Immigration and Health Care Reform Will Wreak Havoc on Rural America

There is a vast gulf between the Republican’s attempt to stand by Trump’s promises to provide health care for all Americans and their longstanding belief that it’s not the federal government’s job to provide subsidies and health care bailouts.

If the federal government can’t come to the aid of those American citizens who need it most, who can they turn to?

While Trump is busy proving himself right about a “Muslim ban,” “so-called judges,” “wiretapping,” “crowd size,” and other nonsensical nonsense, the Republicans are spending most of their health care reform efforts on trying to figure out how to reward the country’s highest earners.

And then there is the immigration ban, which combined with health care reform will likely wreak even more havoc on an already depressed rural America.

Here are some facts that you may or may not know:

Many small towns in America rely on a steady flow of physicians from around the world to treat what ails them.

But Donald Trump's immigration crackdown will mean that fewer doctors will be available in rural communities, and certain visa bans will likely make doctor shortage in rural America even worse.

A recent little known and under-publicized decision by the government to alter the timetable for some visa applications will likely hinder the arrival of thousands of much needed foreign physicians in American towns that desperately need them.

The slowdown in bringing doctors to rural America is going to have a devastating effect throughout small towns.

Thousands of J-1 visa applicants come to the United States to attend medical school, but many of those students will now be turned away, according to the American Association of Medical Colleges (AAMC).

In the past, once these students completed their medical residency, as physicians they could either return to their home country for two years before being eligible to re-enter the U.S. through a different immigration pathway, such as an H-1B worker visa, or they could apply for a Conrad 30 J-1 Visa Waiver. This would allow them to extend their stay in the U.S. as long as they would commit to serving in rural and underserved areas for three years.

In the last 15 years, the Conrad 30 J-1 Waiver has funneled 15,000 foreign physicians into underserved communities, according to the AAMC.

Thousands of foreign doctors in a variety of specialties have in the past flocked to clinics and hospitals in the Mississippi Delta region, Appalachia, the Great Plains, and many other places shunned by American physicians for their own personal and/or professional reasons.

While the press was obsessing over Trumpisms, the government quietly passed a bill to dramatically slow down the premium processing for an H-1B visa.  Foreign physicians who are desperately needed in places like Montana where nine counties do not have a single doctor will be sidelined indefinitely, unable to provide badly needed medical treatment to hundreds of thousands of rural Americans.  

While jobless physicians outside of the U.S. wait to see what our government will decide to do about H-1B visas, facilities in places like Alabama, Pennsylvania, Arkansas, Ohio, Kansas, North Dakota, and Montana, will remain in desperate need of doctors.

And what about Trump’s empty promise to his voters and supporters to provide all Americans with health care and not to cut Medicaid?

The Congressional Budget Office (CBO) recently analyzed the Republican health care legislation, and their numbers show that TrumpCare would push 24 million people out of health care by 2026 and fourteen million of those people will lose Medicaid. The CBO also concluded that the GOP bill will not only repeal much of the Affordable Care Act (ACA) but would decimate the entire Medicaid program as we now know it. 

When President Trump took to the stage in Nashville last week, many worried Americans tuned in to hear what he had to say about the new GOP health care bill. Since millions of Americans who now get health coverage through the ACA would be at risk of losing it under the House Republicans plan, hearing what Trump had to say was of vital importance to them.

But Trump relegated the health care overhaul to a brief mention halfway through his speech. And in his remarks, he falsely claimed that in Tennessee “half of the state has no insurance company” on the ACA marketplace. The truth is that all eight of the state’s rating areas have at least one carrier, and three of them have two carriers.

More than 500,000 Tennesseans have health care thanks to the ACA, which TrumpCare would repeal. And 1.5 million of them get coverage through TennCare which is the state’s Medicaid program, also on the chopping block if the repeal passes.

And yet his adoring crowd of almost 10,000 people cheered Trump on as he failed to get into any health care details and instead spent the bulk of his speech deriding the travel ban ruling and putting down the judge who issued it.

Trump actually suggested that the court who had just ruled against him should be destroyed, while the Nashville crowd in attendance enthusiastically roared in delight and clapped thunderously.

And Trump continued to fire up his howling Nashville audience by reiterating that he preferred to go back to his first more restrictive ban and pursue it to the Supreme Court.

The Nashville crowd loved Trump’s fiery speech. Even though both the health care plan and the stricter visa laws will strip needy Americans in “Trump Country,” including the state of Tennessee of health coverage and desperately needed foreign physicians.    

Not exactly a cheering situation.