Updated on: November 29, -0001

9th Circuit Ruling a Temporary Win for Rural Health

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Original story posted on: February 13, 2017

Thursday evening’s 9th Circuit Court of Appeals’ 3-0 decision upholding a temporary stay on President Trump’s travel ban also marked a temporary reprieve for rural healthcare, experts say.

The issue now appears likely headed for the U.S. Supreme Court, although any ruling at that level could be somewhat moot, being as the ban was listed as having a 90-day expiration date upon its creation via a Jan. 27 executive order.

Journalist Parija Kavilanz with CNN Money reported last week that rural healthcare relies hugely on foreign doctors, especially in underserved areas.

“There could very well be a patient in a rural area who had an appointment with their doctor this week and the doctor was not allowed back into the country," Matthew Shick, director of government relations and regulatory counsel with the American Association of Medical Colleges, was quoted as saying in the article. "At a time when the United States is facing a serious shortage of physicians, international medical students are helping to fill an essential need,"

Each year, Kavilanz wrote, more than 6,000 medical trainees from foreign countries participate in medical residency programs through J-1 non-immigrant visas, according to the American Association of Medical College (AAMC). Whether J-1 visa holders who were out of the country when the ban went into effect will be able to start or finish school remains up in the air.

Once they complete their residency, the report explained, physicians can either return to their home country for two years before they are eligible to re-enter the U.S. through a different immigration pathway, such as an H1-B worker visa, or they can apply for a Conrad 30 J-1 visa waiver, which allows them to extend their stay in the U.S. – as long as they commit to serving in rural and underserved areas for three years.

In the last 15 years, Kavilanz wrote, the Conrad 30 J-1 waiver has funneled 15,000 foreign physicians into underserved communities.

"Even though this is a little known visa program, the J-1 visa waiver has done more to recruit physicians to underserved areas in this country than even the National Health Services Corps," Shick added.

CNN further reported that the American Medical Association, which represents medical doctors across the country, recently sent a letter to the U.S. Department of Homeland Security asking for clarity on the visa ban.

"While we understand the importance of a reliable system for vetting people from entering the United States, it is vitally important that this process not impact patient access to timely medical treatment or restrict physicians and international medical graduates (IMGs) who have been granted visas to train, practice in the United States," the letter read.

The AMA stressed that the ban would worsen access to healthcare in rural areas, noting that foreign medical graduates are "more likely to practice in underserved and poor communities, and to fill training positions in primary care and other specialties that face significant workforce shortages."

Janelle Ali-Dinar, vice president of rural health for MyGenetx and a regular contributor to RACmonitor’s Monitor Mondays, also expressed concern over the ban’s potential effects.

“As more rural communities become more diverse in population, often long-term policy can impact, shift, and shape social detriments (in healthcare),” Ali-Dinar said. “I think if there had been a long-term ruling (on the ban), the issue of J-1 Visa physicians providing a significant amount of primary and specialty care, especially in HPSA areas, would have severely impacted access and delivery of care for patients – and that would have caused significant barriers to care and the bottom line of clinics and systems.”

Read the CNN Money article online in its entirety at: http://money.cnn.com/2017/02/02/news/economy/trump-visa-ban-doctor-shortage/index.html

Mark Spivey

Mark Spivey is a national correspondent for RACmonitor and ICD10monitor who has been editing and writing reports for the websites for eight years.

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