The Senate's immigration bill, expected to come up for a vote later this week, will have an impact on health care employers if it becomes law. First and foremost, the bill overturns the entire employment-based immigration system and replaces it with a highly controversial point system that is billed as one based on merit. An analysis by the National Foundation for American Policy on the impact of the point system on health care can be found at http://www.nfap.com/pdf/0706pointsystem.pdf.

Unlike the STRIVE Act in the House and S.2611, passed last year in the Senate, there is no nurse section of the bill and no green card cap exemption. This apparently is due to the lobbying of Illinois Democratic Dick Durbin who has become the Senator most hostile to nursing immigration.

Physicians are also covered in the bill. While the bill extends the Conrad 30 program permanently and makes J-1 visas dual intent as well as B-1s for doctors coming in for exams necessary to qualify to get in to residency programs, it also would require doctors to enter the US on J-1 visas and no longer on H-1Bs. Critics of this approach worry that the limit of 30 waivers per state for J-1s would not be nearly enough to cover the demand this provision will create. Opponents of the measure are promoting an alternative approach that would offer incentives for doctors on H-1B to work in medically underserved communities such as exemptions from H-1B and green card caps.

There may be health care related amendments offered this week as well. Once the bill passes, we'll report back.

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