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As Americans gather for holiday celebrations, many will quietly thank the health care workers who keep their families and friends well: the ICU nurse who stabilized a grandparent, the doctor who adjusted a tricky prescription, the home health aide who made sure an elderly relative could safely bathe and eat.
What few people can take into account is how many of these professionals are foreign-born, and the kinds of immigration policies made in Washington today could determine whether those same families can get the care they need in the future.
As an economist who studies how immigration affects economies, including health care systems, I see a consistent picture: Immigrants are a significant part of the health care workforce, especially in roles facing staffing shortages.
Yet current immigration policies, such as increased visa fees, strict eligibility requirements, and enforcement actions that impact legally present workers living with undocumented family members, risk decimating this vital workforce, putting millions of Americans at risk for timely access to care. The timing couldn’t be worse.
A perfect storm: increasing demand, increasing shortage
America’s health care system is entering a period of unprecedented stress. The aging population, combined with increasing rates of chronic conditions, is driving the demand for care to new heights.
The workforce is not growing fast enough to meet those needs. The US will face a projected shortage of 86,000 physicians by 2036. Hospitals, clinics and elder care services are expected to grow by about 2.1 million jobs between 2022 and 2032. Many of them will be front-line care roles: home health, personal care and nursing assistants.
For decades, immigrant health care workers have filled gaps where U.S.-born workers are limited. They work as doctors in rural clinics, nurses in understaffed hospitals, and aides in nursing homes and home care settings.
Nationally, immigrants make up about 18% of the health care workforce, and they are even more concentrated in key roles. Roughly 1 in 4 physicians, 1 in 5 registered nurses and 1 in 3 home health aides are foreign-born.
State-level data reveal how deeply immigrants are embedded in the health care system. Consider California, where 1 in 3 physicians, 36% of registered nurses and 42% of healthcare assistants are immigrants. On the other side of the country, 35% of hospital workers in New York state are immigrants. In New York City, they make up the majority of health care workers, representing 57% of the health care workforce.
Even in states with small immigrant populations, their impact is enormous.
In Minnesota, immigrants make up nearly 1 in 3 nursing assistants in nursing homes and home care agencies, despite making up only 12% of the total workforce. Iowa, where immigrants make up only 6.3% of the population, relies on them for a disproportionate share of rural physicians.
These patterns transcend geography and partisan divides. From urban hospitals to rural clinics, immigrants keep facilities running. Policies that reduce their numbers – through higher visa fees, stricter eligibility requirements or increased deportations – have a cascading effect, closing up hospital beds.
While demand for health care is increasing, the pipeline for new health care workers may struggle to keep pace under current regulations. Medical schools and nursing programs face capacity limitations, and the time required to train new professionals – often a decade for doctors – means there is no quick solution.
Immigrants have long filled this gap – not just in clinical roles but also in research and innovation. International students, who often pursue STEM and health-related fields at U.S. universities, are an important part of this pipeline. Yet recent surveys from the Council of Graduate Schools show a sharp decline in new international student enrollments for the 2025-26 academic year, partly driven by visa uncertainties and global talent competition.
If this trend continues, the smaller workforce today will mean fewer physicians, nurses, biostatisticians and medical researchers in the coming decade – exactly when demand will peak. Although no major research organization has yet modeled the full impact that stricter immigration policies could have on the health care workforce, experts warn that stricter visa rules, higher application fees and phased-in enforcement are likely to increase, not reduce, the shortage.
About the author
Bedassa Tadesse is a professor of economics at the University of Minnesota Duluth. This article is republished from Conversation Under Creative Commons license. read the original article,
These policies make it harder to hire foreign-born workers and create uncertainty for those already here. This, in turn, complicates efforts to staff hospitals, clinics and long-term care facilities at a time when the system can least afford the additional stress.
The hidden toll: delayed care, increased risks
Patients don’t feel staffing shortages statistically – they feel it physically.
A delay of months in seeing a specialist could mean an increase in pain. Older adults without home care assistance face greater risks of falls, malnutrition, and medication errors. An understaffed nursing home turning away patients causes hardship for families. These are not imaginary – they are already happening in parts of the country where shortages are severe.
The costs of restrictive immigration policies will be reflected not in the federal budget but in the human toll: months spent in untreated depression, discomfort waiting for procedures, or preventable hospitalizations. Rural communities, which are often served by immigrant physicians, and urban nursing homes, which rely on immigrant colleagues, will feel it most acutely.
Most Americans won’t be reading visa bulletins or labor market forecasts over holiday dinners. But they will notice when it becomes difficult to care for a child, partner, or aging parent.
Aligning immigration policy with the realities of the health care system will not, in itself, fix every problem in American health care. But tightening regulations in the face of surging demand and known shortages almost guarantees more disruption. If policymakers connect immigration policy to the realities of the workforce, and adjust it accordingly, they can help ensure that when Americans reach out for care, there is someone there to respond.