Immigration crackdown deepens NJ health care worker shortage
Advocates rally in Jersey City calling for passage of immigrant bill
Over 100 immigration advocates gathered in Jersey City on Nov. 8, calling for the bill, still pending in the New Jersey Legislature, to be approved.
A federal immigration crackdown is worsening New Jersey’s health care labor crisis, forcing thousands of immigrant workers out of jobs, and putting the state’s most vulnerable residents at risk.
Among the workers is a mother of three living in Metuchen who arrived from Haiti in January 2023. As a home health aide, she cared for the sick, including a paralyzed elderly woman who was her primary client for two years.
“I wash them, feed them, give them medicine, clean their sheets. I go with them if they have to do therapy at the hospital,” she said, asking that her name be withheld because of a pending immigration case.
She is one of thousands of immigrants across New Jersey who have lost legal status, and, with it, their livelihoods. Since taking office, President Donald Trump and his administration have launched an aggressive campaign to detain and deport immigrants in the country illegally. At the same time, the administration has rolled back immigration programs that permitted hundreds of thousands of immigrants to live and work in the United States.
Business leaders say the shrinking of the immigrant workforce has disrupted industries from construction to hospitality — but the impact on health care has been especially dire.
Nearly 30% of New Jersey’s health care workers were born outside the United States — well above the national average of 17%, according to the Migration Policy Institute. Among home health aides, nursing assistants and personal care aides, that share rises to 41%.
The industry already grappled with labor shortages, well before Trump entered his second term with a sweeping agenda of mass deportation. The reasons are varied: too few workers, too many leaving the health care field and the growing demands of an aging population.
The immigration crackdown will worsen critical shortages, said Andy Cassagnol, executive vice president of the New Jersey region of 1199SEIU United Healthcare Workers East. The union represents more than 7,000 workers employed in 78 New Jersey nursing homes.
“To now be placed in a position where they could take a hit in their staff — upwards of one third of their staff in some cases — that could put them in the position of having to shut their doors,” Cassagnol said.
‘Hurting ourselves’
Amid shortages, nursing assistants may have to take on more patients, said Cassagnol. He described a possible scenario.
“Imagine it’s your family,” he said. “That means if your family member is supposed to receive medication at a particular time, they won’t. If they are supposed to be mobilized, meaning walked around a facility, they won’t. Any services they would traditionally get, it’s going to be affected based on how many people work there.”
Employers are very much concerned, he said.
“Immigrants are a lifeline to them at a time when there is very short staffing in this industry. It’s hard to not just attract workers to the field, but also to keep them and sustain them.”
Caring for the elderly and disabled is emotionally and physically demanding work, often for low pay. These jobs have high turnover and are hard to fill, said 1199SEIU spokeswoman Rose Ryan. Longer hours and heavier caseloads also raise safety concerns.
“Ensuring that folks are working in a safe environment means making sure they have the resources they need to get that work done safely,” Ryan said. “Sometimes that resource is as simple as just having another body there right next to you.”
“Many who are 65 or older are moving to a nursing environment,” she said. “What we do now is going to have a profound effect. It just doesn’t make sense. We are hurting ourselves.”
Haitians hard hit
Many Haitian immigrants work in New Jersey’s health care system — and they are among those hit hardest by recent policy changes.
About 530,000 immigrants lost status when a humanitarian parole program for people from Cuba, Haiti, Nicaragua, and Venezuela was terminated in June — including 210,000 people from Haiti. The program grants temporary legal status to individuals or groups for urgent humanitarian reasons.
More than half a million Haitians are also slated to lose Temporary Protected Status — granted to citizens of countries deemed unsafe for return — when it expires on Feb. 3, 2026. TPS for Haiti had been renewed repeatedly since 2010, but the Trump Administration sought to end the designation even earlier than February, although the effort was blocked by a federal court judge.
The Metuchen mother’s work authorization ended after the Trump administration canceled parole for Haitians. Her three daughters — a college student, an aspiring nurse, and a fellow home health aide — also lost their status.
She now fears they will be deported to Haiti, a country roiled by political instability, civil unrest and violence.
“I left my country because it’s really unsafe. Now, it’s very hard, you know. You have to pay bills,” said the woman, who also had to leave a second job at Walmart.
At Interfaith-RISE, a refugee resettlement organization based in Highland Park, Rev. Seth Kaper-Dale said his staff has seen hundreds of Haitian workers lose jobs this year.
The agency had found work for nearly 5,000 Haitian immigrants in just over two years — including 950 in health care jobs, he said.
“We have watched probably a thousand people lose their jobs this summer,” Kaper-Dale said. “All the Walmart folks, they all received layoffs. A bakery company, they laid off everyone. Nursing homes, they laid off a ton of people. All of these people who frankly helped us rebuild our economy after COVID and helped us not fall into a recession.”
They have been pushed from self-sufficiency to poverty, he said. U.S. officials are urging immigrants who lose legal status to self-deport.
Some, like the Metuchen woman, have applied for asylum or TPS, hoping for reprieve.
East Orange Councilman Bergson Leneus, the son of Haitian immigrants, said the losses strike at the heart of New Jersey communities and economies.
“Haitians have seen health care as an honorable profession — a pathway to the American dream,” Leneus said. “It begs the question, who is going to replace these essential health care workers?”
“I know many who are thinking about leaving. Some have already been deported. The fear and pressure have taken a toll on people’s health and wellbeing.”
Calls for reform
While some immigrants are losing work authorization, fewer new arrivals are coming to the United States. As of mid-2025, the nation’s foreign-born population had declined by more than a million people — the first drop since the 1960s, according to the Pew Research Center.
In December, the New Jersey Business Immigration Coalition hosted a forum with health care leaders and advocates who called for federal and state-level reforms to attract immigrant talent and improve healthcare access.
Among the measures, they called for: simpler pathways for foreign-trained medical professionals to get certified; vocational language classes and training; streamlined worker visas; and lifting of caps on visas for some health care professions.
With immigration shrinking instead of growing, the coalition renewed calls for reform in an Oct. 15 statement. They asked federal lawmakers “to move beyond punitive approaches and adopt immigration reforms that reflect the economic realities of the labor market.”
Their statement calls for an “earned legalization program” for law-abiding undocumented workers.
“With millions of jobs going unfilled across the country, especially in essential industries, it is counterproductive to remove workers who are already contributing and willing to meet clearly defined criteria for legal status,” the coalition wrote.
“At the same time, to prevent the reoccurrence of large-scale undocumented immigration, our legal immigration system, which dates back to 1965, needs to be updated to fill the labor needs of the future. More immigrant visas should be made available to cover shortages of workers at all skill levels.”
‘We have to be strong’
Back in Metuchen, the Haitian home health aide clings to hope that a legal pathway will open for her and her daughters to remain in the U.S.
“It’s not safe in Haiti,” she said. “The violence and the gangs — we don’t know what can happen if we go back.”
Still, she tries to stay optimistic. “I tell them to be strong,” she said. “Everybody has bad moments in life. We have to be patient.”
link
