Immigration Reform Should Enhance -- Not Limit -- Access to Care, Says AAFP

Reform Also Should Address Physician Workforce Needs

June 26, 2013 10:55 am News Staff

As the Senate continues to debate immigration reform, the AAFP has urged Senate leaders to resist provisions that would limit access to needed health care, especially to primary care and catastrophic care, and to include provisions that address U.S. physician workforce needs.

Calling immigration reform a "tremendously complicated process that touches many of our nation's values and principles," the AAFP said in a June 21 letter to Senate Majority Leader Harry Reid, D-Nev., and Senate Minority Leader Mitch McConnell, R-K.Y., that although the AAFP does not have a position on S. 744( -- known as the Border Security, Economic Opportunity and Immigration Modernization Act -- the organization does have concerns that a final bill could deny immigrants access to health insurance subsidies provided as part of the health care reform law. Such a denial would make it difficult, if not impossible, for immigrants with low or moderate incomes to purchase insurance and obtain needed health care services.

"The Affordable Care Act mandates the purchase of health care insurance, and provides income-based subsidies for those who could not afford the cost of that insurance," said AAFP Board Chair Glen Stream, M.D., M.B.I., of Spokane, Wash., in the letter. "Without access to the subsidy programs, the requirement to purchase insurance is infeasible for many with low to moderate incomes."

Story Highlights
  • The AAFP has urged Senate leaders to resist provisions in a comprehensive immigration reform bill that would limit access to care.
  • In a letter to Senate leaders, the AAFP said immigration reform also should address U.S. physician workforce needs.
  • In the letter, the AAFP explained that its approach to immigration reform is based on longstanding positions, including an Academy policy that calls for health care for all.

Stream stressed that the AAFP's approach to immigration reform is based on longstanding Academy policies, and he pointed out that the AAFP has advocated the concept of health care coverage for all for more than 25 years.

"The AAFP believes that the nation's health care system should encourage everyone, for reasons of efficiency and quality, to have a relationship with a primary care practice (especially if it is organized as a patient-centered home) and to have the appropriate health coverage that makes such a relationship financially sustainable," said Stream.

In addressing S. 744, Stream cited AAFP policy in urging the Senate to ensure that the federal government trains and distributes "an adequate number of physicians to meet the diverse health care needs of (our) people, as well as to provide training opportunities for physicians from other countries."

"The AAFP supports J-1 visas for physicians from countries not currently in need of those physicians' services," and "supports provisions in S. 744 to make the J-1 visa program permanent and to increase the number of Conrad 30 visas for physicians who work in a health care (professional) shortage area," Stream said.

In addition, Stream praised clarifications, contained in section 2405, of the provisions related to physician immigration that "affect graduate medical training."

"The AAFP would recommend that Congress commission a thorough and objective analysis of the physician workforce requirements and resulting adjustments needed to education, training and immigration policy that would help the nation meet those requirements," Stream said.