The Trump administration’s rollback of temporary immigration protections is creating uncertainty for thousands of immigrant health care workers and the patients who depend on them, according to advocates, employers and affected workers.
The issue centers on Temporary Protected Status, or TPS, a legal program that allows people from countries affected by war, disasters or unsafe conditions to live and work in the United States for limited periods. While TPS does not provide a direct path to citizenship, many recipients have lived in the country legally for decades and built careers in essential industries, including health care.
One of them is Janeth, a 50-year-old nursing assistant from Honduras who has worked in the San Francisco Bay Area for more than two decades. She asked to be identified only by her middle name because of the sensitivity of her immigration case. During her career, she received multiple nursing awards and became known among patients and colleagues for her compassion and reliability.
But after the administration moved to end TPS for Honduras, Janeth lost her work authorization and had to leave her job. She and her elderly mother later moved in with her daughter after she could no longer afford her mortgage.
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“I just want my job back, I just want my life back. I want to take care of my patients again,” she said.
For patients and families, the loss is not just administrative. John Jacoby, whose mother Dolores was treated for acute myeloid leukemia in 2012, said Janeth played a deeply important role in his mother’s final years. He recalled her offering comfort during one of the family’s hardest moments and said patients need caregivers like her at the bedside.
The broader concern is that immigration changes could worsen staffing shortages in an already strained U.S. health care system. Immigrants make up a significant share of hospital workers involved in patient care, and experts say many fill roles that are difficult to replace quickly, including nursing assistants, home health aides and long-term care workers.
An immigration advocacy group estimated that, as of early 2025, nearly 1.3 million people in the U.S. were covered by TPS, with at least 50,000 working in health care. U.S. Citizenship and Immigration Services has said the government does not maintain data on TPS holders’ occupations.
Health care employers say the impact is already being felt. Some nursing homes and care facilities in states such as Florida rely heavily on workers with TPS or other temporary legal protections. Employers warn that losing those workers could mean longer wait times, lower patient satisfaction and more pressure on remaining staff.
The administration has defended its approach, arguing that TPS was meant to be temporary and should not become a permanent immigration status. A Department of Homeland Security spokesperson said previous administrations had allowed the program to function too much like long-term protection, and that decisions are based on country conditions and legal review.
Critics dispute that framing. They argue that many TPS holders have lived and worked legally in the United States for decades, paid taxes, raised families and filled jobs in sectors that are already short-staffed. They also say some terminations have not followed the required legal process, including reviews of conditions in affected countries.
The legal fight remains active. Courts have reviewed or blocked some TPS terminations, while other rulings have allowed the administration to proceed. A separate dispute involving Haitian TPS holders is expected to have major consequences for many immigrants, including health care workers in nursing homes and home care settings.
The administration has also ended or moved to end other temporary immigration programs, including a humanitarian parole program for Cubans, Haitians, Nicaraguans and Venezuelans. Some health care employers say workers who entered through that program were also forced to leave jobs after losing authorization.
For patients, the policy debate can become deeply personal. Older adults, people with serious illnesses and patients with disabilities often depend on caregivers who know their routines, languages and medical needs. When those workers disappear, families may struggle to find replacements.
Supporters of stricter immigration enforcement argue that temporary programs should not be extended indefinitely and that the government has a responsibility to enforce immigration law. But health care leaders warn that sudden changes can leave hospitals, nursing homes and home care providers scrambling.
Why It Matters
The TPS debate is not only about immigration policy. It also affects hospitals, nursing homes, patients and families who rely on immigrant workers for daily care. If large numbers of trained health care workers lose legal status, the result could deepen staffing shortages and make care harder to access for vulnerable patients.
What Comes Next
Legal challenges over TPS and other temporary immigration programs are expected to continue. Courts may decide whether some protections can remain in place, while employers and health care advocates are likely to keep warning lawmakers about the impact on patient care and staffing.
