The Trump administration’s aggressive mass deportation plan could have major consequences for home-based care providers and further limit access to care. That’s one key takeaway from a new research letter published in JAMA.

Undocumented immigrants make up at least 10% of personnel in home care agencies, according to the researchers. A major push to deport undocumented immigrants could therefore worsen the already troubled home-based care labor landscape.

“The Trump administration’s plans to deport undocumented immigrants and some with temporary protected status — which allows some migrants from countries with unsafe conditions to live and work in the U.S. — and increase legal barriers even for skilled immigrants, could worsen workforce shortages,” the researchers wrote.

Researchers examined the number of undocumented immigrants employed in U.S. Census Bureau-designated health industries, hospitals, nursing homes, home care and more, using data from the March 2024 Current Population Survey. The data also included workers who reported working in private households.

Overall, almost 700,000 documented non-citizens, and more than 366,500 undocumented immigrants work in the health care sector, according to the research.

Since taking office, President Trump has signed an executive order that “expands the use of expedited removal.” The executive order impacts several immigration initiatives, programs and enforcement actions. Trump also suspended refugee resettlements.

As immigration policies grow tougher, demand for home-based care is only increasing. The need for home health and personal care aides will see an estimated 21% growth over a decade, according to the Bureau of Labor Statistics,

Forty percent of home health aides are foreign-born, according to the Bureau of Labor Statistics, the highest percentage of any of the 25 health care occupations included in the bureau’s data. 

Significant changes to the home-based care staffing pool would worsen an already “critical” juncture, in which demand has significantly risen without the workforce to match. Most home-based care providers name staffing the industry’s most significant headwind.