The US health care workforce is facing a shortage impacting those seeking kidney care. In 2019, the Association of American Medical Colleges projected that demand for physicians will continue to outpace supply, and the United States will see a shortage of up to 122,000 physicians by 2032 (1). Although this threat facing the US health care workforce has been exacerbated by the COVID-19 pandemic, the kidney care workforce is already facing shortage challenges. Just one practicing nephrologist is available for every 3427 people living with kidney diseases in the United States. As a talented and diverse kidney care workforce is vital to the nation's kidney health (nearly one-half of practicing nephrologists are international medical graduates) (2), ASN is advocating for multiple bipartisan and bicameral efforts introduced in the 117th Congress that will alleviate the constraints that the kidney care workforce confronts.
ASN supports the Healthcare Workforce Resilience Act (S. 1024, H.R. 2255), which directs the US Citizenship and Immigration Services to “recapture” previously unused immigrant visas and make them available to nurses and physicians who petition for such a visa before 90 days after the end of the COVID-19 public health emergency (which was renewed on April 12, 2022, and is expected be renewed again this summer). Up to 40,000 visas are available, with 25,000 reserved for nurses and 15,000 for physicians. Certain family members may accompany the principal beneficiary of a visa provided under this bill and will not count against the 40,000 cap. These recaptured visas would also not be subject to “country caps,” expanding the qualified applicant pool, as they would be drawn from a pool of unused employment-based visas that Congress has previously authorized. This bill would release the commitment and talent of foreign-born medical professionals across the nation providing needed reinforcements to our health care workers who are on the front lines in the fight against COVID-19 and ensure that kidney care professionals are able to meet the needs of their patients.
ASN also supports the Conrad State 30 and Physician Access Reauthorization Act (S. 948, H.R. 3541), which incentivizes foreign physicians to serve in underserved rural communities. The bill waives the typical requirement—that individuals under a J-1 nonimmigrant visa to receive medical training must leave the country and reside for 2 years abroad before being eligible to apply for an immigrant visa or permanent residence. The waiver is provided if the individual meets certain qualifications, including serving for a number of years at a health care facility in an underserved area. In addition to extending the statutory authority for the program for 3 years upon enactment, the bill allows for the number of waivers that each state may obtain in the next fiscal year (FY) to increase from 30 to 35 if a certain number of waivers were used the previous year.
Congress must ensure that there is a robust pathway for kidney health care professionals and invest in the needs of all Americans living with kidney diseases and kidney failure. These bills would bolster the US health care workforce while addressing the nation's kidney care needs, especially among citizens living in rural areas. Updates on progress made to address the challenges facing the kidney care workforce will be provided in subsequent issues of Kidney News and in real time via @ASNAdvocacy on Twitter.
KidneyX Receives Bipartisan Support in the 2023 Funding Cycle
Kidney Innovation Accelerator (KidneyX) continues to receive bipartisan support as lawmakers prepare legislation to fund the federal government in FY 2023. In two letters (3, 4), led by Representatives Suzan DelBene (D-AL), Larry Bucshon (R-IL), Terri Sewell (D-AL), and Neal Dunn (R-FL) in the House and by Senators Ben Cardin (D-MD) and Todd Young (R-IN) in the Senate, congressional champions of KidneyX call for a total of $25 million to be provided for the program in FY 2023.
Citing the past record of success of KidneyX in accelerating innovation, including supporting 67 innovators across five prize competitions since its establishment in 2018, members of Congress note that a full $25 million in funding will allow KidneyX to expand the scale and scope of its Artificial Kidney Prize competition and run competitions in areas such as refining the diagnosis of kidney diseases and developing tools to prevent kidney diseases altogether.
The call for increasing investment in KidneyX comes as negotiations on federal spending for FY 2023 unfold. Facing an election in November, members of Congress are under pressure to continue to address COVID-19, as well as hot-button issues, such as inflation and gun violence. Although final funding levels will reflect these debates, bipartisan support for increased investment in KidneyX is essential for focusing attention on the need for accelerating innovation in kidney health.
References
- 1.↑
Association of American Medical Colleges. New findings confirm predictions on physician shortage. April 23, 2019. https://www.aamc.org/news-insights/press-releases/new-findings-confirm-predictions-physician-shortage
- 2.↑
Association of American Medical Colleges. Physician specialty data report. Active physicians who are international medical graduates (IMGs) by specialty, 2017. December 2017. https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-who-are-international-medical-graduates-imgs-specialty-2017
- 3.↑
DelBene SK, et al. Letter to Chairwoman DeLauro and Ranking Member Cole. Congress of the United States. April 27, 2022. https://www.asn-online.org/policy/webdocs/FY23KidneyXAppropriationsHouse.pdf
- 4.↑
Cardin BL, et al. Letter to Chair Murray and Ranking Member Blunt. United States Senate. May 25, 2022. https://www.asn-online.org/policy/webdocs/FY23KidneyXAppropriationsSenate.pdf