In its May bulletin, the U.S. Department of State's Bureau of Consular Affairs announced limits on new EB-3 visas, which are used by foreign nurses trying to enter the U.S. nursing workforce — a move experts warn could lead to "a catastrophic interruption of the stable flow of healthcare talent."

State Department caps new EB-3 visa filings

The State Department is implementing a visa retrogression for its EB-3 subcategory, which includes all filings for occupations that require at least an associate's degree but do not a require a master's degree.

Foreign nurses, which currently make up around 15% of the nursing workforce, are eligible to enter the United States with an EB-3 visa.

Each year, the State Department imposes a 40,000-green card limit for the fiscal year. In the bulletin, the agency announced that all available spots for which nurses qualify had been filled for this fiscal year.

Now, only individuals who applied before June 1, 2022, will be eligible to continue with visa interviews, regardless of whether they were already offered a job in the United States.

Meanwhile, individuals with more recent applications will have to wait for the quota to reset in October when the next fiscal year begins — a delay that will prevent many international nurses from entering the U.S. workforce until 2025.

Commentary

Following the State Department's announcement, many experts expressed concern about the potential impact this delay could have on the U.S. nursing workforce.

Amid unprecedented burnout and an aging workforce, the United States is experiencing a major nursing shortage. According to federal estimates, the United States will need roughly 200,000 new nurses to enter the workforce every year through at least 2030 to address the shortage.

"Prior to COVID we had a nursing shortage. During COVID, it's estimated that we lost about 100,000 nurses," said Patty Jeffrey, an RN and president of the American Association of International Healthcare Recruitment (AAIHR), a nonprofit advocacy group focused on international recruitment of foreign-educated healthcare professionals.

"If we don't have a steady flow of these international nurses to enter the country and provide services, this is dire for our hospitals, who have become more dependent on this workforce," Jeffrey said.

According to Chris Musillo, an AAIHR-affiliated immigration lawyer and managing partner at Musillo Unkenholt Immigration Law, the EB-3 application is the only option available to most international nurses seeking employment in the United States, except for some advanced practice nurses that may qualify under other visa options.

"American hospitals, particularly those serving rural populations, would have collapsed long ago without the contributions of international nurses," Jeffrey noted. "… Visa retrogression amounts to a catastrophic interruption of the stable flow of healthcare talent to the bedside, and it will be felt acutely by ordinary patients, from pregnant mothers to dialysis patients."

"To freeze the ability for foreign-born nurses to immigrate to the U.S. using the EB-3 visa eliminates a valuable option for bringing more qualified workers into the aging services sector," said Ruth Katz, SVP of policy at LeadingAge, the association of nonprofit aging services providers. 

"This visa retrogression shuts off one meaningful workforce solution, and, ultimately, harms older adults and families who cannot access needed care and services. Without staff, there is no care," Katz said. (Muoio, Fierce Healthcare, 4/24; Weixel, The Hill, 4/25)