Phillip Reese
The well being care sector is a shiny spot within the financial system this 12 months, driving practically half of the nation’s employment positive aspects, however economists and specialists say immigration crackdowns and looming Medicaid cuts pose a menace to future job progress.
Employers added 487,000 jobs from January to August, in keeping with the newest nonfarm payroll knowledge from the Bureau of Labor Statistics. The well being care sector accounted for 48% of that lackluster growth, increasing by about 232,000 jobs, regardless that the sector employs solely about 11% of employees.
“On the labor side, health care growth is driving the economy,” stated Stanford economics professor Neale Mahoney.
Economists say President Donald Trump’s immigration crackdown and cuts to public insurance coverage applications threaten to dampen that progress. They may add unease in regards to the financial system and trigger headwinds for the GOP in subsequent 12 months’s midterm elections. The well being care sector is unusually depending on foreign-born employees, whereas a brand new regulation trimming federal spending on the $900-billion-a-year Medicaid program is projected, based mostly on a preliminary model of the invoice, to set off the lack of 1.2 million jobs nationwide, in keeping with the Commonwealth Fund.
In latest years, well being care job progress has been most pronounced within the residence well being sector, rising by practically 300,000 jobs to 1.82 million employees from August 2019 to August 2025, as tens of millions of older residents rent employees to go to and deal with them, Mahoney stated. Job progress has additionally been robust at hospitals and doctors’ offices. Nursing properties and residential care properties posted weaker numbers from 2019 to 2025 amid a rise within the variety of folks utilizing caregiving at residence.
Some analysis signifies that well being care job progress shouldn’t be all the time good for the financial system. For occasion, a rising variety of directors in well being care could elevate well being care prices without providing much benefit to sufferers. Yet, well being care jobs are thought-about stable and often recession-proof, and the well being care business is now the top employer in most states. Even with job progress within the sector, many locations remain desperate for well being care employees to fulfill rising demand.
But a number of economists stated latest federal coverage adjustments on immigration and Medicaid may drag down job progress.
If immigration crackdowns by the Trump administration proceed, it may get powerful for well being care organizations to search out sufficient folks to rent. “Health care as an industry is pretty reliant on immigrant labor,” stated Allison Shrivastava, an economist with the Indeed Hiring Lab. “It has a large share of non-native labor force, so it’s going to be impacted more.”
About 18% of Americans employed in well being care had been born overseas, in keeping with 2023 Census Bureau knowledge. And about 5% of well being care employees weren’t residents, together with about 60,000 docs and surgeons, 117,000 registered nurses, and 155,000 residence well being or private care aides, census knowledge reveals.
Many of these employees are right here legally; the Census Bureau doesn’t monitor what number of noncitizens reside within the U.S. with authorization. But even these with authorized standing, together with everlasting residents, could also be vulnerable to deportation. The federal authorities deported about 200,000 folks from February by means of August, a big improve from prior months, in keeping with data obtained by The Guardian.
At the identical time, some well being care employees could select to not research in or transfer to America in the event that they understand it as hostile to immigrants. The variety of immigrant visas issued by the United States from March to May fell by about 23,000, or 14%, from the identical interval final 12 months, State Department data shows. In addition, reported unauthorized border crossing makes an attempt have plummeted.
Shrivastava stated Indeed’s job posting knowledge reveals continued robust demand for docs amongst employers prepared to assist with the visa sponsorship course of. But it’s not clear if folks will take them up on the presents.
Meanwhile, Congress this summer time handed what Republicans known as the “One Big Beautiful Bill Act,” which was rapidly signed by Trump. That invoice makes about $910 billion in cuts to federal Medicaid spending over 10 years, in keeping with a KFF analysis of knowledge from the Congressional Budget Office.
Medicaid reductions are projected to trigger tens of millions to be with out medical health insurance within the coming years. Hospitals, nursing properties, and neighborhood well being facilities must absorb more of the cost of treating uninsured folks by lowering companies and staff, or else shut altogether.
The cuts may have a big impression on the job market. California alone may see as much as 217,000 fewer jobs, of which two-thirds could be within the well being care sector, in keeping with an analysis by the University of California-Berkeley Labor Center carried out earlier than the invoice was finalized and signed.
“It doesn’t mean necessarily that 200,000 people are going to lose their job,” stated Miranda Dietz, interim director of the Health Care Program on the Labor Center. “Some people will lose their job, and in some cases, the job growth won’t be as fast as anticipated.”
Complicating the image is Trump’s recent firing of the official who headed the Labor Department’s statistical department, resulting in issues that jobs knowledge won’t be free from political affect.
It’s not clear when — or if — immigration actions and Medicaid cuts will have an effect on hiring within the well being care sector, however there are indicators of potential softening. Federal knowledge confirmed a significant decline in job openings within the well being care and social help sector in July. Indeed’s job posting data additionally reveals a decline in some well being care fields, however Laura Ullrich, director of financial analysis in North America on the Indeed Hiring Lab, famous that, general, postings stay above prepandemic ranges.
For now, job progress is anticipated to stay excessive, significantly amongst nurse practitioners, doctor assistants, and residential well being aides, in keeping with BLS projections.
Many well being care jobs require years of upper schooling however end in excessive pay, with household physicians sometimes making more than $240,000 a year and registered nurses sometimes taking in about $94,000 a year.
Joshua Lejano, president of the Sacramento State chapter of the California Nursing Students’ Association, stated he’s “cautiously optimistic” that he’ll rapidly land a job as a registered nurse when he graduates in December. He stated he’s finishing nursing scientific rotations that give him real-world expertise that can situation him for lengthy shifts.
Lejano stated hospitals in his space are increasing capability whereas some veteran nurses are leaving the occupation as a result of burnout from the covid pandemic, creating openings. “Right now, I think the big thing is just staying on top of all the application cycles,” he stated.
Health care jobs that don’t require as a lot coaching are likely to pay a lot much less. Median annual earnings for the U.S.’ roughly 4.4 million residence well being and private care aides had been about $35,000 final 12 months, roughly equal to pay for waiters and waitresses, federal knowledge reveals.
The progress in well being care jobs has been particularly helpful for ladies, Ullrich stated. Nearly 80% of well being care and social help employees are feminine, in keeping with a latest Indeed study. The analysis discovered that feminine employees accounted for greater than one million new well being care jobs within the final two years.
The sector is resilient, Shrivastava stated, as a result of Americans usually don’t view well being care as a luxurious good: They pay for it in good instances and unhealthy. Health insurance coverage prices are on monitor for his or her biggest jump in at the least 5 years. Also, well being care spending typically facilities on previous and really previous folks, a gaggle rising dramatically as child boomers age. The variety of Americans 65 or older rose from 34 million in 1995 to 61 million in 2024.
“So many of these health care jobs are to support the growing population of older Americans,” Ullrich stated. “So that’s not surprising that we’re seeing growth there. But I think what is surprising is how lopsided it is.”
Phillip Reese is an information reporting specialist and an affiliate professor of journalism at California State University-Sacramento.
This article was produced by KFF Health News, which publishes California Healthline, an editorially impartial service of the California Health Care Foundation.
KFF Health News is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Learn extra about KFF.
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