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HR1585119th CongressWALLET

Conrad State 30 and Physician Access Reauthorization Act

Sponsored By: Representative Valadao, David G. [R-CA-22]

Introduced

Summary

Expand and extend the Conrad State 30 J-1 visa waiver program. This bill would reauthorize the program and change rules to keep more foreign-trained physicians working in rural and medically underserved areas.

Show full summary
  • Physicians: Gives doctors clearer paths to stay and work. It would let spouses and children be eligible for ongoing consideration, allow certain petitions or status adjustments before service is complete, create exceptions to the 2-year foreign residency rule, and set a 3-year service commitment with defined start-date rules and enforcement for broken agreements.
  • Rural communities and patients: Changes waiver allotments to boost placements in shortage areas. States that meet performance thresholds would start with a baseline of 35 waivers and can receive automatic increases of 5 waivers while a 30 waiver floor is preserved.
  • States and academic medical centers: Establishes new allotment mechanics and an explicit waiver route for academic medical centers if the placement is in the public interest. It would also require an annual state-by-state report on program activity.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 1 benefits, 0 costs, 2 mixed.

Protections and start rules for physicians

If enacted, waiver recipients would need a bona fide full-time job offer at a DHS-approved facility in an HHS shortage area. You would have to start by the later of 120 days after the waiver, 120 days after finishing approved training, or 120 days after getting status when timely petitioned. You would agree to at least three years of service, with narrow exceptions and options to find another qualifying job within 120 or 45 days. Employment contracts would have to set on-call limits and pay, state whether malpractice is covered or list employer premium payments, list all work locations, and not include a non-compete. The bill would also extend H-1 status and work authorization to October 1 in some cases, and allow up to a six-month extension if your State denied a waiver only because it hit its cap.

New immigration paths for physicians

If enacted, foreign physicians who finish the required waiver service would be able to file immigrant petitions and apply for adjustment of status. This would include physicians who finished service before enactment and their spouse and children. You could file before finishing service, but DHS would not approve the filing until you complete all waiver requirements. The bill would let an interested Federal or State agency ask DHS to change a J‑1 physician's status to any work-authorized status without counting against numeric limits when the Secretary of State gives a favorable recommendation. It would also clarify dual intent for medical trainees, treat qualifying foreign medical degrees as advanced degrees, and let prior work count toward five-year national interest waiver service rules, including work at VA or facilities serving shortage-area patients.

Changes to state waiver slots

If enacted, the Conrad State 30 program would be extended as if the change began on September 30, 2018 and would run until three years after this bill is enacted. States could be allotted 35 waivers if prior-year use hit 90% among States with at least five waivers, and repeated 90% use would add five waivers per year. Once allotments reach 45 or more, further increases would need 95% usage. A fiscal year with total waivers at least 5% below the last year with an increase would cut five waivers for all States, but allotments could not fall below 30. State agencies could request waivers for academic medical center faculty, but such waivers could not make the State exceed three waivers for that year. If a waiver recipient leaves to work in another State under the law's termination rules, the original State could get an extra waiver that fiscal year.

Sponsors & CoSponsors

Sponsor

Valadao, David G. [R-CA-22]

CA • R

Cosponsors

  • Rep. Bacon, Don [R-NE-2]

    NE • R

    Sponsored 2/25/2025

  • Rep. Schneider, Bradley Scott [D-IL-10]

    IL • D

    Sponsored 2/25/2025

  • Rep. Garcia, Sylvia R. [D-TX-29]

    TX • D

    Sponsored 2/25/2025

  • Rep. Salazar, Maria Elvira [R-FL-27]

    FL • R

    Sponsored 3/3/2025

  • Rep. Davids, Sharice [D-KS-3]

    KS • D

    Sponsored 3/3/2025

  • Rep. Johnson, Henry C. "Hank" [D-GA-4]

    GA • D

    Sponsored 3/4/2025

  • Rep. Scott, David [D-GA-13]

    GA • D

    Sponsored 3/5/2025

  • Rep. Carbajal, Salud O. [D-CA-24]

    CA • D

    Sponsored 3/5/2025

  • Rep. Costa, Jim [D-CA-21]

    CA • D

    Sponsored 3/5/2025

  • Rep. Krishnamoorthi, Raja [D-IL-8]

    IL • D

    Sponsored 3/5/2025

  • Rep. DelBene, Suzan K. [D-WA-1]

    WA • D

    Sponsored 3/5/2025

  • Rep. Cherfilus-McCormick, Sheila [D-FL-20]

    FL • D

    Sponsored 3/18/2025

  • Rep. Riley, Josh [D-NY-19]

    NY • D

    Sponsored 3/24/2025

  • Rep. Houlahan, Chrissy [D-PA-6]

    PA • D

    Sponsored 3/24/2025

  • Rep. Panetta, Jimmy [D-CA-19]

    CA • D

    Sponsored 3/25/2025

  • Rep. Suozzi, Thomas R. [D-NY-3]

    NY • D

    Sponsored 3/31/2025

  • Rep. Meuser, Daniel [R-PA-9]

    PA • R

    Sponsored 3/31/2025

  • Rep. Gillen, Laura [D-NY-4]

    NY • D

    Sponsored 4/1/2025

  • Rep. Gomez, Jimmy [D-CA-34]

    CA • D

    Sponsored 4/1/2025

  • Rep. Ciscomani, Juan [R-AZ-6]

    AZ • R

    Sponsored 4/24/2025

  • Rep. McBride, Sarah [D-DE-At Large]

    DE • D

    Sponsored 4/24/2025

  • Rep. Murphy, Gregory F. [R-NC-3]

    NC • R

    Sponsored 4/29/2025

  • Rep. Wasserman Schultz, Debbie [D-FL-25]

    FL • D

    Sponsored 5/7/2025

  • Rep. Lawler, Michael [R-NY-17]

    NY • R

    Sponsored 5/13/2025

  • Rep. Baumgartner, Michael [R-WA-5]

    WA • R

    Sponsored 5/20/2025

  • Rep. Craig, Angie [D-MN-2]

    MN • D

    Sponsored 6/9/2025

  • Rep. Correa, J. Luis [D-CA-46]

    CA • D

    Sponsored 6/23/2025

  • Rep. Tokuda, Jill N. [D-HI-2]

    HI • D

    Sponsored 6/24/2025

  • Rep. Ryan, Patrick [D-NY-18]

    NY • D

    Sponsored 6/24/2025

  • Rep. Scholten, Hillary J. [D-MI-3]

    MI • D

    Sponsored 6/25/2025

  • Rep. Foxx, Virginia [R-NC-5]

    NC • R

    Sponsored 6/25/2025

  • Rep. Dingell, Debbie [D-MI-6]

    MI • D

    Sponsored 6/25/2025

  • Rep. Gottheimer, Josh [D-NJ-5]

    NJ • D

    Sponsored 6/25/2025

  • Rep. Castor, Kathy [D-FL-14]

    FL • D

    Sponsored 6/25/2025

  • Rep. Ross, Deborah K. [D-NC-2]

    NC • D

    Sponsored 6/26/2025

  • Rep. Casten, Sean [D-IL-6]

    IL • D

    Sponsored 6/26/2025

  • Rep. Peters, Scott H. [D-CA-50]

    CA • D

    Sponsored 6/27/2025

  • Rep. McClellan, Jennifer L. [D-VA-4]

    VA • D

    Sponsored 7/2/2025

  • Rep. Gonzalez, Vicente [D-TX-34]

    TX • D

    Sponsored 7/10/2025

  • Rep. Pettersen, Brittany [D-CO-7]

    CO • D

    Sponsored 7/10/2025

  • Rep. Matsui, Doris O. [D-CA-7]

    CA • D

    Sponsored 7/10/2025

  • Rep. Magaziner, Seth [D-RI-2]

    RI • D

    Sponsored 7/10/2025

  • Rep. Dexter, Maxine [D-OR-3]

    OR • D

    Sponsored 7/14/2025

  • Rep. Veasey, Marc A. [D-TX-33]

    TX • D

    Sponsored 7/17/2025

  • Rep. Crow, Jason [D-CO-6]

    CO • D

    Sponsored 7/29/2025

  • Rep. Vindman, Eugene Simon [D-VA-7]

    VA • D

    Sponsored 7/29/2025

  • Rep. Stanton, Greg [D-AZ-4]

    AZ • D

    Sponsored 8/19/2025

  • Rep. Van Drew, Jefferson [R-NJ-2]

    NJ • R

    Sponsored 9/2/2025

  • Rep. Leger Fernandez, Teresa [D-NM-3]

    NM • D

    Sponsored 9/3/2025

  • Rep. Subramanyam, Suhas [D-VA-10]

    VA • D

    Sponsored 9/17/2025

  • Rep. Lee, Susie [D-NV-3]

    NV • D

    Sponsored 9/23/2025

  • Rep. Stevens, Haley M. [D-MI-11]

    MI • D

    Sponsored 9/30/2025

  • Rep. Meng, Grace [D-NY-6]

    NY • D

    Sponsored 10/6/2025

  • Rep. Lynch, Stephen F. [D-MA-8]

    MA • D

    Sponsored 10/8/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 10/8/2025

  • Rep. Kennedy, Timothy M. [D-NY-26]

    NY • D

    Sponsored 10/17/2025

  • Rep. Vasquez, Gabe [D-NM-2]

    NM • D

    Sponsored 10/17/2025

  • Rep. McDonald Rivet, Kristen [D-MI-8]

    MI • D

    Sponsored 10/24/2025

  • Rep. Thompson, Mike [D-CA-4]

    CA • D

    Sponsored 10/24/2025

  • Rep. Pingree, Chellie [D-ME-1]

    ME • D

    Sponsored 11/7/2025

  • Rep. García, Jesús G. "Chuy" [D-IL-4]

    IL • D

    Sponsored 12/19/2025

  • Rep. Cohen, Steve [D-TN-9]

    TN • D

    Sponsored 4/20/2026

  • Rep. Schrier, Kim [D-WA-8]

    WA • D

    Sponsored 6/15/2026

  • Rep. DeSaulnier, Mark [D-CA-10]

    CA • D

    Sponsored 6/18/2026

  • Rep. Sorensen, Eric [D-IL-17]

    IL • D

    Sponsored 6/29/2026

  • Rep. Gray, Adam [D-CA-13]

    CA • D

    Sponsored 8/24/2026

Roll Call Votes

No roll call votes available for this bill.

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