Asian Journal- The Filipino-American Community Newspaper

DEAR President Obama,

First of all, I would like to thank you for taking the reins of this country in the midst of the worst economic crisis since the Great Depression and period of the worst political divisiveness since perhaps the pre-Civil War era. Against that backdrop, I applaud the efforts you and your staff have undertaken to improve the national economy and reform the healthcare system, which are interrelated issues on many levels that also impinge on US immigration law and policy, which is the legal specialty I have been practicing since my admission to the California bar in 1993.

As Congress, policymakers, and special interest groups argued over the need for health care reform in the US last year, focus was lost on the substance of reform and the debate appears to have devolved to slogan-shouting and name calling in Congress. Indeed, the crux of the health care debate has been whether there should be a "public option," fueling ideological debate and exposing an enormous divide. Watching the health care reform bill lose momentum early this year, I was reminded of the failure of the McCain-Kennedy immigration reform bill just a few years ago: while both sides recognize a pressing need for reform, there are those in Congress who will obstruct the progress of any reform bill for perceived political expediency.

During the Immigration Reform debate, it was the politicians pandering to their party segment that labeled reform an "amnesty" and anyone in support of reform "weak on immigration." In the health care debate, we have politicians pandering to the party segments that label a Government option as "socialism," involving too much "Big Government," or "just too expensive." Each politician vies to put his two cents into the bill to assure his home state constituents that he has their priorities, no matter how wrong headed, in mind in time for the next election. The end result is a Frankenstein’s monster of a bill which, as a whole, no one wants.

I believe that due to the vast divides still plaguing the US Congress, the successful approach toward reform could be something less than "comprehensive," since there are certainly some areas of the law that everyone, Republican, Democrat and yes, Independent, would agree to reform. One issue that politicians on both side of the aisle could agree on, and which would improve both the quality and cost of healthcare as well as immigration policy in the US, is the nursing shortage.

The health care industry continues to face a crisis in filling current open positions with trained, skilled nurses. As the baby boomers enter their golden years, an increasing strain is put on the health care system to provide care for this growing, aging population. Further compounding the problem is the fact that the current nursing population is aging as well. For example, the average age of nurses in California is 47. The California Institute for Nursing and Health Care estimates that the state will need 108,000 new nurses by 2020 to fill the vacancies left by retiring nurses and to fill the new positions opened up to meet the increased demand for health care. Nationally, the US Bureau of Labor Statistics estimates that over 1 million new and replacement nurses will be needed by 2016 to meet staffing needs.

Individual states have ramped up their efforts to tackle their nursing shortages by offering more grants and scholarships to nursing students and trying to increase enrollments at nursing schools. While these efforts may help meet some of the future nursing needs, they do little to nothing to meet current staffing demand, such as the 150,000 open positions across the country for registered nurses. What makes this shortage all the more difficult to understand is the fact that there are thousands of qualified, available nurses from other countries, many currently in the US, who cannot get a visa to enter the country or are technically ineligible to adjust their status to work legally in the US.

There are two different categories of visas foreign nurses can potentially seek to enter the US to work: nonimmigrant visas and immigrant visas. Nonimmigrant visas are temporary visas that allow them to enter the US for a limited amount of time and for a limited purpose. There are three types of nonimmigrant visas for which nurses may possibly qualify: TN visas, H-1C visas and H-1B visas. Nonimmigrant visas present several of difficulties. First, they are valid for a limited amount of time, whereas the nursing crisis is an ongoing problem. Second, there are very few available nonimmigrant visas for which nurses can apply. For example, H1-B visas are only available for jobs requiring a "Bachelor’s degree or higher," and most nursing jobs in the US require only an Associate’s Degree. TN visas, on the other hand, are only available to qualified nurses from Canada and Mexico. Lastly, H1-C visas, which were created specifically to address the nursing shortage, are limited to only 500 annually and currently only 14 hospitals in the US have the required certification to sponsor workers for the visas!

The second option, immigrant visas, allows foreign nurses to obtain permanent resident status in the US, otherwise known as a "green card." Nurses typically are eligible for EB-3 visas, or a "third preference employment-based visa." In order to apply for an immigrant visa, the foreign nurse must be sponsored by a US employer, like a hospital. The employer then must undergo a lengthy application process before the foreign nurse can become eligible to apply for a visa. The process includes filing an I-140 petition and labor certification form with US Citizenship and Immigration Services (USCIS).