(MASSACHUSETTS) Immigrants with legal status are losing jobs in home health care and other medical roles across the state as new federal enforcement and policy shifts ripple through clinics, nursing homes, and private residences. Providers report pulling staff off schedules—even workers with valid employment cards—because managers fear audits or get mixed messages about what’s allowed. The disruption hits a system that depends on immigrant labor and is already stretched thin.
By the most recent estimates, the Massachusetts Health Workforce Composition shows immigrants make up about 25% of all healthcare workers statewide, and roughly 46% of home health aides before the latest migrant arrivals. In Greater Boston, more than half of nursing assistants are foreign-born. Those shares matter: home care shifts don’t fill themselves, and families wait longer when aides disappear overnight from rosters.
A sharp driver is the quickened timeline for Temporary Protected Status (TPS) renewals. In 2025, President Trump’s administration shortened TPS for Haitians to August 3, 2025, moving up the deadline from February 2026. Nationally, about 350,000 Haitians could see their protection end, many working in low-wage long-term care jobs that Massachusetts relies on every day. Workers like Jacques, a certified nurse assistant in Boston, now face a hard stop if paperwork or status issues aren’t resolved in time. For many, there is no simple path to stay on the job.
Policy shifts and enforcement climate
This year’s federal approach revived aggressive enforcement plans, wider vetting, and limits on asylum and refugee entries. Employers say the climate has sparked confusion that reaches hiring desks and human resources teams. Even immigrants with legal status report being sidelined or let go after years with the same employer because of fear that a mistake could bring penalties.
A policy blueprint often referred to as Project 2025 proposes canceling legal protections for broad groups, including TPS holders, while expanding deportations and directing local police to work more closely with federal immigration authorities. Health workers feel the effects in small, personal ways—missed shifts, sudden suspensions, or a call from a supervisor who “doesn’t want the trouble.”
State officials are trying to steady the field. The Massachusetts Attorney General issued updated guidance in January 2025 for hospitals, clinics, and assisted living communities, urging them to protect patient rights and continue care. The state also maintains health coverage options regardless of immigration status to avoid gaps in treatment for patients when caregivers’ jobs end.
According to analysis by VisaVerge.com, those steps help, but they do not fix the core employment squeeze facing immigrant caregivers and their families.
“The friction is clear in home health care, where close to half the workforce is foreign-born. When a home care aide loses a job, an older adult may miss bathing help, wound care, or medication reminders.”
When a facility can’t staff its floor, call buttons ring longer, and burnout climbs among the remaining employees. A daughter or son may have to leave their own job to fill in—shifting strain across families and the whole care system.
Staffing strain and ripple effects
Researchers at the Leah Zallman Center for Immigrant Health Research warn that pulling immigrants from the workforce will worsen shortages that were already deep. Jessica Santos, the center’s director, has stressed that immigrant workers keep Massachusetts’ long-term care system going and raised a blunt question: if these workers lose jobs, who will care for seniors?
Providers see the risk spreading beyond Haitian TPS holders. Salvadoran TPS holders, asylum seekers waiting on decisions, and others with temporary documents fear a chain reaction. Small administrative problems can cascade:
- One expired card can force a leave.
- A delayed mail notice can mean lost income.
- Families dependent on remittances see support dry up.
Steps workers and employers can take now
The legal path is narrow, but there are practical actions to reduce job losses and confusion:
- Verify status and deadlines
- Keep copies of all approvals, receipts, and employment authorization documents in one folder.
- Watch the August 3, 2025 TPS date if you’re Haitian.
- File renewals promptly and keep proof
- TPS holders use Form I-821, Application for Temporary Protected Status and Form I-765, Application for Employment Authorization.
- Bring filing receipts to HR.
- Official form pages: Form I-821 (https://www.uscis.gov/i-821) and Form I-765 (https://www.uscis.gov/i-765).
- Seek legal help
- Consult licensed attorneys or DOJ-accredited representatives about other relief that may fit your case.
- Inform employers about automatic extensions
- Some statuses or work permits carry built-in extensions once you file. HR should review the latest federal rules rather than guess.
- Maintain health coverage
- Massachusetts offers options for care even if your job ends. Enrollment assisters and Health Care For All can guide you.
- For providers: follow state guidance
- Follow the Attorney General’s guidance on immigration enforcement in medical settings.
- Train staff to avoid over-correction that wrongly removes eligible workers from shifts.
Where to find official federal information
For background, federal details on TPS—including country designations, eligibility, and employment rules—are posted by U.S. Citizenship and Immigration Services at https://www.uscis.gov/humanitarian/temporary-protected-status. That page explains how TPS relates to work permits and how automatic extensions work when they apply. It’s also where updates will appear if courts or federal agencies change timelines.
What to watch next
- Court rulings on executive orders and agency rules that could extend, pause, or end protections for large groups.
- The August 3, 2025 Haitian TPS deadline, which may trigger a new wave of job losses if renewals lag.
- Whether elements of Project 2025 move from plan to practice, including broader cooperation between local law enforcement and federal immigration agencies.
- Staffing responses by home health agencies, assisted living communities, and nursing homes, such as expanded training pipelines or incentives to retain current workers.
“In the middle of this, many immigrants with legal status are being judged by their paperwork rather than their performance.”
A home health aide may have worked every weekend for five years, but a manager who misunderstands a federal memo can still pull her from the schedule. That hurts the worker and the client who now waits for help to get out of bed.
Recommendations and final takeaways
Advocates urge a careful line: follow the law, but don’t add barriers the law doesn’t require. Practical steps can reduce needless job losses:
- Employers: check official rules, keep copies of filings, and give workers time to resolve updates.
- Workers: file early, save every notice, and keep HR informed.
- Policymakers and agencies: provide clearer guidance to prevent overreactions that remove eligible workers from shifts.
VisaVerge.com reports that confusion over work authorization checks has led some employers to overreact, even when Employment Authorization Documents remain current. Clear guidance, they argue, could keep many people on the job while still meeting federal requirements.
The stakes for Massachusetts are plain. If immigrant caregivers exit the field, seniors, people with disabilities, and families will face longer waits, higher costs, and tougher choices. The state’s health system—so dependent on the skill and heart of foreign-born aides, nurses, and technicians—will struggle to keep pace with demand.
This Article in a Nutshell
Immigrant caregivers face sudden job losses as federal enforcement tightens. August 3, 2025 TPS changes threaten staffing. State guidance aims to protect patient care, but confusion persists. Employers should verify documents, accept timely renewals, and consult legal help to avoid removing authorized workers and worsening long-term care shortages.
