As Americans gather for holiday celebrations, many will silently thank the health care workers who kept their families and friends healthy. The ICU nurses who stabilized my grandparents, the doctors who adjusted difficult prescriptions, and the home health aides who made sure our elderly relatives could safely bathe and eat.
Do most of us realize how many of these professionals are foreign-born? Do we realize how the immigration policies formed in Washington today determine whether our families receive care?
As an economist who studies how immigration affects the economy, including the health care system, I see a consistent picture. That means immigrants are an important part of the health workforce, especially in roles facing shortages.
But current immigration policies—increasing visa fees, tightening eligibility, and detaining legal immigrants and U.S. citizens, as well as enforcement affecting legally present workers living with undocumented family members—risk eroding this vital workforce. The timing couldn't be worse.
The U.S. health care system is undergoing unprecedented stress. An aging population and rising rates of chronic disease are pushing the demand for care to new heights.
The workforce is not growing fast enough. The United States is projected to face a shortage of up to 86,000 physicians by 2036. Hospitals, clinics, and elderly care services are expected to add approximately 2.1 million jobs between 2022 and 2032.
For decades, immigrant health care workers have filled gaps left by limited U.S.-born workers as doctors in rural clinics, nurses in understaffed hospitals, and aides in nursing homes and home care.
Nationally, immigrants make up about 18% of health care workers and are even more concentrated in critical roles. Approximately one in four doctors, one in five registered nurses, and one in three home health aides are foreign-born.
From urban hospitals to rural clinics, immigrants are helping to staff wards and keep beds free. When policies reduce the workforce, the effects are immediate. Schedules may be thinned, services may be reduced, and production capacity may be reduced.
As medical demand soars, the pipeline of new workers may struggle to keep up under current rules. Training more doctors and nurses is essential, but progress is slow. The quickest way to prevent today's shortages from turning into tomorrow's access crisis is to increase retention and increase the supply of qualified clinicians, including immigrants, to practice here.
International students are an important part of this pipeline. However, recent research from the Council of Graduate Schools shows a significant decline in new international student enrollment for the 2025-26 academic year, due in part to visa uncertainty and global competition for talent.
The smaller cohorts arriving today means there will be fewer doctors, nurses, biostatisticians, and researchers over the next decade when demand peaks. Tighter visa rules, higher application fees and increased enforcement are likely to exacerbate the shortage of medical workers.
Patients don't feel the staffing gap as a statistic, they feel it physically.
Delaying seeing a specialist can worsen pain and worsen outcomes. Older adults without home caregivers are at increased risk of falls, malnutrition, and medication errors. An understaffed nursing home turns away patients, leaving families in turmoil. These are not hypotheses. They are already happening.
The costs of restrictive immigration policies will not show up in the federal budget, but in human costs such as untreated depression, discomfort while waiting for procedures, and avoidable hospitalizations. This will be felt most acutely in rural areas, where immigrant doctors are often in charge, and in urban nursing homes, which rely on immigrant assistants.
If policymakers connect immigration policies to workforce realities and adjust them accordingly, they can ensure that when Americans seek care, someone will answer.
Bedassa Tadesse is a professor of economics at the University of Minnesota Duluth. This article was produced in collaboration with The Conversation.
