The U.S. Supreme Court cleared the way for the Trump administration to end Temporary Protected Status for hundreds of thousands of foreign nationals, triggering immediate anxiety across America’s healthcare sector. According to health policy experts and immigration advocates, the decision threatens to strip work authorizations from over 330,000 individuals from Haiti and Syria, deepening persistent staffing shortages in hospitals, nursing homes, and home care agencies.
Healthcare Workforce Impacts and Staffing Shortfalls
The healthcare sector faces severe disruptions as the federal government prepares to wind down protections for TPS recipients, according to Steffie Woolhandler, a distinguished professor of health policy at City University of New York at Hunter College and a faculty member at Harvard Medical School. Woolhandler, one of three authors of a 2025 research report analyzing mass deportation plans, noted that immigrant labor forms a critical pillar of the American medical system. Census data analyzed by the research team shows that roughly 50,000 physicians in the United States—about 9% of all doctors—are noncitizens, a broad category that includes TPS holders. An additional 145,000 registered nurses fall into this demographic group.
Long-term care facilities and home care agencies face the most acute threats. According to FWD.us, roughly 21,000 Haitian TPS holders work in hard-to-fill jobs as nursing assistants and caregivers. Woolhandler stated that two-thirds of hospitals currently report closing beds due to staffing deficits, while about half of nursing homes turn away new admissions. Removing authorized workers from the care continuum creates operational bottlenecks, frequently leaving vulnerable patients stranded in hospital emergency rooms.
Katie Smith Sloan, president and CEO of LeadingAge, which represents more than 5,300 aging service providers nationwide, characterized the ruling in a statement as a direct threat to care delivery. Sloan noted that legal employees who support older adults daily represent 8% or more of the entire workforce in certain communities, leaving older adults and care providers in an untenable position.
Geographic Distribution and Community Anxiety
The impact of the Supreme Court decision concentrates heavily in specific states and municipalities. Massachusetts holds the third-largest population of Haitians with TPS at 19,000, trailing Florida with 158,000 and New York with 40,000, according to data cited by Woolhandler. In Springfield, Ohio, where one in four residents is of Haitian descent, community members flooded local advocacy groups with phone calls following the ruling.
Viles Dorsainvil, co-founder and executive director of the Haitian Support Center, reported fielding panicked inquiries from dozens of TPS holders. Dorsainvil, who also holds TPS status, noted that constituents expressed deep concern regarding their bank assets, driver’s licenses, and employment authorization. The Department of Homeland Security announced that existing Employment Authorization Documents for affected Haitian and Syrian TPS holders will expire on July 10, though the administration has released minimal details regarding the broader withdrawal process.
Guidance and Legal Uncertainty for Affected Families
As advocacy groups grapple with the impending expiration of work permits, legal aid providers are urging families to take precautionary administrative steps. Dorsainvil advises affected individuals to execute a power of attorney naming a trusted designee. Furthermore, he recommends that parents with American-born children establish guardianship plans to prepare for potential family separations driven by federal immigration enforcement.
Dorsainvil arrived in the United States in 2020 on a visitor visa, intending to stay for six months. Following the assassination of President Jovenel Moïse and subsequent political unrest in Haiti, he and his brother were able to stay in the country due to the Biden administration’s extension of the TPS program for Haitians. After the Trump administration moved to terminate TPS protections for Haitians in 2024, Dorsainvil and his brother applied for asylum, which remains unresolved while he completes graduate studies at Wright State University in Dayton, Ohio.
Keep reading