FARGO — The coronavirus pandemic is exacerbating a backlog in processing visa renewals for health care professionals — a bureaucratic snarl that could hinder access to care, particularly in rural areas.

Sen. Kevin Cramer, R-N.D., is asking Trump administration officials to provide “greater certainty” that health workers' visas will be renewed so they don’t have to live under the cloud of deportation during the pandemic.

“North Dakota’s health care workers need stability and peace of mind about their legal status during this crisis,” Cramer wrote in a letter to Ken Cuccinelli, acting deputy secretary of the Department of Homeland Security. “We need them focused on providing the important, high quality care they are capable of, not worrying about the threat of deportation.

The backlog in processing means some visas set to expire this summer will not be renewed in time, Cramer said.

At least 75 physicians worked in North Dakota on a visa program, or 4.7% of the state's medical doctors, according to 2017 figures cited by Cramer’s office.

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Homeland security officials have said they will use their existing authority to provide flexibility for those going through the renewal process, but Cramer is working with the department to issue official guidelines to provide certainty to immigrant health care workers.

A major concern is the administration’s suspension of what is called premium visa processing, which allows employers to pay a higher fee for expedited processing for certain visas, said Courtney Koebele, executive director of the North Dakota Medical Association, which represents physicians.

“During this pandemic, this action has the potential to impact patient access to medical care for North Dakota residents, particularly in rural areas,” she said Tuesday, April 21.

Cramer is advocating for the resumption of premium visa application processing as well as a waiver of restrictions that tie a doctor to the place of employment at the time a work-related visa was granted, allowing greater flexibility.

Sanford Health supports efforts to clear the visa backlog for physicians.

"We are supportive of current efforts to ease visa processing for health care workers," a statement released by Sanford spokeswoman Erika Batcheller said. "This is an unprecedented time and health care workers are on the frontlines in the fight against COVID-19. Without changes to the bureaucracy around visa renewal, we could face a risk of provider shortages in some areas."

Essentia Health said it was unable to provide comment on the issue.

Meanwhile, health care workers reportedly will be exempt from the immigration ban President Donald Trump has announced that he will impose to try to mitigate the spread of the coronavirus. Migrant farm workers also will be exempted, according to news reports.

Trump will issue an executive order suspending issuance of green cards, which grant permanent residency, for 60 days. Pausing immigration, the president said, will help ensure that unemployed citizens are first in line for jobs.