Program helping US areas of need get foreign doctors up for renewal this week

— -- Amid a brewing debate on the future of America’s health care, a little known program sustaining a pipeline of doctors to underserved communities is set to expire on April 28th.

The program, known as the Conrad 30 Waiver Program, offers individual states the opportunity to exempt up to 30 foreign doctors per year from their visa requirements, in exchange for practicing for a minimum of three years in areas with a dire need of health providers.

From 2013 to 2015, more than half of U.S. states used at least 20-30 of their allotted waivers to remedy critical lapses in health care access, according to the Texas Primary Care Office.

“Rural communities in Minnesota and across the country are short on doctors, and they rely on the Conrad 30 program to fill the gaps. Over the last 15 years, the Conrad 30 program has brought more than 15,000 physicians to underserved areas," said Senator Amy Klobuchar (D-Minn.), who is spearheading the effort to extend the Conrad 30 program, in a statement released earlier this month.

Many physicians from around the world, known as international medical graduates, use J-1 visas to complete medical training in the United States. After their training finishes, they are expected to return to their home countries for two years until they can apply for legal residency in the U.S.

The Conrad 30 allows foreign physicians to bypass that requirement through the provision of a J-1 waiver, letting them remain in the U.S. while working in communities desperately in need of doctors.

The program is designed to counter the shortage of physicians in America. By 2025 the American Medical Association estimates the country will be short of between 60,000 and almost 95,000 physicians -- a deficit that will hit rural and low-income communities especially hard.

Along with Sen. Klobuchar, Senators Susan Collins (R-Maine) and Heidi Heitkamp (D-N.D.) introduced the The Conrad State 30 & Physician Access Act earlier this month to renew the program until 2021. Since its introduction in 1994, the program has been periodically reauthorized.

"We must provide opportunities for American-trained and educated physicians to remain in the country and practice where there is an identified need for quality care," said Senator Collins in a statement. "This legislation would allow for expanded access to health care in our rural or underserved communities, and in turn, would promote healthier lives."

If the program fails to be reauthorized, the next generation J-1 waiver physicians will not qualify to apply for the waiver until the program is reinstated, potentially interrupting a crucial flow of doctors on which Americans depend.

Dr. Sameer Alefrai, a Jordanian physician applying for a J-1 waiver this year, called the program a "win-win."

"You get to stay here and continue working for a limited time until you satisfy your J-1 waiver, stay with your friends, colleagues, and keep progressing your career. And they get a physician in an underserved area," Alefrai told ABC News.

The Conrad 30 program was instituted by Senator Kent Conrad of North Dakota in 1994, looking to address growing shortages of physicians in America, especially in rural communities. By 2006, it had grown tremendously, with the number of waivers from states rising from 89 in 1995 to more than 1,000 per year, leading the U.S. Government Accountability Office to describe it as, "a major means of placing physicians in underserved areas of the United States."

The impact of the program is vast as these doctors may see hundreds to thousands of patients. A study in the Annals of Family medicine estimated than many primary care physicians groups in the U.S. see more than 2,000 patients per year.

In the past, the Conrad 30 program has enjoyed bipartisan support. However, under the new administration, the future of the program is unclear.

"It’ll be a trial balloon, it certainly will test the waters if physician immigration continues to have the support of both sides of Congress as it has had in the past," Connie Berry, former manager of the Texas Primary Care Office told ABC News.

The current legislation also seeks to reform the program, offering clarifications to existing rules, employment protections for physicians to prevent mistreatment and giving spouses work privileges.

The bill also seeks to expand access to doctors, increasing the cap on waivers for individual states.

Priya Raja is a Medical Fellow in the ABC News Medical Unit as a part of the Stanford - ABC News Global Health and Media Fellowship. She is also a rising third year medical student at The University of Texas Southwestern Medical Center.