ICYMI: Brookings Institution: Immigration Would Help Address Caregiver Shortage

Advocacy; Regulations; Legislative

In case you missed it, a new commentary from experts at the Brookings Institution underscores the need for immigration reform in order to expand the supply of caregivers in the United States. As the population ages and Baby Boomers place increased demand on the health care system, the caregiver shortfall must be addressed. The Brookings Institution's Benjamin Harris, vice president of economic studies, and Liam Marshall, research assistant of economic studies, write:

​“In the upcoming years, a confluence of factors will produce an unprecedented shortfall in the necessary supply of caregivers. If left unchecked, this shortfall will result in a series of harmful economic outcomes – including sharply raised caregiving costs, outsized burdens on informal caregivers, and subpar quality of care. Since demand for care is largely out of policymakers' control, the most promising way to address these challenges is by expanding the supply of caregivers. And one of the best strategies for expanding the supply of caregivers is through expanded pathways for legal immigrants."

Immigrants make up
28 percent of all direct care workers in the country and make up a vital part of the long term care workforce. Immigration reform will allow for more caregivers to enter the workforce and will improve outcomes for nursing home residents. Harris and Marshall continue:

​“The positive impacts of immigration on the availability and quality of long-term care are well documented, particularly as they pertain to nursing homes. Studies, such as Furtado and Ortega (2024) and Grabowski, Gruber, and McGarry (2023), have shown that an increase in immigration is linked with raised nursing home staffing levels, as well as improved patient outcomes. Furtado and Ortega found that larger immigrant populations are associated with nursing home residents suffering fewer falls and experiencing a slower decline in their ability to carry out daily tasks, while Grabowski and co-authors demonstrated that short-term hospitalization rates among residents decrease with a rise in immigration."

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) has long supported immigration reform as one of many solutions to help strengthen the long term care workforce, especially as nursing homes continue to face a historic labor crisis. The need for Congress to expand and expedite opportunities for international health care workers who wish to live and work in the United States – especially those who are willing to care for our nation's seniors – has never been more urgent. The Centers for Medicare and Medicaid Services (CMS) is expected to finalize its federal staffing mandate for nursing homes sometime this year; yet, the Administration offers no funding or workforce programs to help nursing homes recruit more caregivers. Meanwhile, current immigration policies have created visa caps and backlogs, blocking providers from filling open positions.

AHCA/NCAL supports the bipartisan Healthcare Workforce Resilience Act, which would recapture unused visas from previous fiscal years for nurses and their families. AHCA/NCAL, along with 13 other senior care organizations, sent a letter to the U.S. Department of State urging the agency to prioritize visa processing for nurse cases so more frontline caregivers can enter the workforce.

AHCA's recent State of the Sector Report found that 99 percent of nursing homes currently have open jobs, while 94 percent of facilities say it is difficult to recruit new staff. We need comprehensive workforce policies that will support staff recruitment and retention, including immigration reform, not a blanket federal staffing mandate that will only exacerbate the caregiver workforce shortage.

Read the full Brookings article HERE.