The impact of Trump’s mass deportations on long-term care

One of the policy proposals we were repeatedly told Kamala Harris didn’t have was to expand Medicare to provide greater access to long-term home care. The centerpiece proposal of Trump’s Second Reich will, needless to say, have the opposite effect:

Some of the earliest and lasting effects from President-elect Trump’s promised immigration crackdowns would be in home health and long-term care, both of which rely on a substantial number of immigrants and undocumented workers.

Why it matters: Reducing an already thin labor market could have serious ramifications for aging adults or those with disabilities — and potentially put more stress on family caregivers.

What they’re saying: “Immigration policy is long-term care policy,” said David Grabowski, a Harvard Medical School professor who’s chronicled how foreign-born workers filled key nursing home roles early in the pandemic.

• He found nursing homes in regions with a higher share of foreign-born nursing assistants provided more direct care and better quality.
• “If you were to tighten up immigration or begin deporting individuals, it’s going to lower the available workforce, and this is only going to add to an already challenging labor situation,” he said.

By the numbers: Between 2021 and 2031, the long-term care sector will need to fill 9.3 million direct care job openings as demand grows and workers exit the field, according to PHI, a research group that studies care workers.

• With the fast-growing senior baby boomer population, many of the gaps have been filled by immigrants.
• The American Immigration Council estimates more than a third of home health aids in the U.S. are immigrants. In states like California, New York and New Jersey, it’s estimated at least 40% of the caregiving workforce is foreign-born.

Trump’s proposals call for mass deportations of undocumented workers and would also curb legal immigration and limit asylum.

The last point is important and under discussed, Trump isn’t just targeting illegal immigrants — he’s hostile to all immigration. This is all going to mean higer prices and fewer people willing to help care for an aging population. It will be a humanitarian disaster in more ways than one.