CHICAGO ... Sept. 5, 2017 ... The American Medical Association (AMA) sent the following letter to Congress today urging prompt action to ensure that individuals with Deferred Action for Childhood Arrivals (DACA) status are able to remain in the United States.

"President Trump's recent announcement to end the DACA program in six months fails to recognize the enormous contributions of hundreds of thousands of individuals who are living, working, and providing vital services in the United States, including health care services," wrote AMA CEO and Executive Vice President James L. Madara, MD. "We particularly are concerned that this reversal in policy could have severe consequences for many in the health care workforce, impacting patients and our nation's health care system. Accordingly, we urge Congress to act quickly to ensure that individuals with DACA status are able to remain in the United States."

Dear Majority Leader McConnell, Democratic Leader Schumer, Speaker Ryan, and Democratic Leader Pelosi:

On behalf of the physician and medical student members of the American Medical Association (AMA), I am writing to urge Congress to take prompt action to protect and provide stability for individuals with Deferred Action for Childhood Arrivals (DACA) status. President Trump's recent announcement to end the DACA program in six months fails to recognize the enormous contributions of hundreds of thousands of individuals who are living, working, and providing vital services in the United States, including health care services. We particularly are concerned that this reversal in policy could have severe consequences for many in the health care workforce, impacting patients and our nation's health care system. Accordingly, we urge Congress to act quickly to ensure that individuals with DACA status are able to remain in the United States.

Our nation's health care workforce depends on the care provided by international medical graduates (IMGs)--one out of every four physicians practicing in the United States is an IMG. These individuals include many with DACA status who are filling gaps in care. The Health Resources and Services Administration reported that there is a current shortage of over 8,200 primary care physicians. Likewise, an independent study by the Association of American Medical Colleges has projected that the total physician deficit will grow to between 61,700 and 94,700 physicians by 2025. Estimates have shown that the DACA initiative could help introduce 5,400 previously ineligible physicians into the U.S. health care system in the coming decades to help address these shortages and ensure patient access to care.

Removing those with DACA status will particularly create care shortages for rural and other underserved areas. Like other IMGs, DACA physicians are more likely to work in high-need areas where communities face challenges in recruiting other physicians. DACA students are also more likely to be bilingual, to come from diverse cultural backgrounds, and to understand challenges in certain ethnic communities. Without these physicians, the AMA is concerned that the quality of care provided in these communities will be negatively impacted and that patient access to care will suffer.

Those protected by the DACA program also include medical students, residents, and fellows who are working to pass the lengthy and rigorous training and education needed to become a physician. In 2016, 108 students with DACA status applied to U.S. allopathic medical schools. Those who enrolled will now face uncertainty about completing their degrees, paying their student loans, and serving patients.

Furthermore, if DACA residents are unable to complete their training, which typically spans three to six years after medical school, this could potentially waste graduate medical education funds, leave training slots unfilled, and generally exacerbate the physician shortage our country is facing, especially for our most vulnerable patients. The AMA believes that these DACA recipients should be able to continue to study, work, and improve patient access to care without the fear and uncertainty of being deported before their training is completed.

The Administration has acknowledged that Congress could act to continue the DACA program and has provided a six-month timeframe for lawmakers to consider alternatives. The AMA urges Congress to pass legislation, such as the Dream Act of 2017 (S. 1615/H.R. 3440), that would provide a solution to ensure DACA recipients are protected and do not face continuous threats and potential legal challenges.

Those with DACA status help contribute to a diverse and culturally responsive physician workforce, which benefits all patients. These individuals have demonstrated their commitment to the United States in numerous ways by attending medical school, training to become doctors, caring for patients, conducting research, and improving our health care system. We therefore urge Congress to support these DACA recipients and pass a legislative solution in the near future.

Sincerely,

James L. Madara, MD

AMA Chief Executive Officer and Executive Vice President