Health Workforce 101: The role of immigrant workers in the U.S
By Tracey Drury/New York Health Journalism Fellow
Changes to federal policy could have a major impact on the U.S. health care workforce, affecting both recruitment and retention of physicians as well as caregivers in the long-term care industry.
Panelists at an HJ26 session discussed the role of immigrant workers in the U.S., including both the history of policies that enabled and supported the influx of foreign health care professionals since the 1960s as well as the status of today’s workforce.
Panel moderator Barbara Feder Ostrov, editorial director at Medscape/WebMD, pointed to new limits on J-1 visas, rate hikes for H1-B visas, immigration bans and freezes on visas from applicants coming from 75 countries.
“There’s been a lot of media coverage of the undocumented, but legal workers are also affected by these policies,” she said. “All these changes are likely to affect the health care workforce in your community.”
The change in fees introduced as part of a bill in March for H1-B visas would have a significant impact on sponsor organizations, shifting from $2,000-$5,000 apiece to $100,000. The American Medical Association and 60 other organizations are now urging the federal government to exempt health care workers from the new rates, according to panelist Eram Alam, associate professor of the history of science at Harvard University, who authored the 2025 book “The Care of Foreigners: How Immigrant Physicians Changed US Healthcare.”
“Last year, roughly 8,000 physicians came here on this visa. Imagine this scenario if you’re a rural hospital,” she said. “The consequence is they’ll have fewer physicians, and now that work is going to be redistributed to six physicians instead of 10. The outcome is going to be poor patient care and longer wait times.”
Demand for workers has also drawn many immigrants into long-term care settings, including skilled nursing sites, as well as to residential living and home care jobs such as certified nursing assistants, practical care aides and home care aides.
“There’s a great demand for workforce as the aging trend continues in the U.S. and with the increasing prevalence of dementia,” said panelist Lei Chen, a postdoctoral scholar at the University of California San Francisco. “There’s also a shortage of workers in this setting.”
Chen reviewed research by KFF that shows immigrants make up 28% of the overall long-term care workforce, including 20% of nurses and 30% of aides though they make up just 17% of the total U.S. workforce.
Panelist Vanessa Sanchez, senior health reporter with El Timpano, talked about the impact for workers, including the loss of salaries and benefits tied to job losses, but also the loss of trust.
She stressed the importance of building trust with immigrant sources and minimizing the risk that they will be exposed to law enforcement attention or retaliation.
“When you are covering the immigrant population, it is a race won in tiny increments,” she said. “Health care is a very politicized issue. … We know there is so much fear and mistrust (of) the media industry. It’s important to think about being a reliable presence in the community.”
Tracey Drury is a senior reporter with Buffalo Business First in Buffalo, New York
