Trump Backs Special Tech Worker Visas, What About Nurses And Care Aides?
By JCA on March 19, 2025
by Howard Gleckman, from his blog on howardgleckman.com
Despite his vow to close the US borders to nearly all immigrants and deport millions of others, President-elect Trump says he’ll continue special H-1B work visas for tech workers. That decision came in response to some of his Silicon Valley supporters, who insist foreign labor is critical because there are not enough US-born engineers and others to do this important work.
By that logic, Trump also ought to protect the direct care workers who assist people with disabilities and frail older adults from his mass deportation plans and even create a new special immigration status for them. Why? Because, well, there are not enough US-born people willing to do this important work.
Making America Strong
Elon Musk, who led the charge to convince Trump to continue the H-1B visa program, has called immigrants “critical people who built SpaceX, Tesla and hundreds of other companies that made America strong.”
But in reality, the argument for direct care workers may be even more powerful than it is for tech. That’s because some tech companies have used the H-1B visa program to replace native-born employees with temporary, lower-cost foreign-born workers.
That is not the case with care workers, where severe shortages of US-born aides and nurses are real, not just an opportunity to lower labor costs.
Besides, caring for frail older adults and younger people with disabilities also makes America strong.
It helps maintain quality of life for those who need care, many of whom pay taxes and were enormously productive during decades of their working lives. But more than that, access to paid aides, nurses, and other direct care workers can make it possible for their family members to continue to work at productive paid jobs (perhaps some are even computer engineers).
And the personal care they provide may help avoid costly preventable acute medical episodes, emergency department visits, and hospitalizations—all of which can reduce the amount the US spends on health care. This might be of some interest to Musk, who is advising Trump on how to lower government spending.
A Severe Shortage
The need for more care workers is clear.
For example, the US will need nearly 200,000 additional nurses by 2030, according to the Bureau of Labor Statistics. A different report concludes the US will face a shortage of nearly 79,000 RNs this year alone.
The research and advocacy organization PHI estimates nearly 5.5 million home care job openings will need to be filled in the decade 2022-2032, an estimate that includes replacing current workers who leave their jobs and meeting new demand from an aging population.
The worker shortage should be no surprise. Home care aides have among the most dangerous jobs of all occupations, largely caused by back injuries from moving patients. They make an average hourly wage of a bit more than $16 and their median annual income is only about $22,000. Nearly one in six live in poverty and about 60 percent receive some public assistance.
Interestingly, the total home care workforce is expected to grow by more than 700,000 jobs over the period, more than any other occupation and by twice as much as software developers.
Just as with tech workers, immigrants are critical to filling the deep gap between demand for direct care workers and supply of those willing to do these difficult jobs.