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Midwest Diagnosis: Immigration Reform and the Healthcare Sector

RESEARCH Policy Brief by Nicole Fisher
An ambulance drives past a hospital; background is blurred
Camilo Jimenez

The recommended policy changes would not only address issues in the Midwest, but would help ensure an improvement in healthcare across the country.

Executive Summary

Healthcare is a critical part of the local economy, providing jobs for millions of Midwesterners and billions of dollars in wages across the 12-state region. However, the growing healthcare needs of the baby boomers as they age, coupled with acute shortages of healthcare workers, are straining the sector. Immigrants—foreign- born physicians, researchers, nurses, health aides, and hospital workers—are key to the future vitality of healthcare in the United States, and federal immigration reforms are urgently needed to ensure that the sector is able to maximize their contributions. However, legislation remains stalled in Congress, leaving Midwest healthcare to grapple with challenging issues:  

  • US-born medical school graduates are likely to pursue careers in lucrative specialties and relocate to coastal cities, causing severe shortages of critical primary care, pediatric, and family medicine physicians in the rural Midwest.
  • Foreign-born healthcare professionals who have completed their training overseas face complicated, inconsistent reaccreditation processes in the United States, leaving many unable to practice in their fields.
  • Undocumented immigrants, unable to access health insurance under current laws, are dependent on expensive, ineffective emergency room care to address health issues or avoid receiving care altogether, compromising health outcomes.
  • The linguistic and cultural assets of foreign-born healthcare workers are increasingly in demand given the growing diversity of the United States. Yet visa shortages and licensing issues complicate their hire.

A continued stalemate on immigration reform means these issues will only grow in urgency. Changes based on the following policy recommendations, developed with input from regional stakeholders from the healthcare sector, would not only remedy these issues in the Midwest but would ensure a vibrant healthcare sector across the country:  

  • Issue visas according to labor force demands.
  • Remove quotas and caps on doctors and surgeons.
  • Address credentialing challenges for foreign-born professionals.
  • Allow undocumented individuals to access some forms of insurance.
  • Train healthcare professionals to provide linguistically and culturally competent care to diverse populations.
  • It is vitally important that the region properly plan for the employment, economic, and healthcare needs of all residents, regardless of country of origin
About the Author
Nicole Fisher
Founder and CEO, HHR Strategies
Nicole Fisher is the founder and CEO of HHR Strate­gies, a healthcare- and human-rights-focused advising firm started in the Midwest. She is also a senior policy advisor on Capitol Hill and an expert on health econom­ics, technology, and reform, specifically as they impact vulnerable populations.