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LUGPA Policy Brief: Expanding Access to Care:
Support for the Doctors in Our Borders Act (H.R. 1201)

April 2025 

The United States faces a growing physician workforce crisis, with a projected shortfall of nearly 86,000 physicians by 2036. This shortage poses a serious threat to access, especially in rural and underserved communities where medical needs are already going unmet.

One effective tool in addressing this challenge is the Conrad 30 program, which allows states to sponsor up to 30 foreign medical graduates (FMGs) on J-1 visas each year. In exchange for a waiver of the two-year home residency requirement, these physicians commit to practicing in underserved areas for at least three years, helping to fill critical gaps in care.

Legislative Solution

The Doctors in Our Borders Act (H.R. 1201)—reintroduced by Representatives Michael Lawler (R-NY) and Yvette Clarke (D-NY)—seeks to modernize and expand the Conrad 30 program by increasing the number of waivers available to each state or regional commission from 30 to 100.

This important bipartisan legislation would better align the program’s capacity with today’s healthcare workforce needs.

Why This Bill Matters

  • Expands Access to Care: Increasing the waiver cap gives states more flexibility to recruit and retain qualified physicians, ensuring that more patients in high-need areas receive timely care.
  • Targets Underserved Areas: Many rural and low-income urban communities continue to face significant provider shortages. By enabling up to 70 additional physicians per state, H.R. 1201 would make a meaningful difference in these regions.
  • Promotes Care Continuity: Allowing more J-1 visa physicians to remain in the U.S. after residency strengthens long-term care delivery and reduces disruptions in provider availability.
  • Upholds Service Requirements: Physicians receiving waivers must still commit to a minimum three-year service term in a federally designated Health Professional Shortage Area (HPSA) or Medically Underserved Area (MUA), ensuring a direct benefit to the communities most in need.

Key Provisions of H.R. 1201

  • Increased State Waiver Cap: Raises the maximum number of Conrad 30 waivers from 30 to 100 per state or regional commission.
  • Focus on Shortage Areas: Ensures participating physicians are placed in HPSAs or MUAs, targeting the areas with the greatest need.
  • Retention of U.S.-Trained Talent: Allows more foreign-born graduates of U.S. medical residency programs to remain and contribute their skills to the American healthcare system.

Why It Matters to LUGPA and Independent Urology Practices

LUGPA members operate across diverse geographic regions—including many rural and underserved areas—and are directly impacted by ongoing physician workforce challenges. Urology practices, in particular, struggle to meet demand amid specialty shortages.

Expanding the Conrad 30 program would:

  • Improve Patient Access: Allow more urologists to serve in communities with limited access to specialty care, reducing wait times and improving outcomes for patients with complex urologic conditions.
  • Strengthen the Workforce: Help independent practices recruit and retain skilled professionals, ensuring continuity and sustainability of care delivery.
  • Advance Health Equity: Increase access to high-quality, specialized care in areas disproportionately affected by healthcare disparities.

LUGPA strongly supports the Doctors in Our Borders Act (H.R. 1201) and urges Congress to advance this smart, bipartisan solution. By expanding the Conrad 30 program, lawmakers can address a key bottleneck in the healthcare workforce pipeline—without requiring new federal spending.

We encourage members of Congress to co-sponsor and support H.R. 1201, and we call on stakeholders across the healthcare system to join us in advocating for a more equitable and accessible healthcare future.