Health care workers gathered at the union’s Manhattan headquarters to show support for the Haitian and Syrian communities after the U.S. Supreme Court ruled the Trump administration could end temporary protected status for potentially millions of foreign nationals from countries experiencing conflict and violence. The decision means more than 330,000 Haitians and Syrians could lose their work permits and the ability to remain in the country.
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In the recent flurry of back-to-back Supreme Court decisions, it is the Temporary Protected Status decision that is causing the most concern in the American healthcare sector.
Last week’s decision cleared the way for the Trump administration to end TPS for Haitians and Syrians. Experts say deporting TPS recipients from Haiti would have a catastrophic impact on the nation’s health care workforce crisis, a workforce that relies heavily on immigrant labor.
The pain will be felt in hospitals and emergency departments, which already operate under chronic staffing shortages, but it is the long-term care sector, including nursing facilities and home care, that will suffer the most disruption, said Steffie Woolhandler, a distinguished professor of health policy at the City University of New York at Hunter College and a faculty member at Harvard Medical School.
“It would be a disaster in the Boston area, where many of our nursing homes and home health aides are Haitian,” Woolhandler told NPR. But beyond that, she added, “if the United States becomes inhospitable to non-citizens, which I think Trump is doing, we’re going to have a lot of problems staffing our entire health care system.”
Massachusetts has the third largest Haitian population with TPS (19,000) behind Florida (158,000) and New York (40,000), respectively.
Woolhandler is one of three authors of the 2025 report, which analyzes the impact of Trump’s mass deportation plans, including the potential impact of stripping TPS protections of people from 17 countries deemed eligible by the federal government. The status is intended to protect persons from those countries who reside in the United States from having to return to places where armed conflicts, natural disasters or other conditions make life there unsafe. According to census data, the research team found that about 50,000 doctors in the USA are non-citizens, a category that includes people who receive TPS protection. This is about 9% of all doctors in the United States. Another 145,000 are registered nurses.
FWD.us takes the numbers even further, estimating that 21,000 Haitian TPS holders hold hard-to-find positions as nursing assistants and caregivers.
The shortage of qualified health workers is already placing enormous strain on existing facilities. Woolhandler said two-thirds of hospitals report they have had to close beds due to staffing shortages, and about half of nursing homes similarly say they can’t accept new patients because they don’t have enough staff.
“It must be said that because of this, everyone’s health will be at risk. If you start cutting out workers who are key to the entire continuum of care … that tends to create bottlenecks or backups,” she said.
If a family can’t find a nursing home bed or in-home caregiver, those people could end up in the hospital or emergency rooms, Woolhandler said.
Kathy Smith Sloan, president and CEO of LeadingAge, which represents more than 5,300 aging service providers nationwide, called the decision a direct threat to the provision of much-needed care and services.
“This puts older adults and the providers who care for them at a disadvantage,” Sloan said in a statement. “Staff and caregivers who support older adults every day—legal workers who in some of our communities make up 8% or more of the workforce—now could lose their jobs overnight.”
Legal uncertainty is causing concern among the population, especially in Springfield, Ohio, where one in four residents is of Haitian descent. Within hours of the ruling, dozens of panicked TPS owners called Wiles Dorsainville asking for advice. The 40-year-old is the co-founder and executive director of the Haiti Support Center, a non-profit organization that provides a range of services to Haitian citizens and refugees, including legal assistance.
“They’re wondering if they’ll still be able to keep their assets or their money in the bank, if they’ll still be able to go to work because TPS came with a work permit and a driver’s license,” Dorsainville told NPR. “The community is devastated.”
The Trump administration has released little information about how it will end program protections for the more than 330,000 Haitian and 4,000 Syrian TPS holders affected by last week’s High Court decision. On Wednesday, the Department of Homeland Security announced that existing work authorization documents that allow TPS recipients to legally work in the country will expire on July 10.
Dorsainville said he advises people that the most important step they can take is to sign a power of attorney for someone they trust. Parents of American-born children should also plan to sign over custody of their children in case DHS seeks family separation, he said.
At this point, he said, he has nothing more to share with people calling, but he shares their concerns.
Dorsainville is also a TPS recipient, but unlike those who fled the devastating 2010 earthquake, he came to the U.S. in 2020 on a visitor visa. At that time, he had no intention of staying here for more than six months. But during his tenure, Haiti’s already fragile political system degenerated into unrest and violence that led to the assassination of President Jovenel Moïse and continues to this day.
“I didn’t have the opportunity to go home,” Dorsainvil said, adding that it was the Biden administration’s extension of the TPS program for Haitians that allowed him and his brother to remain in the country. It wasn’t until 2024, when Trump first considered ending the TPS program for Haitians, that Dorsainvil and his brother, a former doctor in Haiti and now a nurse in Chicago, both applied for asylum. These claims are still unresolved.
Over the next few weeks, he said, he will move forward with his life, believing that somehow things will get better. He is trying to complete graduate school at Wright State University in Dayton, Ohio – he is studying in a dual master’s program in international relations and public administration.
When he first decided to stay in the US, phone calls home to his mother and daughter were about the dangers of armed gangs that had taken over much of the country due to the existing political vacuum. They now spend most of their calls discussing political unrest in the United States.
“When I was outside the US, the way they sell it to you, you could believe that if you came to this country everything would be fine. But this is completely different,” he said.