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PHI Midterm Policy Brief Series: Support Immigrants

Brief
June 24, 2026
PHI Midterm Policy Brief Series: Support Immigrants

Immigrant direct care workers are facing mounting pressure from federal immigration policy, with consequences that extend far beyond the immigrants themselves—to the millions of older adults, people with disabilities, and families who depend on their care. This brief, the second in PHI’s three-part midterm policy series, examines how immigration restrictions, enforcement actions, and cuts to immigrant eligibility for Medicaid and other public programs are pushing immigrant workers out of the field and eroding the pipeline of new workers the long-term care system urgently needs.

Support Immigrants assesses these policy developments and their impact on the direct care workforce, and sets out concrete recommendations for policymakers, from halting and reversing punitive immigration policies to developing thoughtful immigration pathways and investing in a national direct care workforce strategy.

Click here to read the first brief in this series, Restore Medicaid, which examines how Medicaid cuts are destabilizing the direct care workforce.

Key Takeaways

Immigrants make up more than one in four direct care workers nationwide — a share that's grown from 21 to 28 percent in just over a decade — and research shows they're more likely than U.S.-born workers to stay in the field, supporting workforce stability and continuity of care.
Federal immigration policy, including TPS terminations, visa restrictions, and HR 1's elimination of Medicaid and other benefits for many lawfully present immigrants, is pushing immigrant direct care workers out of the field through status loss, fear-driven withdrawal from services, and self-deportation.
Policymakers must halt punitive immigration policies, build dedicated immigration pathways for direct care workers, strengthen protections for immigrant workers already in the field, and invest in a national direct care workforce strategy.
 
Contributing Authors
PHI

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