Sponsors (2)
The bill streamlines and standardizes how waiver slots and medical-immigrant placements are allocated—helping place physicians and reducing implementation uncertainty—while risking reductions of slots in some States, new administrative costs and compliance burdens, and privacy concerns for applicants.
International medical graduates and patients in underserved areas: a centralized portal plus a 60-day secondary match and access to unused 212(e) waivers increases chances that IMGs will be placed and that hospitals can fill physician vacancies faster.
State governments and federal agencies: clearer statutory allocation rules, deadlines, and standardized best practices reduce legal and administrative uncertainty and support more consistent implementation across States.
Immigrants (nonmedical workers/visitors): updated rules for allocating flex (waiver) nonimmigrant slots can increase lawful temporary admission opportunities in some States.
Immigrants in some States: the new allocation method could reduce the number of available flex waiver slots in certain States, limiting temporary admission opportunities for prospective nonimmigrants.
State governments: States that lose or see reductions in slots may face competition, allocation disputes, or legal challenges as resources are reallocated.
Taxpayers and government agencies: implementing the new allocation method, IT changes, and expanded recruitment/processes could impose additional administrative costs on DHS, DOJ, States, and taxpayers.
Based on analysis of 3 sections of legislative text.
Changes how State "flex" waiver slots are defined and creates a USCIS secondary-match portal so eligible J-1 physicians can be recruited into unused State waiver slots.
Official title: Increase by 5 the number of flex waivers available in each State for J-1 nonimmigrants and to establish a secondary physician match portal to assist alien physicians who are unable to find employment in their preferred State of residence to find employment in another State.
Introduced May 21, 2026 by Kevin Cramer · Last progress May 21, 2026
Creates a USCIS-run "secondary physician match" portal to allow certain J-1 international medical graduates who were not selected for a State 212(e) waiver (or could not apply because a State cap was reached) to be visible to States and employers with remaining waiver slots. It also replaces existing statutory language that governs how many "flex" waiver slots each State receives and requires USCIS to consult State health departments and publish best practices to streamline the secondary match process. The bill changes how State waiver allocations are defined (amending INA 214(l)(1)(D)(ii)) and adds procedural requirements for USCIS to run the secondary match, set match timelines, collect and transmit credentialing information, and require employer attestations about recruitment efforts.