TPS expirations spark fears about healthcare worker shortage

Healthcare leaders are urging the Trump administration not to revoke work permits for immigrants from Haiti, and several other countries, who have Temporary Protected Status (TPS).

The status is a designation that allows foreign nationals to stay and obtain a work authorization document in the US if the federal government deems their country of origin to be too unsafe for them to return.

Haitians with TPS are set to lose their authorization to work on July 24, according to US Citizenship and Immigration Services, an extension from a previous July 10 expiration. Workers from six other countries, including Syria and Ethiopia, lose TPS on July 17.

It’s unclear exactly how many workers this will affect, but FWD.us, a criminal justice and immigration policy organization, estimated in 2024 about 50,000 healthcare services workers hold this status.

Leaders say the potential losses threaten a workforce that’s already struggling to maintain adequate staff in the face of burnout and a rapidly aging population.

The Department of Homeland Security (DHS) declined to respond on the record to questions from Healthcare Brew.

Shortage status. As of December 2025, about 92 million people lived in a primary care health professional shortage area, and 137 million people in a mental health professional shortage area, according to the Health Resources and Services Administration.

Almost half of US nursing homes reported limiting admissions due to labor shortages as recently as March 2024, per an American Health Care Association survey.

Unequal impacts. Though these shortages are nationwide, some areas could be hit harder by the loss of TPS holders.

Florida has the most TPS holders at nearly 404,000 as of March 2025, the National Immigration Forum, an immigrant advocacy group, estimates. That number spans all industries, not just healthcare.

Emmett Reed, CEO of long-term care advocacy organization the Florida Health Care Association, penned a July 7 letter to current DHS Secretary Markwayne Mullin, urging him to create another path to immigration for long-term caregivers to minimize employment disruption.

In his letter, Reed estimates up to 35,000 Florida healthcare workers are Haitian TPS holders. That’s a small portion of the state’s healthcare employees, which KFF puts at 1.2 million in May 2025. But there are also “thousands” of unfilled positions, according to the Florida Hospital Association’s 2025 workforce report.

“Replacing these workers is neither immediate nor easy,” Reed wrote in the letter.

Zooming in. In New York, leaders from the New York State Association of Health Care Providers, the New York State Nurses Association, the New York State Health Facilities Association, and healthcare worker union 1199SEIU United Healthcare Workers East held a press conference July 10 to call for a TPS extension.

The conference highlighted Haitian TPS holders. FWD.us estimates 7,000 work as caregivers or nursing assistants in the state of New York, which employed over 566,000 home health and personal care aides in 2023, according to the Bureau of Labor Statistics.

Though this is a small portion of New York’s workforce, it may have a big impact on some organizations.

For instance, the Arc Rockland, a nonprofit that supports over 600 people with intellectual and developmental disabilities in Rockland County, New York, would lose 19 direct support professionals if these work permits expire, CEO Jessica Pizzutello said during the press conference.

The organization already has 60 direct care vacancies, and employees are working overtime to fill the gaps, she explained.

Some of these staff members have treated the same patients for over a decade, forming a relationship that would be difficult to replace.

“They know…small changes in expression or routine that tell them when something isn’t right, even when the individual cannot communicate so with words. That kind of knowledge cannot be learned from a chart or transferred during a shift change,” she said.