The Crisis of Care Work

What the report says

The American Prospect reports that the U.S. care workforce is under growing strain as immigration restrictions and proposed federal spending cuts collide with rising demand for elder care, disability services, hospice and home-based support. The article focuses on workers from Haiti and other countries who provide low-paid, labor-intensive care in nursing homes, private homes and related settings, often through systems funded by Medicaid, Medicare, the VA or other public programs.

According to the Prospect, care jobs commonly start at $20 an hour or less and may top out around $25 for experienced workers, leaving employers with persistent recruitment problems. The article says unions such as SEIU have tried to raise wages through organizing and higher Medicaid reimbursements, including in Massachusetts, but gains have been limited by broader pressure on public budgets.

The report links the shortage to the Trump administration’s immigration agenda, especially the rollback of Temporary Protected Status. It says TPS covered about 1.3 million people at the start of Trump’s second term, including more than 600,000 Venezuelans and roughly 331,000 Haitians. The Prospect says a June 25 Supreme Court decision in Mullin v. Doe strengthened presidential authority to end TPS protections, putting Haitians at risk of deportation, though a final administration action was described as pending as of the article’s publication.

The piece says Haitians have played a significant role in the care economy and notes estimates that about 30 percent work in care-related jobs. It also cites political and industry pushback, including a House bill to protect Haitian TPS, while warning that loss of legal status could disrupt families, providers and patients already affected by high turnover and low wages.