Eldercare will feel the sting of decreased immigration
Facilities that care for the elderly are some of the most exposed to Trump’s visions for immigration
The White House’s crackdown on immigration will certainly cause problems for many industries facing labor shortages. Growing demand for eldercare and an increasing reliance on foreign-born workers suggests the direct-care workforce could suffer disproportionately.
Reducing immigration would push up the cost of labor. Companies that provide caregivers would have to weigh cost-cutting measures to break even. As advanced economies around the world grapple with aging populations, the Trump Administration’s immigration policies are poised to cripple an increasingly important industry that desperately needs workers.
America’s aging population is already causing a strain in industries that care for the elderly. 10,000 people turn 65 every day in the U.S. To assist them, the longterm care industry employs over 2 million aides, more than double the size of the workforce 10 years ago.
Of those 2 million workers, one in four is an immigrant. The trend of toward foreign born workers is expected to continue. Most of the immigrants working in eldercare take the family-based path to legal status, making them particularly vulnerable to the Trump administration’s planned rollbacks to “chain-migration”.
In the next 10 years, home care will grow more than any other occupation, with an additional 633,100 new jobs anticipated. Foodservice, for comparison, has the 2nd highest projected demand and will grow only half as much. These estimates from the Bureau of Labor Statistics only include aides working for organizations, meaning any workers directly employed by families are not counted. Moreover, BLS projections are modeled on today’s demographics. They do not include the expected growth of the elderly population, so the numbers are likely severe underestimates.
Stephen Campbell, an analyst for longterm care research firm PHI, estimates that 11,000 workers in the field today are from travel ban countries, 35,000 are at risk of losing temporary restricted status, and 189,000 could be denied renewed green-cards. Collectively, these groups make up a tenth of the current eldercare workforce.
Paired with cuts to the influx of new immigrants, Campbell thinks the outlook is worrisome. “There is already a nationwide shortage of direct care workers, and limiting the number of immigrants will only lead to more gaps in services [which] have harrowing consequences on consumers” Campbell said.
Reducing immigration could deal a serious blow to employers and consumers alike. Hiring in a shrinking pool of workers will push up labor costs for facilities that already operate on thin profit margins. Providers make money through a complex web of Medicaid reimbursements, which makes increasing prices difficult. Instead, they may have to consider fewer aides per shift to cut costs, potentially harming the quality of care given to patients.
Minnesota retirement homes are already experiencing problems. A large portion of the state’s immigrant eldercare workers, 1 in 7, are Somali. President Trump’s travel ban has effectively frozen the number of migrants coming from Somalia. Speaking at an event last month, the state’s Republican Senator Ron Johnson took an opposing view, saying “no policies, no tax cuts, no deregulation is going to make up for the fact that we simply don’t have enough workers… we’re going to need a vibrant, legal immigration population.”
Marvin Plakut is President and CEO of Episcopal Homes, a Minneapolis-based nonprofit that runs 10 retirement communities serving over 1,400 seniors. Well above the national average, about half of his staff are immigrants. “If the immigrants left our employ, we would be forced to close our doors overnight” Plakut said.
Aide workers working in long-term care would welcome the increased wages. Home health and personal care aides without certification are the lowest paid professionals working in the health field according to the BLS. A home health aide can expect to make between $12 and $14 an hour, and nursing aides who have a certification make just a dollar more. Because eldercare is often part-time or irregular, PHI estimates the median income is about $13,300, well below the poverty line for a family of three.
Low pay is not the only drawback. The jobs are also physically strenuous. Aides may work on their feet for long shifts, which entail cleaning, bathing, and administering medicine for seniors who cannot always take care of themselves. The jobs are difficult to fill, and this is part of the reason advocates argue immigrants are necessary. Plakut, President of Episcopal Homes, says that he has trouble hiring native workers for current job openings. “If we have policies that reduce the number of immigrants, it would have a significant negative impact on our facility” Plakut said.
The U.S. aging population means the direct-care labor shortage is not going away anytime soon, and if immigration policy continues on its current path it won’t be long before facilities are forced to adapt or go out of business. “Many of my colleagues have already closed their doors” Plakut said. “Our workers are stressed”.
