Relaxing immigration policies in America may actually save lives

By Jessica Hall

New research says targeted immigration policies can address workforce shortages and support the U.S. population as it ages

Immigrants make up a substantial share of the U.S. healthcare workforce.

Cutting immigration to the U.S. may have life-and-death consequences for older adults, while relaxing immigration policies may save lives.

A new working paper from the National Bureau of Economic Research found that there's a "striking and statistically meaningful" connection between death rates for older adults and immigration.

For every 1,000 additional immigrants there would be 9.8 fewer deaths among the elderly annually, according to the research. Raising immigration by 325,000 would prevent the deaths of 5,000 older adults, said Jonathan Gruber, one of authors of the paper and chair of the economics department at the Massachusetts Institute of Technology.

"Immigrants play a vital role in our healthcare system. Lower immigration will reduce the quality of healthcare and lead to more deaths," Gruber told MarketWatch. "There's a real, meaningful consequence."

Immigrants help older adults avoid nursing homes by providing home healthcare services. For older adults who are in nursing homes, meanwhile, immigrants support staffing levels, leading to better quality of care, the NBER paper said.

"We find that immigration saves elderly lives," the authors wrote.

Read: There's already a caregiver crisis. So who will take care of Mom if immigrant workers get deported?

The NBER paper comes amid a crackdown on immigration by the Trump administration. In the first year of President Donald Trump's second term, more than 675,000 immigrants were deported and an estimated 2.2 million immigrants left on their own or "self-deported," according to the Department of Homeland Security.

At the same time, a record number of baby boomers are turning 65 - 11,000 of them every day - in a demographic wave known as "Peak 65." This trend will continue through 2027, according to the Retirement Income Institute at the Alliance for Lifetime Income. People also are living longer lives, but that trend is frequently accompanied by a higher prevalence of multiple chronic conditions, according to the National Institutes of Health.

"Millions of people have been taken out of the workforce," said Jennie Murray, president and chief executive of the National Immigration Forum. "It's really weakened the healthcare system in the U.S."

Immigrants make up a substantial share of the U.S. healthcare workforce, accounting for more than 18% of the nation's 15 million healthcare workers. They comprise 26% of physicians and surgeons, 40% of home health aides, 28% of personal care aides and 21% of nurse assistants, according to the NBER paper.

"Immigrants, particularly those working as in-home or personal care aides, may make it easier for older adults to age in place and avoid a nursing home," the NBER paper said.

Home care workers provide personal assistance with activities such as bathing, dressing and eating, among other duties. Home healthcare providers already turn away more than 25% of referred patients due to staff shortages, according to the Home Care Association of America.

"Workforce shortages existed before the changes to immigration policy. As you're driving immigrants out of this workforce, it creates unmet care needs, increased mortality and further strain on the family caregiver network to pick up those care hours," said Kezia Scales, vice president of policy research and evaluation at PHI, a nonprofit that tracks issues in the healthcare workforce.

The U.S. is home to nearly 48 million immigrants, representing about 14% of the total population. About 27% of the immigrant population lacks full legal status, but many of these individuals have permission to be in the country as asylum seekers or holders of temporary protected status.

Because workers from Haiti make up a significant share of the healthcare workforce, Gruber said, bringing in 330,000 additional Haitians would prevent 9,000 deaths among older people.

Haiti's TPS designation was slated to be terminated on Feb. 3. However, a judge in the U.S. District Court for the District of Columbia issued an order staying the termination.

"The Department of Homeland Security vehemently disagrees with this order and is working with Department of Justice to determine next steps," the Department of U.S. Citizenship and Immigration Services said on its website.

The issue of the strength of the healthcare workforce is at the forefront as an aging U.S. population faces an increasing need for long-term healthcare.

"We are 10 to 15 years away from the peak long-term-care needs of the baby boomer population. One of the main barriers to expanding the workforce is immigration policy," Gruber said.

The immigration policy changes carried out by the Trump administration have compounded an existing physician shortage in the U.S., the National Immigration Forum's Murray told MarketWatch.

Admitting 1,000 new immigrants would result in 142 additional foreign healthcare workers - without crowding out U.S.-born healthcare workers, the NBER paper said.

"The boomer-care challenges are pretty significant. We're not able to meet this need for healthcare services. We should be trying to recruit foreign-born workers to strengthen our healthcare workforce," Murray said.

The ramifications of the loss of immigrant workers will affect older adults in terms of the availability and the cost of care, she said.

"The fear is that older adults will have a lack of care, and the care that is available will become more expensive. The price is going to skyrocket as care becomes more scarce. That escalation in price is another barrier to care for many older adults," Murray said.

-Jessica Hall

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02-19-26 1033ET