U.S. Immigration Policy Changes Threaten Direct Care Worker Shortage

Immigrants make up 30 percent of the direct care workforce, which includes home health aides, personal care aides, and nursing assistants. The loss of these workers would severely disrupt care for elderly and disabled Americans, who rely on them for daily assistance.

The State Department has already revoked more than 750 visas through its Birth Tourism Prevention Task Force, targeting fraud where visitor visas are used to give birth in the U.S. This is part of a broader immigration crackdown that includes stricter visa screening and increased deportation efforts.

In addition to immigration enforcement, changes to wage and benefit policies are making direct care jobs less attractive to immigrant workers. Lower pay and reduced benefits, combined with the threat of deportation, are pushing many to leave the field or avoid entering it altogether.

Healthcare providers warn that the shrinking workforce will lead to longer wait times for home care services, increased strain on nursing facilities, and higher costs for families. The shortage is especially acute in states with large immigrant populations, such as California, Texas, and Florida.

Advocates for the elderly and disabled are calling on policymakers to address the root causes, including creating a pathway to citizenship for immigrant care workers and improving job conditions. Without action, they say, the care system could face a crisis that affects millions of vulnerable Americans.