The Washington Post reports:

The leaders of Sanford Medical Center had waited all summer to learn the fate of the 59 nurses planning to move across the world to their isolated state capital. The reinforcements from the Philippines, Kenya and Nigeria would allow the hospital to expand its heart unit and staff a new wing. Costly temporary nurses would go. The scramble to fill shifts would finally be over.

But by the time the hospital’s department heads gathered in a conference room this fall to hear the latest development, the news already had spread. The nurses were delayed — again.

“We’re projecting no arrivals until the first quarter of 2025 or later,” Wendy Kopp, the chief of nursing and clinical services, told the solemn room.

Days before the early morning meeting in September, the State Department had announced that it would issue the type of work visas that the nurses needed only to those who had applied before December 2021. That would exclude dozens of new hires critical to Sanford’s efforts to replenish its depleted bedside staff during its biggest workforce crisis in years. The nurses were left adrift with no immediate path to the United States.

It was one more gut punch from a broken immigration system untouched by Congress for 33 years and largely operating on a framework dating to 1965. As a record surge of unauthorized migrants enters the United States through its southern border, stoking political divisions and straining resources, the troubled system for those eligible to come here legally has buckled in the background. Congress splintered over the issue again this month, as Republicans resisted calls from the Biden administration for more aid to Ukraine unless it comes with more-stringent border policies.

Since Congress last updated the number of new arrivals the country will admit each year — a tiny fraction of whom are allowed to come in permanently to work — the economy is more than twice as large. But despite growing demand to help fill 8.7 million open jobs with skilled and unskilled foreign-born workers, strict quotas keep out millions of qualified immigrants every year. Demand was so high this year that the State Department was forced to restrict many types of visas, including — for the first time in years — those for nurses.

Getting a coveted pass to enter the United States means waiting in backlogs for years in a neglected bureaucracy of overlapping, resource-starved federal agencies. There are record delays at an obscure Labor Department office, a backed-up processing queue at a Homeland Security agency so overburdened that it has wasted thousands of untouched green card applications, and years-long waits for final interviews at some U.S. consulates.

“The legal immigration system is collapsing under its own weight,” said Theresa Cardinal Brown, a former federal immigration official who is now a senior policy adviser on the issue at the Bipartisan Policy Center in Washington.

The visas are blocked, year after year, by what David Bier, an immigration expert at the Cato Institute, calls “an almost insurmountable barrier of bureaucratic red tape.” [Continue reading…]