Will the end of Temporary Protected Status for Haitians mean a caregiving crisis?

The U.S. Supreme Court decision allowing the Trump administration to end Temporary Protected Status for Haitians could create a caregiving crisis, lawmakers from both political parties said.

"Of the 350,000+ lawful Haitian TPS holders, roughly 1/3 work in our healthcare system. Immediately shutting off TPS will create a crisis in our hospitals, nursing homes, and in the (intellectual disabilities) community," U.S. Rep. Mike Lawler, R-N.Y., wrote on X.

U.S. Rep. Ayanna Pressley, D-Mass, said, "Seniors will lose their caregivers when we already have a caregiving crisis, and seniors will lose their ability to age in community with much needed assistance." 

Temporary Protected Status, or TPS, is a program that allows foreign nationals from countries experiencing crises such as natural disasters or armed conflict to live in the U.S. for up to 18 months. The federal government previously renewed the designations, making them effectively permanent before President Donald Trump took office again. 

Lawler’s estimate of 350,000 and his statistic about how many Haitians with TPS work in the U.S. healthcare system is within range of what the data shows.  

The decision affects around 330,000 Haitians whose TPS-related work authorizations expire July 10. They face deportation unless they qualify for another status. The ruling also applies to Syrians and Venezuelans. 

About 158,000 Haitians in Florida have TPS, the majority of whom are in South Florida. The Sunshine State has the largest population of TPS recipients in the U.S, nearly 404,000 people. More than half are from Venezuela and about a third are from Haiti, according to the Congressional Research Service, a nonpartisan research arm. 

With an aging U.S. population and an existing caregiver shortage, healthcare experts say the end of TPS for Haitians will have a significant effect on the healthcare industry. 

Of the 330,000 Haitian TPS holders, about 13,000 work daily as nursing assistants, caring for 65,000 patients, The Boston Globe found. Another 8,000 Haitian caregivers serve 12,000 children and aging people, according to Americans for Immigrant Justice, a Miami-based nonprofit law firm that provides free legal representation to low-income immigrants.

Experts said the TPS healthcare workforce exodus  will be felt most acutely in New York, Massachusetts and Florida. Florida, with its high populations of older people and immigrants, will be particularly hard hit.

David Grabowski, a Harvard Medical School healthcare policy professor, said the decision will "have a major impact on nursing homes, assisted living facilities and home care agencies."

What will happen if most Haitians with TPS get deported? 

Healthcare researchers say deporting Haitian TPS recipients will add pressure on a strained system.

Immigrants who have TPS are more likely to work in healthcare, with one 2025 study finding that recipients represent 15% of all noncitizen healthcare workers. (TPS recipients make up about 2.1% of the total immigrant population). Immigrants make up a large share of direct care workers — people who are home health aides, personal care aides and nursing assistants.

There’s already a national shortage for home health aides, personal care aides, nursing assistants and other long-term care and eldercare workers, but the U.S. will need even more in the future. The U.S. 65-and-up population is expected to jump from 58 million to 82 million by 2050 — a 42% increase. 

Nearly half of U.S. nursing homes in the U.S. report limiting admissions because of staffing shortages, and 19% recently met minimum staffing levels set by the Centers for Medicare & Medicaid Services. In 2023, shortages of nurses and other employees caused about two-thirds of U.S. hospitals to operate below capacity.

"People who run nursing homes, chronic care hospitals and home care agencies, they are all saying this is a crisis," said Dr. Steffie Woolhandler, a distinguished professor of public health at City University of New York’s Hunter College. "There has long been a shortage of folks who are willing to do direct care work as nursing aides, and there’s still a shortage now, so of course if the U.S. deports them all it’s just going to make it worse."

Drishti Pillai, director of Immigrant Health Policy at KFF, said,"The long-term care industry is already facing shortages prior to these immigration policy changes, so I think it’s accurate to say that this is going to further exacerbate the situation."

Why do so many Haitians with TPS work in caregiving?

Healthcare experts pointed to several reasons for TPS holders' high numbers in direct care, including job availability, an easier certification process compared with other healthcare jobs and prior experience caring for family members.

"We do not have sufficient native-born workers to fill all the caregiving jobs," Grabowski said. 

These positions also typically have lower barriers to entry for licensure or no English language requirements, experts said, and refugee settlement organizations often recommend the work to immigrants for those reasons.

The positions are "extremely difficult to fill," because they’re physically and emotionally demanding with low pay and with little or no employee benefits, said Priya Chidambaram, senior policy manager with KFF’s program on Medicaid and the uninsured.  

Some Haitians also have experience caring for sick family members in their homes, given the lack of nursing home infrastructure in their home country.

In the end, experts said there will be many more people who need this care than people who will be able to provide it. 

"This was true before the ruling," Chidambaram said. "Now, the impact will only be worse."

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