“If you punish and harass immigrants, you’re punishing Americans who need medical care,” said Dr. Steffie Woolhandler, one of the study’s co-authors and a Harvard lecturer.
In particular, rolling back legal status for Haitian immigrants in the Northeast would have a striking impact on the medical workforce, said Woolhandler, who is also a City University of New York professor. The study was conducted by researchers at Harvard Medical School, The City University of New York, The Institute for Community Health, and the Edward M. Kennedy Community Health Center in Worcester.
The senior care workforce would likely be hit hardest in Massachusetts, Woolhandler said. Forty percent of the front-line staff in Massachusetts nursing homes are immigrants, mostly from Haiti, who often earn relatively low wages and work closely with patients in difficult, skilled jobs that are hard to fill.
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About 5,000 of Massachusetts’ nursing home employees are immigrants to the state under Temporary Protected Status, according to nursing home industry estimates.
The potential threat to the elder care workforce comes as the US population is aging — the number of people over 65 is projected to increase by nearly 50 percent by 2050, according to the Population Reference Bureau.
Within his first few days back in office, Trump moved to roll back Temporary Protected Status for Haitian and Venezuelan immigrants, which permits migrants from countries impacted by war or other political instability to temporarily live and work in the United States. A federal judge paused the plan to end protections for hundreds of thousands of Venezuelans on Monday. The scaling back of protections for Haitian migrants still stands, but is facing similar legal challenges.
The state’s skilled nursing facilities already have 1 in 7 positions vacant due to critical workforce shortages, according to a January statement from Massachusetts Senior Care, a nursing home trade association.
Non-citizen workers’ “ranks include skilled personnel who would be difficult to replace, especially if legal immigration is further restricted,” the researchers wrote. “Many health care workers may be removed if President Trump implements plans to deport undocumented immigrants and those losing [Temporary Protected Status].”
In response to the study, the Trump administration said its immigration efforts were in line with what voters wanted.
“President Trump was given a resounding mandate from the American people to enforce our immigration laws and put Americans first,” said White House SpokespersonKush Desai. “The Trump administration is committed to delivering on that mandate while building on the progress made during the first Trump presidency to bolster our healthcare workforce and increase healthcare affordability, such as with President Trump’s price transparency executive orders.”
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But the ripple effects on the health care industry from losing immigrant staffers could be substantial, researchers said.
A loss of nursing home and home health staff would likely lead to medical providers not being able to accommodate as many patients, said Woolhandler, so when an elderly person needs to go to the hospital, they end up having to stay there for longer until they can find an available long-term care option, placing further strain on already-crowded hospitals.
“I just think the situation is going to go from bad to worse if we start deporting a lot of non-citizen immigrants, many of them working in the US health care system,” said Woolhandler.
The immigration policy and attitude changes may also dissuade many internationally-trained medical professionals from coming to the United States in the first place, she said. Massachusetts recently passed a law aimed at providing pathways for internationally trained physicians to practice in the state to ease primary care shortages.
“For highly skilled people, nurses, and physicians, they may have other options,” said Woolhandler. “Many of them probably will go elsewhere, particularly those that feel the US is becoming hostile to them.”
Maren Halpin can be reached at maren.halpin@globe.com.
