Musillo Unkenholt is pleased to announce the launch of our redesigned website and the relocation of this blog to its new home at: https://www.muimmigration.com/blog/.
To continue receiving our immigration updates and insights,
we invite you to subscribe on our new site. This page will continue to
remain available for an interim period to allow readers to view prior posts but
all new content will be made exclusively on our new site moving forward.
MU will be hosting a FREE webinar on Tuesday, April 21st at 2PM Eastern for our friends and clients. Please join us!
Join us for this FREE webinar to learn more about:
MU will be hosting a FREE webinar on Tuesday, January 13th at 2PM Eastern for our friends and clients. Please join us!
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As discussed in a previous blog post, Musillo Unkenholt is pleased to report that the Healthcare Workforce Resilience Act (HWRA) has been reintroduced into Congress. The HWRA has bipartisan sponsorship of Senators Durbin and Cramer in the Senate and Representatives Brad Schneider and Don Bacon in the House.
The HWRA offers an immediate response to the U.S.’s nursing shortage crisis by recapturing 25,000 previously authorized but unused immigrant visas (Green Cards) for highly-qualified international nurses who meet strict professional requirements. The bill does not displace any U.S. nurses or increase the total number of available immigrant visas (Green Cards).
Musillo Unkenholt endorses the HWRA, an efficient and long-awaited step toward immigration reform that will work to meet the country’s growing need for a strong U.S. health care workforce.
The HWRA has the highest chance of passing in Congress with more co-sponsorship. If you or your employer would benefit from common-sense lawmaking to remedy the U.S. nursing shortage, contact your congressional representative about co-sponsorship of the HWRA.
The Department of Labor (DOL) announced on October 31, 2025 that it has resumed its processing of immigration-related requests for prevailing wages, labor certification determinations, and other wage applications via its online filing system, FLAG.
As discussed in an MU blog last month, the government shutdown has shuttered the DOL’s FLAG operations since October 1, 2025, when the website was made completely unavailable.
Although the government shutdown is ongoing, the DOL’s resumption of its processing is welcome news for employers and immigrants who have been ineligible to file certain cases without requisite DOL wage determinations.
DOL did not clarify whether FLAG will resume processing indefinitely
throughout the remainder of the government shutdown. However, optimistically, in
its announcement, DOL notes that it “is taking all steps necessary to resume
application processing” and is “transition[ing] back to full operational
status”.
On Thursday, October 16, the U.S. Chamber of Commerce filed a lawsuit challenging President Trump’s $100,000 H-1B fee. MU posted its first blog on the $100,000 fee detailing the fee’s application last month.
The U.S. Chamber of Commerce, the nation’s largest business association and advocacy organization, brings this suit under claims that the fee exceeds the President’s authority and violates the Administrative Procedure Act (APA).
The lawsuit cites several studies and articles attesting that the H-1B program benefits the U.S. economy and is vital in addressing the U.S. labor shortage crisis. It also includes statements from businesses and investors regarding the devastating effects the proclamation will have on American businesses.
On Monday, October 20, USCIS updated its H-1B webpage with new guidance that the $100,000 fee is not required for petitions filed on behalf individuals who are already in the US on valid temporary status (such as an F-1, H-4, J-1, etc.).
The guidance also provided details on the type of case that may qualify for an exception from the fee and finally provided a mechanism for payment of the $100,000 fee.
MU will discuss these updates and more in detail
during our free webinar on Tuesday, October 28, at 2PM Eastern. Register
to attend!
MU will be hosting a FREE webinar on Tuesday, October 28th at 2PM Eastern for our friends and clients. Please join us!
Join us for this FREE webinar to learn more about:
MU will be hosting a FREE webinar on Tuesday, October 7th at 2PM Eastern for our friends and clients. Please join us!
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to learn more about:
Late Friday, September 19,
2025, President Trump issued the Presidential
Proclamation, Restriction on Entry of Certain Nonimmigrant Workers. The Proclamation creates a $100,000 fee due
on each H-1B petition at the time the case is filed, although some exemptions
exist. There was – and continues to be
-- widespread confusion about the applicability of the Proclamation to various
types of H-1B cases.
Please join our webinar
on Tuesday, September 23, 2025 at 2PM.
We will spend much of the webinar addressing the new Proclamation. We have been involved with some non-public
conversations with Washington DC. We
will share what we are allowed to share during that webinar.
Here’s what we currently
know. We will share updates as soon as they are announced:
MU will update our clients
with additional information as this Proclamation is implemented and challenged
in court. Again, please join us on
Tuesday’s webinar for the latest information.
MU will be hosting a FREE webinar on Tuesday, September 23rd at 2PM Eastern for our friends and clients. Please join us!
Join us for this FREE webinar to learn more about:
Musillo Unkenholt is pleased to report that the Healthcare Workforce Resilience Act (HWRA) has been reintroduced into Congress. The HWRA has bipartisan sponsorship of Senators Durbin and Cramer in the Senate and Representatives Brad Schneider and Don Bacon in the House.
As America grapples with a devastating nursing shortage that is directly undermining the quality, accessibility, and affordability of healthcare for millions of Americans in rural communities across the country, Musillo Unkenholt endorses policymakers taking immediate action.
The HWRA offers an immediate response to this crisis by recapturing 25,000 previously authorized but unused immigrant visas (Green Cards) for highly-qualified international nurses who meet strict professional requirements. The bill does not displace any U.S. nurses or increase the total number of available immigrant visas (Green Cards).
This bipartisan solution will help to ensure rural and elderly Americans receive the nursing care they need today while policymakers seek additional solutions to help America produce more nurses in the future and end this crisis once and for all.
Musillo Unkenholt endorses the HWRA, an efficient and long-awaited step toward immigration reform that will work to meet the country’s growing need for a strong US health care workforce.
On August 19, 2025, USCIS issued a policy alert that the agency will review “anti-Americanism” as a discretionary factor when reviewing certain benefit requests.
“Anti-Americanism”
will be reviewed in requests such as employment authorization applications, F
visa extension applications and changes of status, requests for National
Interest Waivers, and employment-based adjustments of status.
USCIS dictates
that officers should give “overwhelmingly negative weight” to evidence of an
applicant’s support for or promotion of terrorist ideologies, antisemitism, or other
conduct USCIS may consider “anti-American”. The agency asserts that such
conduct will likely lead to denial of the requested benefit.
The policy
explicitly allows officers to consider public behavior, including social media
activity, as part of this discretionary review, making it important for
applicants to be mindful of their digital footprint when applying for
immigration benefits.
MU will be hosting a FREE webinar on Thursday, July 10 at 3PM Eastern for our friends and clients. Please join us!
IMMIGRATION UPDATES AND THE STATE OF THE HEALTHCARE INDUSTRY
Join us for an information-packed webinar designed for HR leaders, immigration professionals, and staffing companies navigating today’s complex immigration landscape.
In just half an hour, we’ll deliver critical updates and actionable strategies on:
As the U.S. healthcare system grapples with a critical nursing shortage, maintaining lawful, streamlined immigration pathways for foreign-trained nurses is essential to ensuring effective and continuous patient care.
A recently published article by Digital
Health Insights (DHI) highlights the severity of this shortage, which
is exacerbated by tightening immigration policies and a growing number of
nurses leaving the profession.
Drawing on data from the Migration
Policy Institute, DHI notes that as of 2021, nearly 20%, approximately
2.8 million, of healthcare workers in the United States are immigrants.
The total supply of RNs in the U.S. decreased
by more than 100,000 from 2020 to 2021, which is the greatest drop in the past
40 years. Between 2020-2022, nursing turnover skyrocketed to 27% nationwide.
Due to high demand and Department of State
backlogs, foreign-trained nurses who qualify for a Green Card are currently
waiting more than two years to enter the U.S. after their cases are approved.
An approved case indicates the foreign-trained nurse meets all U.S. requirements
to enter the profession and has a U.S. employer sponsor.
To address these barriers, DHI proposes innovative
solutions, such as extending the National Interest Waiver for Physicians to
include other healthcare professionals. Likewise, it suggests that the U.S.
follow the example of countries like Canada and the United Kingdom, which have
implemented dedicated healthcare visa programs.
Meeting the U.S. healthcare workforce
shortage—particularly in nursing—requires accessible and effective legal
pathways for foreign-trained professionals.
In March 2025, the Healthcare Workforce Coalition issued a press release on their recent meetings on Capitol Hill. The purpose of their meetings was to urge lawmakers to swiftly pass legislation to ease serious US healthcare workforce shortages.
The Healthcare Workforce Coalition is made up of healthcare industry leaders, including Ascend Learning, Brickyard Health, Fisher Titus Medical Center, Greater Baltimore Medical Center, LifeBridge Health, MedPro International, MedStar Health, Meritus Health, PRS Global, and St. Joseph’s University.
Representatives of the Healthcare Workforce Coalition met with the
offices of US Senators and Representatives from both parties to urge support
for measures to make visas for foreign-educated Registered Nurses and
physicians immediately available.
The Commission on Graduates of Foreign Nursing Schools (CGFNS) announced it will change its name to TruMerit™.
Immigration regulations require that when filing an immigration petition for certain healthcare occupations, including Registered Nurses, the Petitioner must include a healthcare worker’s certificate (sometimes called a Visa Screen) from an authorized credentialing organization, such as CGFNS.
CGFNS
indicated the name change will be the centerpiece of a comprehensive rebranding
of the organization, which will also involve changes to its website, customer
portals, credentials and certificates, and social media channels. The
rebranding effort will begin rolling out in mid-March and will be completed by
the summer.
MU Law will be hosting a FREE webinar for our clients and friends on Tuesday, February 11, 2025 at 2PM Eastern (1PM Central).
Join us for this FREE webinar to learn more about:
Rice University’s Baker Institute for Public Policy has recently published a report on current and future US health care labor shortages, as well as the role immigration policy reform could play in meeting the challenges of a labor shortage.
Health Care Industry Labor Shortages
Research from the Bureau of Labor Statistics (BLS) shows that fewer people are working in the health care sector, in part as a result of COVID-19 pandemic job losses. While the industry showed progress in 2023, the sector’s overall employment rates have not fully recovered to pre-pandemic rates.
Rice University’s report gathers data from the Association of American Medical Colleges (AAMC), Forbes, ADA Health Policy Institute, and the National Association for Home Care and Hospice that predict health care labor shortages in the coming 10-15 years across many positions in the industry, including physicians, nurses, clinical laboratory specialists, dental hygienists, pharmacists, and home care workers.
Proposed Immigration Policy Reform Targeting Health Care Industry Needs
Rice University cites the Migration Policy Institute’s research that immigrants made up 18% of employees in a health care occupation in the US in 2021, including 26% of physicians and surgeons and almost 40% of home health aides. Immigrants make up roughly 14% of the US population, meaning immigrants’ representation is outsized in the health care sector.
To alleviate the labor shortages in the health care workforce, Rice University’s report recommends immigration policy reforms, including:
Musillo
Unkenholt endorses the report’s
contention that implementing comprehensive reforms such as these would help to
meet the country’s growing health care needs, support economic growth by
improving access to efficient health care, maintain high-quality patient
services while promoting greater access to care, and create a more flexible and
responsive health care workforce.
The National Center for Health Workforce Analysis projects a 9 percent nursing workforce shortage through 2036. The problem will be particularly acute in non-metro areas, where the shortage is expected to grow to 14%. The ten states with the largest projected RN shortages in 2036 are: Georgia (29%), California (26%), Washington (26%), New Jersey (25%), North Carolina (23%), New Hampshire (23%), South Carolina (21%), Maryland (20%), Michigan (19%), and Oregon (16%).
The
current shortage is about 250,000 and is expected to grow to a shortage of 350,00
full-time registered nurses in 2026.
The
National Center for Health Workforce Analysis (NCHWA) collects data, conducts
research, and generates information about the U.S. health care workforce to
inform and support Public- and private-sector decision making. Learn about
the National
Center for Health Workforce Analysis.
Legislation
proposed by Rep. Bayer (D-VA) calls for 20,000 nurse visas for rural
shortage areas. Unfortunately, that
legislation has probably been introduced too late in this congressional term to
pass both houses of Congress before the term ends on December 31, 2024.
Philippines nurses seem to be choosing contract positions with an aim toward moving abroad. ABS-CBN News reports that ACT-Teachers party-list Rep. France Castro questioned why there did not appear to be an increase in permanent (Plantilla) healthcare positions in the last year.
Rep.
Angelica Natasha Co speculated that healthcare workers opt for temporary or
contractual positions when they have plans to work abroad. Last year saw one of the greatest numbers of
Philippine nurses enter the US in many years, as the American nursing shortage
continues to get worse. As of 2021, about
300,000 Philippine nurses worked abroad.
