they do
have access. As the economy continues to falter and as the unemployment
rate spikes, millions of Americans are losing their health insurance.
That state of affairs will only make the health disparities worse.
Consider these statistics:
African-American women are nearly three times as likely to die from
pregnancy complications and childbirth as White women.
Native American, African-American and Hispanic women are most likely
to receive inadequate prenatal care.
Compared with White women, African American women are twice as likely
and Hispanic women are nearly three times as likely to be uninsured.
Furthermore, African Americans and Hispanics are much more likely than
Whites to lack a usual source of care and to encounter other
difficulties in obtaining needed care.
Certain minorities also have much higher rates of diabetes-related
complications and death, in some instances by as much as 50 percent
more than the total population. It is truly an epidemic.
Nearly 31 percent of African American girls in the 4th grade were
overweight in 2001.
Thirteen percent of Houston high school students are overweight and
17 percent are at risk.
Thirty-four percent of African American women are obese, compared to
19 percent of White women.
Forty-four percent of African American women are projected to be
obese by 2020, and 47 percent by 2040.
As of February 2006, African-Americans represented only 13 percent of
the U.S. population, but accounted for 40 percent of the 944,306 AIDS
cases diagnosed since the start of the epidemic and approximately half,
49 percent, of the 42,514 cases diagnosed in 2004 alone.
African-Americans also account for half of new HIV/AIDS diagnoses in
the 35 States/areas with confidential name-based reporting.
The AIDS case rate per 100,000 population among African-American
adults/adolescents was nearly 10.2 times that of Whites in 2004.
African-Americans accounted for 55 percent of deaths due to HIV in
2002 and their survival time after an AIDS diagnosis is lower on
average than it is for other racial/ethnic groups.
HIV was the third leading cause of death for African-Americans, ages
25-34, in 2002 compared to the sixth leading cause of death for Whites
and Latinos in this age group.
African-American women account for the majority of new AIDS cases
among women, 67 percent in 2004; while White women account for 17
percent and Latinos 15 percent. Among African-Americans, African-
American women represent more than a third, 36 percent, of AIDS cases
diagnosed in 2004.
Although African-American teens, ages 13-19, represent only 15
percent of U.S. teenagers, they accounted for 66 percent of new AIDS
cases reported among teens in 2003.
It is my hope that the language that I worked to get included in the
bill will promote the delivery of critically needed medical services to
Americans in low-income and impoverished communities, rural areas, and
communities that are in desperate need of physician services.
I urge my colleagues to support this bill.
Mr. KING of Iowa. I have no further speakers, and I will yield myself
such time as I may consume.
Mr. Speaker, I rise in support of this bill. I think reauthorizing
the J visas for access to health care across this Nation, allowing
people practicing medicine to come in at the rate of 30 per State, and
look around to see which States utilize that and which ones don't, it
is easy for us to see those States that need that access to health
care. This will help. It will help in a lot of the States. In fact, it
will help in all the States, if they use it.
I urge its adoption.
I yield back the balance of my time.
Mr. SCOTT of Virginia. Mr. Speaker, I yield back the balance of my
time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Virginia (Mr. Scott) that the House suspend the rules
and pass the bill, H.R. 5571, as amended.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. KING of Iowa. Mr. Speaker, I object to the vote on the ground
that a quorum is not present and make the point of order that a quorum
is not present.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.
The point of no quorum is considered withdrawn.
____________________