Immigrants’ Role in the U.S. Health Care Workforce

Immigrants make up nearly one in five workers in the U.S. health care sector, filling critical roles in hospitals, long-term care, and physician support—yet their contributions face growing scrutiny amid workforce shortages and policy debates over immigration reform. According to a June 2026 issue brief from the Kaiser Family Foundation (KFF), immigrants account for 19% of all health care workers in the U.S., with their presence most pronounced in direct long-term care and hospital staffing. The data underscores how their labor sustains an industry struggling with labor gaps, even as political and regulatory shifts threaten to reshape their access to licensure and employment.

The KFF analysis highlights that immigrants hold 28% of jobs in direct long-term care—such as home health aides and nursing assistants—where they often fill roles that domestic workers avoid due to lower pay and physically demanding conditions. In hospitals, immigrants represent 17% of the workforce, with particularly high concentrations among registered nurses (20%) and physicians (22% of international medical graduates). These figures align with broader labor trends: the U.S. Bureau of Labor Statistics reported in May 2026 that health care employment grew by 2.4% year-over-year, outpacing other sectors, yet 1.2 million positions remain unfilled nationwide.

What drives this reliance? A 2025 study published in Health Affairs found that immigrants are more likely to pursue health care careers due to pathways like the U.S. visa waiver for certain medical professionals and the fact that many arrive with prior clinical training. "The U.S. health system has long depended on immigrant labor, especially in areas where domestic workers are scarce," said Dr. Amara Nwankwo, a health policy researcher at Harvard Medical School, citing data from the American Medical Association. "But without clear policies, we risk losing a workforce that keeps hospitals and nursing homes running."

The brief also notes disparities in licensure hurdles. States like California and New York have streamlined pathways for immigrant nurses, while others impose stricter English proficiency or criminal background checks that disproportionately affect temporary visa holders. A 2026 report from the National Council of State Boards of Nursing found that 15% of foreign-trained nurses who passed U.S. licensing exams in 2025 faced delays of six months or more due to bureaucratic backlogs—delays that can force them to seek work elsewhere.

How might policy changes affect this dynamic? The Biden administration’s proposed 2027 immigration reforms include expanded visas for skilled health care workers, but critics argue the measures may not address the root causes: wage stagnation and limited career advancement for frontline roles. Meanwhile, hospitals in states like Texas and Florida—where immigrant workers constitute over 25% of nursing staff—have begun lobbying for federal intervention, citing patient care risks if shortages worsen.

What comes next depends on whether policymakers treat immigrant health care workers as a solution or a problem. The KFF brief concludes that without targeted reforms, the U.S. could face a "double crisis": deeper labor shortages in an aging population and the loss of a workforce that has long filled gaps in critical care.

Key figures from the KFF brief (June 2026):

• 19% of all U.S. health care workers are immigrants.
• 28% of direct long-term care workers are immigrants.
• 20% of registered nurses and 22% of international medical graduates are immigrants.
• 15% of foreign-trained nurses face delays of six months or more in licensure.

Sources:

• Kaiser Family Foundation (KFF), The Role of Immigrants in the U.S. Health Care Workforce (June 2026)
• U.S. Bureau of Labor Statistics, Employment Projections (May 2026)
• Health Affairs, Immigrant Health Care Workers and U.S. Labor Market Dynamics (2025)
• National Council of State Boards of Nursing, Licensing Delays for Foreign-Trained Nurses (2026)