The Trump administration’s efforts to revoke humanitarian protections for Haitians would significantly exacerbate nationwide health care worker shortages, limit available health care services, and endanger patients, according to a new report prepared by three Massachusetts federal lawmakers and released Tuesday.
The Massachusetts health care sector in particular would be disproportionately affected if the administration succeeds, the lawmakers wrote, since the Haitian community here makes up a sizable portion of the state’s workforce, providing crucial care especially to older adults and people with disabilities.
“If the Trump administration ends legal protections for Haitian workers, everyone will be worse off,” Senator Elizabeth Warren said in a statement to the Globe about the report, which was issued by Warren, Senator Ed Markey, and US Representative Ayanna Pressley. “This cruel decision would put patient care at risk nationwide. We must keep fighting back.”
More than 300,000 people from Haiti live in the United States under Temporary Protected Status, a program that blocks the deportation of immigrants from certain countries that are undergoing armed conflict, environmental disasters, or other extraordinary country conditions.
In Massachusetts, the end of TPS for Haitians could affect approximately 45,000 residents who rely on the program to live and work here legally.
The Supreme Court is poised to release a decision by the end of its yearly session in late June or early July on whether the Trump administration can revoke these protections. Immigrants who lose TPS would have to leave the country voluntarily, apply for other legal pathways to stay in the United States lawfully, or remain here without legal status, which could make them ineligible for permission to work here — and subject to potential deportation.
“The termination of TPS for Haiti threatens to seriously disrupt the healthcare, senior care, and disability care workforces amid a nationwide healthcare crisis and persistent staffing shortages,” the report says.
The report, called “Care in Crisis: The Healthcare Workforce Consequences of Ending Haitian TPS,” is the product of the lawmakers’ investigation into how the termination of TPS would affect the health, elder, and disability care workforces.
Warren received responses and data from the Association of Developmental Disabilities Providers, The Arc of Massachusetts, Massachusetts Senior Care Association, LeadingAge, and the National Domestic Workers Alliance — and “every organization identified Haitian workers as central to the care workforce,” the report says.
About 13,000 Haitian TPS holders work as nursing assistants in the United States, caring for approximately 65,000 patients every day, according to National Domestic Workers Alliance data in the report.
Pressley said in a statement to the Globe that while her mother Sandy was battling leukemia, she was cared for by Haitian nurses “who met her with compassion ... going above and beyond to comfort her before she transitioned.”
“There are tens of thousands of people just like her across America who receive the same essential care from Haitian TPS holders,” Pressley said. “This report makes plain the essential role that Haitian TPS holders play in our care economy and communities writ-large.”
The Massachusetts Senior Care Association, which has 350 long-term care facilities across the state, told the investigators about 2,000 care workers either already lost or remain at risk of losing their work authorization because of the Trump administration’s efforts to end legal pathways for immigrants to stay in the United States. There is already a 13 percent vacancy rate for direct care roles, the association said.
The nursing home industry in particular has faced years of difficulties in recruiting enough workers to look after residents, especially nurses and nursing assistants. The senior care association warned that these staffing shortfalls could “force some facilities to limit new admissions thereby aggravating existing bottlenecks in the broader healthcare system,” the report said.
The Association of Developmental Disabilities Providers told Warren’s office that without Haitian workers with TPS, its members would have had about 50 shifts go unfilled on Feb. 3, the day a federal judge temporarily blocked the administration’s effort to end TPS for Haiti.
The patients being cared for, the group said, are “some of the most fragile people in the Commonwealth.”
“A TPS holder cares for someone’s elderly grandparent, feeds and tends to someone’s child, and nurses back to health someone’s sick loved one,” Markey said in a statement to the Globe.
The Arc of Massachusetts, a Waltham-based advocacy organization for people with developmental and intellectual disabilities, said that there were already reports of some caregivers skipping work due to fear of immigration enforcement, or self-deporting from the United States entirely.
The loss of these trusted caregivers “would likely result in service disruptions and a reduced ability for individuals with IDD and autism to live safely and with dignity in community-based programs,” The Arc of Massachusetts said in a letter to Warren quoted in the report.
Some Haitians on TPS have been in the United States for a decade or longer. Haitian nationals were granted TPS after the country’s devastating 2010 earthquake, which killed more than 200,000 people, wreaked havoc on the economy, and led to years of government instability. Deadly gang violence has surged since the 2021 assassination of the country’s president, Jovenel Moïse.
The Trump administration has repeatedly said publicly that Haitians can now return home even though gangs still commandeer about 90 percent of Port-au-Prince, the capital city. The State Department also recently renewed its highest tier level four “Do Not Travel” advisory for Haiti, due to “kidnapping, crime, terrorist activity, civil unrest, and limited health care,” in the country.
The Trump administration nevertheless seems determined to end the TPS program. After the federal judge temporarily halted the administration’s move to dismantle TPS, the administration appealed to the Supreme Court.
In a statement to the Globe, a spokesperson for the Department of Homeland Security said that TPS “was never intended to be a de facto asylum program.”
“The United States has had a generous asylum program – those who can prove a need for it should apply instead of expecting extensions of their temporary status," the spokesperson said. “The Trump administration is restoring integrity to our immigration system to keep our homeland and its people safe, and we expect a higher court to vindicate us in this.”
Pressley, a Democrat who is the cochair for the House Haiti Caucus, in April led a bipartisan charge in the House to extend TPS for Haitians for three more years, with 10 Republicans siding with Democrats in favor of the bill.
The measure has yet to be voted on in the Senate.
“For decades, Haitian TPS holders have offered stability, dignity, and security to so many,” Markey told the Globe, “and they deserve the same in return.”
Giulia McDonnell Nieto del Rio can be reached at giulia.mcdnr@globe.com. Follow her @giuliamcdnr.