Politics

The lawmakers' investigation found that terminating TPS would "exacerbate" shortages in the health care workforce, limit high-quality care, and "endanger patients," the report says.

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Three Massachusetts politicians issued a report Tuesday examining the potential repercussions for the United States health care system if the Trump administration ends humanitarian protections for Haitian immigrants.

As Haitian immigrants make up a significant portion of the health care workforce, the termination of Temporary Protected Status (TPS) would have a substantial impact on the sector, the lawmakers wrote in the report. 

The report comes as many await a Supreme Court decision that will determine if the administration can legally dismantle TPS, a program designed to prevent the deportation of individuals from nations struggling with environmental disasters, armed conflict, or other extraordinary conditions. 

In Massachusetts alone, ending TPS for Haitians would impact roughly 45,000 residents who depend on the program to live and work in the U.S.

The 10-page report, titled “Care in Crisis: The Healthcare Workforce Consequences of Ending Haitian TPS,” was authored by Sen. Elizabeth Warren, Rep. Ayanna Pressley, and Sen. Ed Markey. They wrote that terminating TPS would “exacerbate” shortages in the health care workforce, limit high-quality care, and “endanger patients.” 

“If the Trump administration ends legal protections for Haitian workers, everyone will be worse off,” Warren said in a statement to Boston.com. “The health care system is already strained from significant federal budget cuts, and this cruel decision would put patient care at risk nationwide. We must keep fighting back.”

The release follows an investigation launched Feb. 1, led by the three authors alongside Sen. Chris Van Hollen and Reps. Diana DeGette, Robin Kelly, and Deborah Ross. This congressional effort, supported by 52 members of Congress, examined how the proposed policy change would influence patients and the workforce in disability, elder, and health care services. 

The report noted Warren gathered insights from leading organizations representing health care providers.

Among these, The Arc of Massachusetts informed Warren that group homes, day programs, and other community-based supports are grappling with “severe” staffing deficits; these existing challenges are expected to be “exacerbated” if TPS is revoked, according to the report. 

Similarly, members of LeadingAge reported that the prospect of losing TPS and the persistent ambiguity surrounding immigration status are currently “constraining access to care and weakening provider capacity.” This decline is attributed to individuals losing their legal right to work or choosing to leave their positions early due to anxiety over their future status, according to the report. 

Roughly 2,000 direct care workers in Massachusetts have been or remain at risk of losing work authorization due to the end of Cubans, Haitians, Nicaraguans, and Venezuelans parole and possible TPS termination for Haitians, the Massachusetts Senior Care Association estimated. 

At the same time, the National Domestic Workers Alliance estimated 13,000 Haitian TPS holders work as nursing assistants and serve roughly 65,000 patients daily, according to the report. 

The investigation revealed that staff shortages would lead to restricted care, including increased wait times, fewer nursing home placements, expanding waiting lists, and diminished service capacity. 

One Association of Developmental Disabilities Providers member shared in the report that an older patient and wheelchair user wept while describing her fear of losing veteran staff and the anxiety of having new, unfamiliar workers manage her total care. 

“Terminating TPS for Haitians would do more than just eliminate jobs — it would mean losing years of accumulated expertise, the ability to provide culturally sensitive care, language skills, leadership experience, and the established trust between residents, clients, and their families,” the report states. 

The Massachusetts Senior Care Association warned that losing these vital workers would further burden an already “fragile” health care system precisely as service demand surges, the report said. 

The report additionally emphasized that Massachusetts would face a disproportionate impact due to its significant Haitian immigrant community.

For instance, the ADDP noted that if TPS had ended Feb. 3, their facilities would have had approximately 50 vacant shifts on that day alone. 

Beyond those directly losing authorization, the report highlighted broader challenges in recruitment and retention within the health care industry. 

NDWA reported that workers are facing “fear” around immigration status, causing them to reduce hours or leave work altogether. 

One ADDP provider has lost 101 Haitian staff members since June, managing to replace only 60% of them while facing $24,000 in additional costs per pay period due to overtime needs, according to the report. 

“Some people … have had the same job for 10 years and lose it. And what you lose is the experienced workers,” one home care worker shared. “The patients’ quality of care goes down as a result.”