Healthcare Workforce Resilience Act Easing Doctor Green Card Backlog

A bipartisan group of senators has reintroduced the Healthcare Workforce Resilience Act (HWRA), a targeted immigration bill that would try to ease the United States 🇺🇸 doctor and nurse shortage by attacking the long-running green-card backlog for foreign medical workers already in the country. The proposal would not raise the overall immigration ceiling. Instead, it would recapture 40,000 unused immigrant visas that Congress previously authorized but the government never issued, and then dedicate them to physicians and nurses over a three-year period.

How the visa recapture would work

Under the bill, 15,000 immigrant visas would go to physicians and 25,000 to nurses, with all of them exempt from existing per‑country caps that often slow or block green card access for professionals from high‑demand countries such as India and China.

Supporters say this narrow fix could quickly convert thousands of frontline workers from temporary status into permanent residents, locking in their skills for hospitals and clinics that are struggling to recruit and retain staff.

Source of the visas

• The unused visas would come from employment‑based green card numbers that Congress approved between 1992 and 2024 but that the government never actually issued.
• Immigration lawyers often call these “lost” or “wasted” visas.
• The HWRA would pull them back into circulation and reserve them for healthcare workers only.

According to analysis by VisaVerge.com, this approach makes the proposal politically different from broader immigration reforms that seek new visa numbers instead of recycling old ones.

Sponsors and the healthcare need

Senator Dick Durbin (D‑IL) and Senator Kevin Cramer (R‑ND) are leading the effort, stressing that the United States cannot meet its healthcare needs through domestic training alone.

They point to federal projections of a shortage of up to 86,000 physicians by 2036, with roughly half of that gap in specialist roles. Rural communities and underserved urban areas feel the crunch most sharply, and in many of those places immigrant physicians are already the only specialists available for miles.

Who would benefit

The bill would mainly help doctors and nurses who are already in the country on temporary visas, such as H‑1B or other employment‑based categories, and who are stuck in the green-card backlog because of annual numerical limits and per‑country caps.

• Many have spent years in legal limbo despite working full‑time in U.S. hospitals.
• Granting them permanent residence is intended to give stability to both the workers and the communities that rely on them.

Family members of these physicians and nurses would also be eligible for the recaptured visas, allowing spouses and children to gain permanent status at the same time. This provision is especially important for workers from backlogged countries, where waits for family‑based green cards can stretch for many years.

• The HWRA aims to keep children from “aging out” of eligibility when they turn 21, a problem that has pushed some young adults out of the United States despite their parents’ long‑term legal employment.

Protections, requirements, and vetting

To address concerns about job competition, the bill requires employers to attest that hiring through these recaptured visas will not displace U.S. workers. Hospitals and other medical employers would need to confirm that they are filling genuine shortages—not replacing American doctors or nurses who are able and willing to work.

The legislation also preserves all existing requirements for:

• State medical licenses
• Nursing licenses
• Other professional approvals

Foreign‑trained workers would still need to meet the same standards as any U.S. graduate before they could benefit.

Security and vetting would also remain strict. The proposal calls for “rigorous national security and criminal background checks” for all applicants using these recaptured visas. That mirrors existing screening rules for employment‑based green cards handled by U.S. Citizenship and Immigration Services and the Department of State.

Official guidance on employment‑based permanent residence, including medical workers, is publicly available on the U.S. Citizenship and Immigration Services website.

Support from medical organizations

Major medical groups supporting the HWRA include:

• American Medical Association (AMA)
• American Hospital Association (AHA)
• American College of Physicians
• American Academy of Neurology

They argue the bill focuses on a narrow, high‑impact group: clinicians who are already here, already trained, and already working. Hospital leaders warn that when these workers leave due to stalled immigration cases, the consequences can include longer wait times, clinic closures, and reduced access to specialist care—especially in small towns.

Why this bill is politically distinct

Immigration policy specialists note that the HWRA’s focus on the green-card backlog makes it different from broader reforms that have struggled in Congress.

By limiting itself to a plan to recapture 40,000 unused immigrant visas and apply them only to healthcare workers, the bill offers:

• A specific and easily measured outcome
• Avoidance of hot‑button issues tied to border security or asylum policy that often derail wider immigration packages

Relation to domestic training efforts

The measure is designed to work alongside, rather than replace, domestic training efforts. Lawmakers have linked it to the Resident Physician Shortage Reduction Act of 2025, a separate bill that would expand Medicare‑supported residency positions by 14,000 over seven years.

• Residency slots control how many new doctors the U.S. system can train annually.
• Supporters say expanded training is essential but will take many years to yield results.
• By contrast, immigrant doctors and nurses already here could move into permanent roles much faster if paperwork barriers eased.

Human impact

For individual physicians and nurses caught in the queue, the debate is not abstract. Many have spent a decade or more on temporary visas, tied to specific employers and unable to make long‑term plans.

• Their children often grow up in the United States but face losing status as adults if the parents’ cases do not move before the children’s 21st birthdays.
• The HWRA could give many families a clear path to stability that has been out of reach despite years of service in U.S. hospitals.

For communities where a single foreign‑born cardiologist or neurologist is the only specialist available, the outcome of this debate could shape access to care for years to come.

Main criticisms and supporters’ response

Critics of employment‑based immigration sometimes argue that bringing in more foreign workers can:

• Depress wages
• Weaken incentives to improve conditions for U.S. staff

Supporters of the HWRA respond:

• The bill does not open new doors to overseas recruitment; it keeps people already working in U.S. hospitals and clinics.
• It does not increase total statutory visa numbers, possibly making it an easier political sell.

Outlook

Whether Congress will pass the Healthcare Workforce Resilience Act (HWRA) remains uncertain in a deeply divided political climate. However, the legislation has drawn attention because it offers a relatively narrow approach to shore up the healthcare system by fixing one slice of the immigration puzzle.