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Op-Ed: Cancellation of TPS “Could Hit Health Care Hard”

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Chicago, IL – In an op-ed for Crain’s Chicago Business, Sara McElmurry, communications strategist and nonresident fellow for immigration at the Chicago Council on Global Affairs, makes a compelling case on how the revocation of Temporary Protected Status (TPS) has issued a threat to a crucial pipeline of Midwestern workers: home health care aides.

The piece in its entirety can be accessed here, and follows below:

When the White House unveiled a hard-line plan last week to choke off immigration, it issued a threat to a crucial pipeline of Midwestern workers: home health care aides.

In the crosshairs is a region that’s graying at a rapid clip yet stubbornly conflicted about immigrants—a region where foreign-born workers punch well above their weight. Immigrants are currently 24 percent of the nation’s home health aides. And while they make up 13 percent of the U.S. population, more immigrants are in their prime working age and have a higher rate of job participation compared to their native-born peers, representing 17 percent of the overall workforce, according to a new report by the Chicago Council on Global Affairs.

Examining the mushrooming demand in one industry—home health—illustrates the crisis to come. Analysts expect 1.1 million of these jobs to come online by 2026 as America’s population of seniors rises to 71.5 million by 2030. Chicago, Columbus, Minneapolis and Cleveland are already four of the top five metropolitan areas with the highest employment levels for the occupation. But in a region that has lost nearly a quarter of its native-born working-age population since 2000, where will the Midwest find new workers to meet the demand?

Home health aides log long, physically demanding hours taking care of people who cannot care for themselves and helping families who need extra hands to care for loved ones. They bathe and feed ailing clients, check vitals, monitor medications, and change bedpans and bedsheets. These jobs are certainly not glamorous and decidedly hard to fill, given the physically—and emotionally—challenging duties.

While many home health aides complete on-the-job training and hold professional certificates, the positions often require only a high school degree and no previous work experience, making them an accessible entry point into the U.S. labor force for immigrants and refugees.

Yet these so-called “low-skilled” workers will prove difficult to replace if the pipeline of immigrants suddenly slows. Home health aides earn a mean $23,840 annually in Illinois. Improved pay and benefits should be top of employers’ to-do lists but may prove futile in attracting aging U.S.-born workers, particularly Midwesterners, who are closing in on retirement themselves.

Yet the U.S. immigration system is increasingly hostile to the foreign-born talent needed to fill the gaps. The fast-approaching end to Deferred Action for Childhood Arrivals on March 5, coupled with the Trump administration’s cancellation of many Temporary Protected Status programs, could hit health care hard. One in five DACA recipients is employed in health care, and many TPS holders—especially among the 50,000 Haitians who received TPS after an earthquake leveled the island in 2010—work in home health care.

Moving forward, many would-be home health aides will not meet the lofty criteria of the points-based immigration systems being championed by the White House. And if the administration is successful in implementing its plans to curb family-based immigration, end the “diversity” visa lottery and dismantle other elements of our immigration system as outlined in last week’s State of the Union address, the pool of foreign-born health workers will be further compromised.

In recent years, the Midwest has led the charge to bring more immigrant workers into health care. Local nonprofits like Chicago’s Instituto del Progreso Latino have pioneered immigrant-friendly pipeline programs that provide language skills and certifications for in-demand healthcare careers. Several Midwestern states, including Illinois, have made higher education more accessible for immigrants by offering in-state tuition rates at public institutions. Missouri and Minnesota have created licenses and policies that help more qualified immigrants enter tough-to-fill healthcare jobs.

These innovative local programs are ripe to be scaled nationally. But instead, the federal government’s immigration crackdown threatens their success by pushing out current work-authorized immigrants and limiting the channels for new workers to enter the country to replace them.

Sara McElmurry is a communications strategist and nonresident fellow for immigration at the Chicago Council on Global Affairs. The views expressed are her own.