The Trump Administration’s restrictive immigration policies, including mass deportations, tighter visa requirements and reductions in refugee admissions, could seriously impact medical care in America, according to a new report. Immigrants make up nearly one in five healthcare workers nationwide, including a substantial proportion of doctors, nurses, and home health aides.
Limiting the entry of skilled professionals from overseas and threatening deportation of immigrants currently in the country risk deepening the already critical shortage of healthcare workers, particularly in underserved rural and urban areas, reports KFF.
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Furthermore, the uncertainty surrounding visa renewals and employment authorization for immigrant healthcare workers threatens to disrupt care delivery and exacerbate burnout among the remaining workforce, placing additional strain on the U.S. healthcare system.
More than 1 in 4 Hospital Physicians Are Immigrants
Approximately 16% of hospital workers in the United States are immigrants, a similar proportion to the share of immigrants in the overall workforce, according to a 2023 survey from KFF. Within hospitals, immigrants account for significant roles across both clinical and nonclinical positions:
- 27% of hospital physicians are immigrants, including 19% who are naturalized citizens and 8% who are noncitizen immigrants. Many physician specialties already face acute shortages, a problem expected to worsen through 2037 if pathways for immigrant physicians are restricted.
- 22% of nursing assistants and 16% of registered nurses (RNs) are immigrants. RNs alone represent 43% of clinical hospital workers, and with one-third of hospitals now hiring foreign-trained nurses, their importance is evident in addressing persistent staffing gaps.
- Immigrants constitute 29% of hospital building cleaning and maintenance workers, nearly double the share of nonclinical hospital workers overall. Approximately 17% are naturalized citizens, while 12% are noncitizen immigrants.
Immigrants account for at least 20% of hospital workers in nine states, with particularly high concentrations in California (32%), Florida (20%), New York (20%), and Texas (20%). These states’ high share of immigrant hospital workers aligns with their larger overall immigrant populations.
The Trump administration has implemented numerous immigration-related policy changes, ranging from restricting entry into the country to ramping up deportation efforts. Although primarily aimed at undocumented immigrants, these policies produce broader consequences that affect immigrants of all statuses, including those with lawful presence in the United States.
Key concerns highlighted by a recent KFF poll include:
- Immigration-related anxieties among legally present immigrants who worry about detention or deportation impacting their families.
- Potential workforce challenges due to reduced pathways for immigrants to work in healthcare settings. This could exacerbate existing shortages, decrease access to care, and increase hospitals’ labor costs, some of which may be passed on to patients.
The strain is particularly acute in specific categories of healthcare workers. For example, foreign-trained physicians and specialty doctors constitute a large proportion of hospital medical staff, especially in populous states. A reduction in international hiring would likely worsen already critical deficits projected in several specialties by 2037.
American Physicians Look to Move to Canada Amid Immigration Policy Concerns
The impact of immigration policies is not limited to immigrant workers alone. A growing number of U.S.-trained physicians are reportedly seeking opportunities in Canada. Physician recruiters and licensing bodies in Canada have noted record interest from doctors disillusioned with U.S. healthcare policies. Among the contributing concerns are the implications of restrictive immigration policies that affect collaboration and intercultural exchange in healthcare institutions.
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Canada, which boasts a publicly-funded healthcare system and professional pathways considered more supportive by some, has become an attractive alternative for American doctors. This trend, however, could place further strain on already struggling U.S. healthcare systems, especially in underserved regions dependent on immigrant and foreign-trained physicians.
Immigration Policies Could Increase Healthcare Costs, Decrease Quality and Availability of Medical Care
The intersection of immigration policies and healthcare workforce dynamics holds significant implications across multiple dimensions:
- Access to Care: Workforce shortages may disproportionately impact rural and medically underserved areas, where access to healthcare is already constrained.
- Quality of Care: Understaffed facilities and reduced diversity among healthcare providers could result in lower-quality care for patients.
- Cost of Care: Increased hospitals’ labor costs due to reliance on overtime or contracted labor may translate into higher expenses for payers and patients.
