Health care workers demonstrate at a Manhattan union headquarters to show support for the Haitian and Syrian communities after the US Supreme Court ruled that the Trump administration could end temporary protected status for potentially millions of foreign nationals from countries experiencing conflict and violence. The decision means that more than 330,000 Haitians and Syrians
Health care workers demonstrate at a Manhattan union headquarters to show support for the Haitian and Syrian communities after the US Supreme Court ruled that the Trump administration could end temporary protected status for potentially millions of foreign nationals from countries experiencing conflict and violence. The decision means that more than 330,000 Haitians and Syrians could lose their work authorizations and their ability to remain in the country.
Spencer Platt/Getty Images
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Spencer Platt/Getty Images
Amid the avalanche of recent landmark Supreme Court decisions, it is the temporary protected status decision that most concerns the U.S. healthcare sector.
Last week’s ruling cleared the way for the Trump administration to cancel TPS for Haitians and Syrians. Experts say deporting Haitian TPS recipients will have a catastrophic impact on the nationwide health care workforce crisis, a workforce that relies heavily on immigrant labor.
The pain will be felt in hospitals and emergency rooms, which are already operating with persistent staff shortages, but it is the long-term care sector, including senior care facilities and home care, that will suffer the biggest disruptions, 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’s going to be a disaster in the Boston area, where many of our home care and elder care aides are Haitian,” Woolhandler told NPR. But beyond that, he added, “if the United States becomes inhospitable to noncitizens, which I think Trump is doing, we’re going to have a lot of trouble staffing our entire health system.”
Massachusetts has the third largest population of Haitians with TPS (19,000), behind Florida (158,000) and New York (40,000), respectively.
Woolhandler is one of three authors of a 2025 report analyzing the impact of Trump’s mass deportation plans, including the potential effects of removing TPS protections from people from the 17 countries the federal government deemed eligible. The status is intended to protect people from those countries who live in the United States may have to return to places where armed conflict, natural disasters, or other conditions make living there unsafe. Based on census data, the The research team found that approximately 50,000 doctors in the united states They are noncitizens, the category that includes people with TPS protections. That’s about 9% of all doctors in the US. Another 145,000 are registered nurses.
FWD.us breaks down the numbers even further, estimating that 21,000 Haitian TPS beneficiaries are in hard-to-fill positions as nursing assistants and caregivers.
The shortage of qualified healthcare workers is already putting existing institutions under enormous pressure. Woolhandler said two-thirds of hospitals report they have had to close beds because they don’t have enough staff, and about half of nursing homes similarly say they can’t accept new admissions because they don’t have enough staff.
“The thing to say is that everyone’s health care is going to be compromised by this. If you start laying off workers who play a key role in the entire care process… it tends to create a bottleneck or a backup,” he said.
If a family can’t find a nursing home bed or an in-home caregiver, then those people may end up stuck in a hospital or emergency rooms, Woolhandler said.
Katie Smith Sloan, president and CEO of LeadingAge, which represents more than 5,300 senior services providers nationwide, called the ruling a direct threat to the delivery of much-needed care and services.
“It puts older adults and the providers who care for them in an untenable position,” Sloan said in a statement. “Staff and caregivers who support older adults every day – legal employees who in some of our communities make up 8% or more of the entire workforce – now stand to lose their jobs overnight.”
The legal limbo has communities racked with worry, particularly in Springfield, Ohio, where 1 in 4 residents is of Haitian descent. Hours after the ruling, dozens of panicked TPS beneficiaries called Viles Dorsainvil for advice. The 40-year-old is co-founder and executive director of the Haitian Support Center, a nonprofit organization that provides a variety of services to Haitian citizens and refugees, including legal assistance.
“They’re wondering if they can still keep their assets or their money in the bank, if they can still go to work because TPS comes with the work permit and with the driver’s license privilege,” Dorsainvil told NPR. “The community is devastated.”
The Trump administration has released little information about how it will withdraw protections under the program for more than 330,000 Haitian and 4,000 Syrian TPS holders affected by last week’s high court ruling. On Wednesday, the Department of Homeland Security announced that existing Employment Authorization Documents, which allow TPS recipients to work legally in the country, will expire on July 10.
Dorsainvil said he is advising people that the most important step they can take is to sign a power of attorney in the name of someone they trust. Parents with children born in the United States should also plan to give up custody of their children, in case DHS seeks family separations, he said.
For now, he said, he has little else to share with callers, but he shares their anxiety.
Dorsainvil also receives TPS, but unlike those who fled the destruction of the 2010 earthquake, he arrived in the United States in 2020 on a visitor visa. At that time he had no intention of staying more than six months. But during his stay, Haiti’s already fragile political system descended into unrest and violence that led to the assassination of President Jovenel Moïse, and which continues to this day.
“There was no way I could come 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 proposed ending the TPS program for Haitians, that Dorsainvil and his brother, a former doctor in Haiti who now works as a nurse in Chicago, applied for asylum. Those requests have not yet been resolved.
For the next few weeks, he said, he will move forward with his life, trusting that somehow things will work out. He is trying to finish his graduate studies at Wright State University in Dayton, Ohio; is in a double master’s program in international relations and public administration.
When he decided to stay in the United States, phone calls to his mother and daughter revolved around the dangers of armed gangs that have taken over much of the country due to the political vacuum that exists. They now spend most of their calls discussing political turmoil in the US.
“When I was outside the United States, because of the way they sell it to you, you would think that if you came to this country everything would be fine. But it is totally different,” he said.
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