As nursing visas again hit their annual limit, industry groups call for Congress to step in

International workers’ high demand for employment-based immigrant visas has led the State Department to effectively cut off the flow of green cards for skilled workers, including nurses, for the remainder of the fiscal year.

In its Visa Bulletin for July 2024, the department wrote that “it has become necessary” to retrogress its final action date for those applying for its EB-3 subcategory of visas.

In other words, for immigrants from most countries, the government will now only be considering applications from those who applied on or before Dec. 1, 2021—a cutoff nearly a full year earlier than what the department was communicating in June’s bulletin.

Further, the State Department wrote that “it will likely be necessary to either further retrogress the final action date or make the category 'Unavailable' in August.”

The EB-3 subcategory includes all occupations that require at least an associate’s degree but not a master’s degree. About 40,000 EB-3 visas are issued each fiscal year, which ends Sept. 30, and the subcategory is typically dominated by IT workers. That total has remained unchanged since 1990 and forced the country into a similar logjam last spring.

The latest announcement triggered alarm bells for healthcare workforce groups, who were quick to point out widespread nursing shortages and limited means to increase the country’s pipeline.

"We're reaching a dangerous inflection point where acute nurse staffing shortages feed burnout in a force-multiplying cycle that grows worse every day," Patty Jeffrey, president of the American Association of International Healthcare (AAIHR), said in a statement. "Until we can correct capacity issues that force nursing schools to reject thousands of qualified applicants annually, international nurses will remain essential to safe nurse staffing. This latest visa freeze halts the flow of qualified international nurses when American hospitals need them most, and the only way to correct it is through congressional action."

AAIHR noted that the State Department’s announcement lands shortly after the Biden administration finalized a nursing home staffing rule that will require over 20,000 new registered nurse hires over the coming years.

Similar warnings came from the Healthcare Workforce Coalition, a group formed late last year by AAIHR, the American Hospital Association (AHA) and other provider associations to lobby for workforce protections.

The coalition pointed to the bipartisan, industry-backed Healthcare Workforce Resilience Act that would recapture 25,000 green cards that were issued to international nurses but went unused, as well as another 15,000 for international physicians. The bill specifies that international workers must meet their licensing and background requirements prior to receiving the recaptured employment visas and that their employers attest that the roles being given to international workers won’t displace domestic employees.

“Foreign-trained nurses and doctors play critical roles in providing support for our hospitals and health systems,” Megan Cundari, senior director of federal relations for the AHA, said in a release from the Healthcare Workforce Coalition. “While we must invest in developing our domestic health care workforce, the [Healthcare Workforce Resilience Act] would help ease current shortages so we can continue to serve our patients and communities.”

Jennifer Cook, senior counsel in the immigration practice at law firm Clark Hill, advised in an online post that healthcare employers continue to sponsor nurses "because although the visa processing queues ebb and flow, they never stop altogether." 

Similar to last year, she said her practice expects there will be a "significant priority date advancement" in October, the start of the government's new fiscal year. Employers who continue to sponsor nurses during such a retrogression period "despite alarmist predictions about the impact of retrogression on healthcare providers" have historically been rewarded once the department catches up on its backlog and realigns, Cook wrote.