The US healthcare system faces a “perfect storm”, more than 100 members of Congress warn today, as Donald Trump’s administration risks exacerbating pressure on its workforce by stripping nearly one million US immigrants of work authorization and legal protection.
Temporary Protected Status (TPS) has granted about 570,000 US workers protection from deportation, as their home countries are regarded as dangerous, due to factors like war and natural disaster.
Under Trump, the federal government has sought to cancel this status for people from eight countries – Afghanistan, Cameroon, Haiti, Honduras, Nepal, Nicaragua, Syria, and Venezuela – raising concerns about the impact on key sectors of the US workforce.
In a letter sent today to senior Trump officials, seen by the Guardian, an array of Democratic lawmakers led by the veteran senator Elizabeth Warren caution that the US healthcare system “cannot withstand yet another blow” after broader cuts since Trump return to office. “The most vulnerable Americans in need of healthcare will pay the price,” they warn.
Signatories of the letter – sent to Kristi Noem, US homeland security secretary; Robert F Kennedy Jr, health and human services secretary; and Lori Chavez-DeRemer, labor secretary – include Warren, senators Chris Van Hollen, Ed Markey, Cory Booker, Tammy Duckworth, andKirsten Gillibrand, as well as ongresswomen Alexandria Ocasio-Cortez, Pramila Jayapal, and Jasmine Crockett.
Bernie Sanders, the independent senator from Vermont, who caucuses with the Democrats, also signed the letter.
Immigrants make up between 32 to 40% of workers in US home care settings, they note in the letter, 24% in residential care, and 21% in nursing facilities. Some 15% of non-citizen healthcare workers originate from nations under temporary protected status.
“The TPS terminations, together with the massive cuts to Medicaid from President Trump’s One Big Beautiful Bill Act (OBBBA), will combine to create a perfect storm for Americans’ health care,” the lawmakers write. “While the termination of TPS will remove thousands of health care workers from the workforce, the OBBBA will make deep cuts to Medicaid, force hospital and nursing home closures, and trigger health care workforce layoffs.”
The revocations could result in tens of thousands of immigrants reverting to being undocumented, and place them at risk of arrest and removal by Immigration and Customs Enforcement (Ice). They also raise questions about the administration’s claims that they are only focused and targeting “criminals” and the “worst of the worst” in deportation efforts.
“The revocation of TPS belies the claim that they’re going after criminals on its face, because everyone who has TPS has undergone rigorous and ongoing background checks,” said Chris Newman, legal director and general counsel for the National Day Laborer Organizing Network (NDLON), told the Guardian. “This is why it’s so laughable on its face, that the Trump administration equates TPS with gang activity, because these are all people who have undergone background checks. It defies reality to make that claim.
“It’s obvious the Trump administration is using the language of criminality as a justification to target and punish the innocent.”
Newman also represents the family of Kilmar Ábrego García, a father of three in Maryland whom the Trump administration wrongfully deported to El Salvador in March. A federal court later ordered his return to the US. The administration has continued in court to try to have Ábrego García deported again. He is being held in an immigration detention center in Pennsylvania.
In their letter, the lawmakers warn the TPS cancellations will result in significant staff losses that healthcare facilities across the US will struggle to replace, as the industry struggles to meet the growing demand for home healthcare and nursing workers for an ageing populace.
“Americans will pay the price if the health care workforce crisis is worsened by President Trump’s TPS terminations,” the letter added. “As research on nursing home staffing shows, fewer nurses mean more medication errors, more falls, more delayed diagnoses, and increased patient mortality.
“Fewer nursing and home health professionals also have a ripple effect across the health care system, contributing to discharge backlogs in many other care settings – from post-acute rehabs to hospitals.”
The departments of homeland security; health and human services; and labor have been approached for comment.
