Times Opinion: US needs immigrants to sustain the health care workforce

As Americans gather for holiday celebrations, many will quietly give thanks for 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 ensures an aging relative can bathe and eat safely.

Will most of us notice how many of these professionals are foreign-born? Will we recognize how immigration policies shaped in Washington today could determine whether our families can get care?

As an economist who studies how immigration influences economies, including health care systems, I see a consistent picture: Immigrants are a vital part of the health care workforce, especially in roles facing staffing shortages.

Yet current immigration policies — increased visa fees, stricter eligibility, and enforcement that affects legally present workers living with undocumented family members, in addition to detention of legal residents and U.S. citizens — risk eroding this critical workforce. The timing couldn’t be worse.

America’s health care system is entering an unprecedented period of strain. An aging population, coupled with rising rates of chronic conditions, is driving demand for care to new heights.

The workforce isn’t growing fast enough. The U.S. faces a projected shortfall of up to 86,000 physicians by 2036. Hospitals, clinics and elder-care services are expected to add about 2.1 million jobs between 2022 and 2032.

For decades, immigrant health care workers have filled gaps where U.S.-born workers are limited, as doctors in rural clinics, nurses in understaffed hospitals and aides in nursing homes and home care.

Nationally, immigrants make up about 18% of the health care workforce, even more concentrated in critical roles. Roughly one in four physicians, one in five registered nurses and one in three home health aides are foreign-born.

From urban hospitals to rural clinics, immigrants help keep units staffed and beds open. When policies shrink that workforce, the effects show up quickly: schedules thin out, services are scaled back, and capacity can drop.

While health care demand soars, the pipeline for new workers could struggle to keep pace under current rules. Training more doctors and nurses is essential — but it’s slow. The fastest ways to prevent today’s shortages from becoming tomorrow’s access crisis are to improve retention and increase the supply of qualified clinicians who can practice here, including immigrants.

International students are a key part of this pipeline. Yet recent surveys from the Council of Graduate Schools show a sharp decline in new international student enrollment for the 2025-26 academic year, driven partly by visa uncertainties and global talent competition.

Smaller cohorts arriving today will mean fewer physicians, nurses, biostatisticians and researchers in the coming decade — when demand peaks. Tighter visa rules, higher application fees and stepped-up enforcement are likely to intensify shortages in the health care workforce.

Patients don’t feel staffing gaps as statistics — they feel them physically.

A specialist appointment delayed can mean worsening pain and worse outcomes. Older adults without home care aides face higher risks of falls, malnutrition and medication errors. An understaffed nursing home turning away patients leaves families scrambling. These aren’t hypotheticals; they’re already happening.

The costs of restrictive immigration policies won’t appear in federal budgets but in human tolls: untreated depression, discomfort awaiting procedures, preventable hospitalizations. Rural communities, often served by immigrant physicians, and urban nursing homes, reliant on immigrant aides, will feel this most acutely.

If policymakers connect immigration policy to workforce realities and adjust it accordingly, they can help ensure that when Americans reach out for care, someone is there to answer.

Bedassa Tadesse is a professor of economics at the University of Minnesota Duluth. This article was produced in collaboration with the Conversation.