Health care workforce shortages could grow under Trump deportation plan, new report says
The Trump administration’s plan to deport millions of immigrants without legal status could deepen an already precarious workforce crisis at nursing homes, hospitals and home health care agencies across the country, according to a new report by five New York and Massachusetts medical professionals.
The report, published Thursday on the JAMA Network, an open-access medical journal published by the American Medical Association, found that more than 1 million noncitizen immigrants — roughly one third of whom are without legal status — work in health care settings nationwide, including as physicians, nurses and home care aides. Replacing those workers would be difficult, if not impossible, if their status was revoked, the authors said.
The U.S. Department of Homeland Security didn’t respond to a request for comment on the report’s findings.
The report said 12.8% of health care workers in New York State are noncitizens, the highest percentage of any high-population state.
“New York had, by far, the highest proportion of noncitizen immigrants in its health care workforce,” Dr. Stephanie Woolhandler, a co-author of the report and a professor of public health at Hunter College, said in a Wednesday interview, citing a high number of immigrant doctors, nurses and nurse’s aides working in the field.
Nationwide, the report said, at least 10% of staff working at home care agencies are noncitizens, along with 7% of nursing home workers and 4% of hospital staff.
In total, the report found that working nationwide in the health care field are more than 2.3 million naturalized citizen immigrants and more than 1 million noncitizens — including more than 366,000 immigrant workers without legal status.
The authors analyzed occupation and citizenship data from the March 2024 Current Population Survey, the primary source of labor statistics for the U.S. population, which is sponsored jointly by the U.S. Census Bureau and the U.S. Bureau of Labor Statistics.
In the roughly 10 weeks since President Donald Trump took office, his administration has said it has deported more than 100,000 immigrants without legal status while also stripping temporary protected status for some Venezuelan immigrants — a move a federal judge in California temporarily blocked this week.
TPS allows noncitizens to live and work in the country legally and is granted to people from countries Homeland Security designates as unsafe to return to because of reasons including ongoing armed conflict and environmental disasters.
The deportations, Woolhandler said, could compromise health care for elderly and disabled residents at long-term care facilities, such as nursing homes, where immigrants play a significant role in the workforce.
Separately, last month the American Health Care Association released its annual report on the state of the nursing home industry nationwide. Based on a survey, it found 90% of nursing homes currently have open positions, including 89% that are trying to hire registered nurses.
In addition, the association found 72% of 441 nursing home providers surveyed said their current staffing levels were lower than before the COVID-19 pandemic and almost half had limited new admissions because of labor shortages.
“Our updated State of the Sector report demonstrates clearly what nursing home providers across the country already know: the ongoing labor shortage is nothing less than a crisis for our sector,” Mark Parkinson, president and chief executive of AHCA, said in a statement.
A 2024 report by KFF, a nonpartisan organization focused on health policy, found only 19% of nursing facilities nationwide currently meet the new minimum staffing levels mandated by the Centers for Medicare & Medicaid Services that are set to go into effect by 2029.
Richard Mollot, executive director of the Long Term Care Community Coalition, an advocacy group for nursing home residents, said in an interview that continued deportations could once again expose weaknesses in the health care field, such as staffing shortages and inadequate infection control procedures, similar to those that came to light during the pandemic.
The administration’s efforts to deport immigrants without legal status “will undoubtedly exacerbate long-standing staffing shortages in nursing homes and other health care settings,” Mollot said. “This impact will likely be especially severe in the New York metropolitan area, a longtime hub for immigrants.”
Cristina Freyre Batt, senior vice president of federal policy at the Healthcare Association of New York State, said in a statement that “foreign-born workers fill essential clinical and non-clinical roles in hospitals and nursing homes statewide.”
She added: “HANYS opposes policies that would reduce the available health care workforce, as a worsening workforce crisis would further threaten New Yorkers’ access to care.”
Staffing shortages, Woolhandler said, can have cascading impacts across the entire health care spectrum, where patients can’t be discharged from emergency rooms to nursing homes or to home care agencies because of a lack of available beds or staffers available to care for people with chronic conditions.
“It creates a real bottleneck,” she said,” that can grind the whole system into real gridlock.”
The Trump administration’s plan to deport millions of immigrants without legal status could deepen an already precarious workforce crisis at nursing homes, hospitals and home health care agencies across the country, according to a new report by five New York and Massachusetts medical professionals.
The report, published Thursday on the JAMA Network, an open-access medical journal published by the American Medical Association, found that more than 1 million noncitizen immigrants — roughly one third of whom are without legal status — work in health care settings nationwide, including as physicians, nurses and home care aides. Replacing those workers would be difficult, if not impossible, if their status was revoked, the authors said.
The U.S. Department of Homeland Security didn’t respond to a request for comment on the report’s findings.
The report said 12.8% of health care workers in New York State are noncitizens, the highest percentage of any high-population state.
“New York had, by far, the highest proportion of noncitizen immigrants in its health care workforce,” Dr. Stephanie Woolhandler, a co-author of the report and a professor of public health at Hunter College, said in a Wednesday interview, citing a high number of immigrant doctors, nurses and nurse’s aides working in the field.
Nationwide, the report said, at least 10% of staff working at home care agencies are noncitizens, along with 7% of nursing home workers and 4% of hospital staff.
In total, the report found that working nationwide in the health care field are more than 2.3 million naturalized citizen immigrants and more than 1 million noncitizens — including more than 366,000 immigrant workers without legal status.
The authors analyzed occupation and citizenship data from the March 2024 Current Population Survey, the primary source of labor statistics for the U.S. population, which is sponsored jointly by the U.S. Census Bureau and the U.S. Bureau of Labor Statistics.
In the roughly 10 weeks since President Donald Trump took office, his administration has said it has deported more than 100,000 immigrants without legal status while also stripping temporary protected status for some Venezuelan immigrants — a move a federal judge in California temporarily blocked this week.
TPS allows noncitizens to live and work in the country legally and is granted to people from countries Homeland Security designates as unsafe to return to because of reasons including ongoing armed conflict and environmental disasters.
The deportations, Woolhandler said, could compromise health care for elderly and disabled residents at long-term care facilities, such as nursing homes, where immigrants play a significant role in the workforce.
Separately, last month the American Health Care Association released its annual report on the state of the nursing home industry nationwide. Based on a survey, it found 90% of nursing homes currently have open positions, including 89% that are trying to hire registered nurses.
In addition, the association found 72% of 441 nursing home providers surveyed said their current staffing levels were lower than before the COVID-19 pandemic and almost half had limited new admissions because of labor shortages.
“Our updated State of the Sector report demonstrates clearly what nursing home providers across the country already know: the ongoing labor shortage is nothing less than a crisis for our sector,” Mark Parkinson, president and chief executive of AHCA, said in a statement.
A 2024 report by KFF, a nonpartisan organization focused on health policy, found only 19% of nursing facilities nationwide currently meet the new minimum staffing levels mandated by the Centers for Medicare & Medicaid Services that are set to go into effect by 2029.
Richard Mollot, executive director of the Long Term Care Community Coalition, an advocacy group for nursing home residents, said in an interview that continued deportations could once again expose weaknesses in the health care field, such as staffing shortages and inadequate infection control procedures, similar to those that came to light during the pandemic.
The administration’s efforts to deport immigrants without legal status “will undoubtedly exacerbate long-standing staffing shortages in nursing homes and other health care settings,” Mollot said. “This impact will likely be especially severe in the New York metropolitan area, a longtime hub for immigrants.”
Cristina Freyre Batt, senior vice president of federal policy at the Healthcare Association of New York State, said in a statement that “foreign-born workers fill essential clinical and non-clinical roles in hospitals and nursing homes statewide.”
She added: “HANYS opposes policies that would reduce the available health care workforce, as a worsening workforce crisis would further threaten New Yorkers’ access to care.”
Staffing shortages, Woolhandler said, can have cascading impacts across the entire health care spectrum, where patients can’t be discharged from emergency rooms to nursing homes or to home care agencies because of a lack of available beds or staffers available to care for people with chronic conditions.
“It creates a real bottleneck,” she said,” that can grind the whole system into real gridlock.”
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