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On June 25, Mr Decision of the United States Supreme Court allowed President Donald Trump and his administration to end Temporary Protected Status (TPS) for Haitians, paving the way for their legal removal.
Trump has pushed to end TPS in several categories, as part of his efforts to restrict immigration to the US.
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But lawmakers from both political parties say removing Haitians from TPS could create a health care crisis, given their presence in key industries such as health care.
“Of the 350,000+ legal TPS Haitians, nearly 1/3 work in our healthcare system. Closing TPS immediately will create a crisis in our hospitals, nursing homes, and (intellectually disabled) communities,” Republican Representative Mike Lawler wrote on the X platform.
Democratic Representative Ayanna Pressley echoed that sentiment in her speech.
He wrote: “The elders will lose their caregivers when we already have a problem to care for us, and the elderly will stop aging in their community with much needed help.”
The Temporary Protected Status program allows people from countries facing crisis, such as natural disasters or war, to stay in the United States for 18 months. The federal government renewed the designations, making them permanent, before President Trump takes office for a second term in 2025.
Lawler estimates that the number of Haitians with TPS who work in US hospitals is within that range.
The Trump administration’s decision — and the Supreme Court’s decision — affects about 330,000 Haitians whose TPS-related permits expire on July 10. They face deportation unless he is entitled to another position. This decision also applies to Syrians and Venezuelans.
About 158,000 Haitians in Florida have TPS, most of them in South Florida. The Sunshine State has the most TPS recipients in the US: about 404,000 people. More than half are from Venezuela and about a third are from Haiti, according to the nonpartisan Congressional Research Service.
With an aging population and a shortage of available caregivers, medical experts say the end of TPS for Haitians will have a major impact on the US medical industry.
Of the 330,000 Haitian TPS holders, about 13,000 work every day as nurse’s aides, caring for 65,000 patients, The Boston Globe found. Some 8,000 Haitians serve 12,000 children and the elderly, according to Americans for Immigrant Justice, a Miami-based nonprofit that provides free legal services to low-income immigrants.
Experts say the exodus of TPS health care workers will be felt most in New York, Massachusetts and Florida.
With an aging and immigrant population, Florida is expected to be the hardest hit.
David Grabowski, a professor of medicine at Harvard Medical School, said the decision “will have a significant impact on nursing homes, assisted living facilities and home care organizations”.
What would happen if more Haitians with TPS were deported?
Health researchers say deporting Haitians who have received Temporary Protected Status will add stress to the already strained system.
Immigrants with TPS are more likely to work in the healthcare sector, with one 2025 study finding that recipients represent 15 percent of all non-citizen healthcare workers. (TPS recipients make up about 2.1 percent of all immigrants.)
Immigrants make up a large part of the direct labor force – people who are home health aides, personal assistants and nursing assistants.
There is already a national shortage of health care workers, social workers, nursing assistants and other long-term workers and caregivers, but the US will need more in the future. The US population 65 and over is expected to rise from 58 million to 82 million by 2050 – an increase of 42 percent.
About half of nursing homes in the US report reducing admissions due to staff shortages, and 19 percent have recently experienced staff shortages set by the Centers for Medicare & Medicaid Services. In 2023, a shortage of nurses and other staff will cause two out of three US hospitals to be understaffed.
“People who run nursing homes, hospices and home care organizations – they all say this is a problem,” said Dr Steffie Woolhandler, a distinguished professor of public health at the City University of New York’s Hunter College. “There’s been a shortage of people who are willing to work in nursing, and right now, if the U.S. were to get rid of them all, that would only increase.”
Drishti Pillai, director of immigration policy at the non-profit organization KFF, said, “Immigrant care companies are facing a long-term shortage before this, and I think it’s fair to say that this will exacerbate the situation.”
Why do so many Haitians with TPS work in social care?
Health professionals cited a number of reasons for direct care of TPS individuals, including the availability of work, an easier certification process compared to other health care services, and a history of caring for family members.
“We don’t have enough newborn workers to do all the care,” said Grabowski, the health professor.
These positions also have low barriers to entry, or no English language requirements, experts said. Immigration agencies often recommend this service to immigrants for that reason.
These positions are “very difficult to fill” because they are physically and emotionally demanding, with low wages and no work benefits, said Priya Chidambaram, KFF’s policy manager for Medicaid and the uninsured.
Some Haitians also have the ability to care for sick relatives in their own homes, due to the lack of nursing homes in their country.
Ultimately, experts say that there will be more people who need this care than can afford it.
“This was true before the verdict,” Chidambaram said. “Now, the consequences will be worse.”
