The Trump administration's decision to revoke Temporary Protected Status (TPS) for Honduras and other countries has forced thousands of healthcare workers out of their jobs, causing severe disruptions in the US healthcare system and devastating patients who depended on them.
Healthcare Workers Lose Legal Status Overnight
Janeth, a 50-year-old nursing assistant from Honduras who worked at a Kaiser Permanente hospital in the San Francisco Bay Area for 23 years and won a prestigious national nursing award seven times, lost her job in September 2024 when TPS for Honduras ended. She and her 85-year-old mother had to move in with her daughter because she could no longer pay her mortgage. "I just want my job back, I just want my life back. I want to take care of my patients again," she said.
Janeth's case is not isolated. According to FWD.us, an immigration advocacy organization, as of early 2025, nearly 1.3 million people in the US were on TPS, with at least 50,000 working in the healthcare sector. The US Citizenship and Immigration Services (USCIS) does not maintain data on TPS holders' occupations, but individual employers report significant reliance on these workers. Amina Dubuisson, vice-president of clinical services at Ventura Services Florida, which oversees nine nursing homes across Miami, said at least 20% to 30% of their workers are TPS holders, with each nursing home employing 200 to 300 staff members. "They do a lot of the jobs that Americans don't want to do," she said, such as nursing assistants who clean and feed patients.
Patients and Families Devastated
Dolores Jacoby, diagnosed with acute myeloid leukemia in 2012 and given three months to live, lived for three years largely thanks to Janeth's care. Her son, John Jacoby, recalled that after hearing the devastating diagnosis, Janeth entered the room with each family member's favorite beverage and said, "If there's anybody who can recover, it's your mother." When John learned that Janeth had lost her job due to her immigration status, he was gutted. "That makes no sense," he said. "They need to take her back for the patients. I just hope I don't ever end up in a hospital bed without someone like [her] by my side."
Janeth's former colleagues at Kaiser Permanente described her as irreplaceable. A nurse who worked with her for eight years noted that Janeth could turn "difficult patients" into her "biggest fans," recalling a patient with alcoholism who only wanted Janeth after one shift. "That kind of skillset you can't ever replace," the nurse said. Since Janeth left, the hospital has felt her absence. "There is a lack of joy and camaraderie that's been prompted by her leaving," another nurse said.
Impact on the Healthcare System
The Trump administration's policies are straining an already fragile multi-trillion dollar US healthcare system. About one in six hospital workers directly involved in patient care is an immigrant, and an estimated 4% of hospital workers are not naturalized citizens. "Just because we are stopping immigration pathways and banning people from these countries doesn't mean we can ban patients, too," said Kimberly Pierce Burke, executive director of the Alliance of Independent Academic Medical Centers, a national organization of about 90 independent teaching hospitals.
In addition to TPS revocations, the Trump administration ended a humanitarian parole program (CHNV) in June 2024, which had allowed nearly 500,000 people from Cuba, Haiti, Nicaragua, and Venezuela to enter the US. According to FWD.us, about 30,000 healthcare workers under that program lost their work authorization. Joseph Durandis, a doctor in Miami, lost one of his three medical assistants through the program. Almost a year later, he still hasn't found a replacement. "Triage takes much longer and that causes annoyance among patients," he said, adding that patient retention and satisfaction are dropping.
Legal Battles and Uncertainty
The administration's actions have been challenged in court. In December 2024, a federal court ruled that the termination of TPS for Honduras, Nepal, and Nicaragua was unlawful because the Department of Homeland Security (DHS) did not consult other agencies or review country conditions. However, the Ninth Circuit Court of Appeals upheld the revocation in February 2025, and the plaintiffs decided not to take the case to the Supreme Court. For Haiti, TPS remains in limbo. A federal judge blocked its termination, but the government appealed, and the Supreme Court is expected to rule soon. In oral arguments, lawyers for TPS holders argued that the administration is discriminating against non-white immigrants, citing President Trump's reference to Haiti and other countries as "shitholes." DHS denied the accusation, stating that decisions are based on country conditions and that TPS was always intended to be temporary.
Workers and Patients Face Uncertain Future
Jhony Silva, who came from Honduras as a three-year-old and grew up in the Bay Area, lost his job as a nursing assistant at Stanford hospital and had to drop out of nursing school after TPS ended. He became a lead plaintiff in a lawsuit against the government. "I'm going to use my voice to speak up about what's going on, for people that can't speak like me," he said. He still washes his hospital scrubs regularly, hoping to return to work.
Esther Birnbaum, a 96-year-old in Palm Beach County, depends on Maryse Balthazar, a Haitian home health aide who has cared for her brother and now her. "I can't imagine my day-to-day life without her," Birnbaum said. Balthazar, who has two children, said, "There is no plan B. This is where my life is, I wouldn't know what to do if TPS isn't protected."
Marie Esther Duval, a Haitian healthcare worker who runs an adult family home in Spokane, Washington, cares for four young women with severe mental illness. She risks losing her legal status but hasn't told her patients, fearing it would worsen their anxiety and depression. "These are people with chronic anxiety and depression. They won't be able to handle this news," she said.
