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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
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
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.
Purpose and Summary.............................................. 1
Background and Need for the Legislation.......................... 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.
The Committee on the Judiciary held no hearings on H.R.
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.
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
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
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
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.
Peter R. Orszag,
Honorable Lamar S. Smith.
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
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
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
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
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.
The following discussion describes the bill as reported by
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
* * * * * * *
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.
* * * * * * *