English exam singles out massage therapists, hurts immigrants

Taiwanese student Ti “Joyce” Chun-Shan studied hard when she came to the United States in 2016. She finished a massage therapy program and earned an associate’s degree at Chandler-Gilbert Community College.

Joyce even lined up a job at a reputable salon. “I had five interviews,” she says. “All of them wanted to hire me.” Two days before her graduation, however, Joyce made a decision that upended her plans: She truthfully checked a box on her application for an Arizona massage therapy license, stating she was not a native English speaker.

If Joyce had lied, her license would have been assured. Native speakers are exempt from further scrutiny. Nonnative speakers get worked over. Put simply, the rules for them are a pain in the neck.

Arizona law includes a “communication proficiency requirement” for massage therapy, measured by a four-part test. If applicants fall below a certain level in even one section, they cannot practice their chosen occupation in Arizona.

Joyce should have been fine. She attended all her classes in English, maintained good grades, and earned English as a Second Language (ESL) certification. Unfortunately, the Arizona State Board of Massage Therapy, which regulates the industry, has set standards beyond the reach of most immigrants and international students.

Minimum required scores exceed the mean for all groups of test takers—including college graduates, native English speakers, and people born in the United States. The board’s standards even exceed the minimum requirements for graduate school admission at each of Arizona’s three public universities. An international student who could clear the hurdle would be one of Yale University’s “most competitive applicants.”

The board claims the rigor is necessary to ensure that massage therapists can evaluate clients and communicate with first responders in emergency situations. Yet first responders face no similar requirement to demonstrate English proficiency. Neither do doctors, dentists, dieticians or mental healthcare providers. A nonnative English speaker could earn an MBA, teach school, design circuits or perform brain surgery in Arizona—but not rub someone’s neck and shoulders.

Overall, nearly one-in-four U.S. workers face licensing requirements in more than 100 occupations. Yet only massage therapists, physical therapists and nurses face any English proficiency requirement in Arizona.

The barrier to work is not just wrong, but unconstitutional. People have a right to support their families without unreasonable or excessive government interference. Oversight boards need a legitimate public interest before they deprive someone of honest income.

Singling out immigrants for extra hassle is also counterproductive from an economic standpoint. As research has shown, employment restrictions on this group impede assimilation and promote dependency on taxpayer-funded programs.

“License to Work,” a national report from our public interest law firm, the Institute for Justice, suggests the entire regulatory regime for Arizona massage therapy is unnecessary. Fees and education requirements vary widely, yet massage techniques do not change when a person crosses state lines. Sore muscles work the same everywhere.

Nevertheless, New York requires 1,000 clock hours of training, Arizona requires 500 hours, and Maine requires zero. Six states—California, Indiana, Kansas, Minnesota, Oklahoma and Wyoming—require no license at all for massage therapy. Meanwhile, only Arizona and Michigan have English proficiency requirements, yet the standards are much less onerous in Michigan.

Nonnative English speakers could leave Arizona to practice massage therapy, but they shouldn’t have to do so. Rather than accept the arbitrary requirement, Joyce refused to take the state-mandated English test. “I was frustrated,” she says. “I love massage therapy. I have a passion for this.”

Eventually, the work authorization that came with her student visa expired, and she returned to Taiwan in January 2021. This would have happened regardless, but the English proficiency requirement prevented Joyce from maximizing her time and training in the United States. And the rule will make her life difficult if she returns to Arizona under a new visa, which she hopes to do.

Unnecessary occupational licensing rules also hurt Arizona consumers, who get few options and pay higher prices. The restrictions on well-trained massage therapists represent just one pain point. Other examples abound in at least 68 lower-income occupations in Arizona.

The regulatory overkill is enough to rub anyone the wrong way.

Paul Avelar is a Tempe-based senior attorney at the Institute for Justice. Daryl James is an Institute for Justice writer in Arlington, Virginia.