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110th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 2d Session                                                     110-646

======================================================================

 
  TO EXTEND FOR 5 YEARS THE PROGRAM RELATING TO WAIVER OF THE FOREIGN 
  COUNTRY RESIDENCE REQUIREMENT WITH RESPECT TO INTERNATIONAL MEDICAL 
                               GRADUATES

                                _______
                                

  May 15, 2008.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Conyers, from the Committee on the Judiciary, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 5571]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on the Judiciary, to whom was referred the bill 
(H.R. 5571) to extend for 5 years the program relating to 
waiver of the foreign country residence requirement with 
respect to international medical graduates, having considered 
the same, reports favorably thereon without amendment and 
recommends that the bill do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     1
Background and Need for the Legislation..........................     2
Hearings.........................................................     2
Committee Consideration..........................................     2
Committee Votes..................................................     2
Committee Oversight Findings.....................................     3
New Budget Authority and Tax Expenditures........................     3
Congressional Budget Office Cost Estimate........................     3
Performance Goals and Objectives.................................     4
Constitutional Authority Statement...............................     4
Advisory on Earmarks.............................................     4
Section-by-Section Analysis......................................     4
Changes in Existing Law Made by the Bill, as Reported............     4

                          Purpose and Summary

    H.R. 5571 reauthorizes the Conrad 30 J Waiver Program and 
extends the waiver provision for 5 years to ensure that States 
can recommend such a waiver for areas with a shortage of 
doctors. The Conrad 30 J Waiver Program allows States to ensure 
medically underserved areas can hire physicians who receive 
medical training in the United States on a J-1 visa for 3 years 
where there is no other doctor available to fill the position.

                Background and Need for the Legislation

    The Immigration and Nationality Act allows for foreign 
doctors to train in the United States under the ``J-1'' visa 
program, otherwise known as nonimmigrants in the Exchange 
Visitor Program. This Exchange Visitor Program seeks to promote 
peaceful relations and mutual understanding with other 
countries through educational and cultural exchange programs. 
Accordingly, many exchange visitors, including doctors in 
training, are subject to a requirement that they must return to 
their home country to share with their countrymen the 
knowledge, experience, and impressions gained during their stay 
in the United States. Unless U.S. Citizenship and Immigration 
Services (USCIS) approves a waiver of this requirement in those 
cases, the exchange visitors must depart from the United States 
and live in their home country for 2 years before they are 
allowed to apply to return to the United States.
    A waiver of the 2-year foreign residency requirement 
(commonly referred to as the ``Conrad 30 J Waiver Program'') is 
available for doctors who have trained in the United States 
under the J-1 visa if a State or an interested government 
agency sponsors the physician exchange visitor to work in a 
health manpower shortage area for 3 years as a nonimmigrant in 
H-1B status (temporary worker in a specialty occupation). The 
Secretary of Health and Human Services determines which areas 
have a health manpower shortage.
    The current authorization for the Conrad 30 J Waiver 
Program will sunset on June 1, 2008. H.R. 5571 would extend 
this waiver for 5 years to ensure that States can recommend 
such a waiver for areas with a shortage of doctors. The Conrad 
30 J Waiver Program allows States to ensure medically 
underserved areas can hire physicians who received medical 
training in the United States on a J-1 visa for 3 years where 
there is no other doctor available to fill the position.

                                Hearings

    The Committee on the Judiciary held no hearings on H.R. 
5571.

                        Committee Consideration

    On March 12, 2008, the Subcommittee on Immigration, 
Citizenship, Refugees, Border Security, and International Law 
met in open session and ordered the bill, H.R. 5571, favorably 
reported, without amendment, by voice vote, a quorum being 
present. On April 2, 2008, the Committee met in open session 
and ordered the bill, H.R. 5571, favorably reported without 
amendment, by voice vote, a quorum being present.

                            Committee Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that there 
were no recorded votes during the Committee's consideration of 
H.R. 5571.

                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII of the Rules 
of the House of Representatives, the Committee advises that the 
findings and recommendations of the Committee, based on 
oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated in the 
descriptive portions of this report.

               New Budget Authority and Tax Expenditures

    Clause 3(c)(2) of rule XIII of the Rules of the House of 
Representatives is inapplicable because this legislation does 
not provide new budgetary authority or increased tax 
expenditures.

               Congressional Budget Office Cost Estimate

    In compliance with clause 3(c)(3) of rule XIII of the Rules 
of the House of Representatives, the Committee sets forth, with 
respect to the bill, H.R. 5571, the following estimate and 
comparison prepared by the Director of the Congressional Budget 
Office under section 402 of the Congressional Budget Act of 
1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                    Washington, DC, April 14, 2008.
Hon. John Conyers, Jr., Chairman,
Committee on the Judiciary,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 5571, a bill to 
extend for 5 years the program relating to waiver of the 
foreign country residence requirement with respect to 
international medical graduates.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Mark 
Grabowicz, who can be reached at 226-2860.
            Sincerely,
                                           Peter R. Orszag,
                                                  Director.

Enclosure

cc:
        Honorable Lamar S. Smith.
        Ranking Member

H.R. 5571--A bill to extend for 5 years the program relating to waiver 
        of the foreign country residence requirement with respect to 
        international medical graduates.

    CBO estimates that implementing H.R. 5571 would result in 
no significant net cost to the Federal Government. The bill 
would affect direct spending, but we estimate that any effects 
would be insignificant. Enacting the bill would not affect 
revenues.
    H.R. 5571 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act and 
would not affect the budgets of State, local, or tribal 
governments.
    Current law permits foreign students attending medical 
school in the United States to remain after graduation if they 
agree to work for at least 3 years in certain regions of the 
country considered to be underserved by physicians or if they 
accept employment with certain Federal agencies. The program is 
scheduled to expire on June 1, 2008; H.R. 5771 would extend it 
through June 1, 2013.
    Based on the participation of foreign medical students in 
the targeted regions or Federal agencies in recent years, CBO 
expects that the bill's provisions would affect fewer than 
2,000 persons annually. The Department of Homeland Security 
(DHS) would collect fees to provide work permits for those 
individuals. Those fees are classified as offsetting receipts 
(a credit against direct spending). The department is 
authorized to spend such fees without further appropriation, so 
the net impact on DHS spending would be insignificant for each 
year.
    The CBO staff contact for this estimate is Mark Grabowicz. 
This estimate was approved by Theresa Gullo, Deputy Assistant 
Director for Budget Analysis.

                    Performance Goals and Objectives

    The Committee states that pursuant to clause 3(c)(4) of 
rule XIII of the Rules of the House of Representatives, H.R. 
5571, will extend the program relating to waiver of the foreign 
country residence requirement with respect to international 
medical graduates (the Conrad 30 J Waiver Program) for 5 years, 
to continue promoting delivery of critically needed medical 
services to people in the United States lacking adequate access 
to physician care, including vulnerable populations in low-
income and impoverished communities, or in communities with 
high infant mortality rates or exhibiting other signs of a lack 
of necessary physician services.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds the authority for 
this legislation in article I, section 8, clause 4 of the 
Constitution.

                          Advisory on Earmarks

    In accordance with clause 9 of rule XXI of the Rules of the 
House of Representatives, H.R. 5571 does not contain any 
congressional earmarks, limited tax benefits, or limited tariff 
benefits as defined in clause 9(d), 9(e), or 9(f) of Rule XXI.

                      Section-by-Section Analysis

    The following discussion describes the bill as reported by 
the Committee.
    Sec. 1. Extension of Waiver Program. This section extends 
the Conrad 30 J Waiver Program for 5 years, until June 1, 2013.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, existing law in which no change 
is proposed is shown in roman):

IMMIGRATION AND NATIONALITY TECHNICAL CORRECTIONS ACT OF 1994

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TITLE II--TECHNICAL CORRECTIONS OF IMMIGRATION LAWS

           *       *       *       *       *       *       *


SEC. 220. WAIVER OF FOREIGN COUNTRY RESIDENCE REQUIREMENT WITH RESPECT 
                    TO INTERNATIONAL MEDICAL GRADUATES.

  (a) * * *

           *       *       *       *       *       *       *

  (c) Effective Date.--The amendments made by this section 
shall apply to aliens admitted to the United States under 
section 101(a)(15)(J) of the Immigration and Nationality Act, 
or acquiring such status after admission to the United States, 
before, on, or after the date of enactment of this Act and 
before [June 1, 2008] June 1, 2013.

           *       *       *       *       *       *       *