Trump’s deportation plans threaten 400,000 direct care jobs: Older adults and people with disabilities could lose vital in-home support
If the Trump administration follows through on its goal of deporting 4 million people over four years, the direct care industry would lose close to 400,000 jobs—affecting 274,000 immigrant and 120,000 U.S.-born workers. This dramatic reduction in trained care workers would compromise home-based care services, forcing family members to scramble for informal arrangements to support relatives who are older or have disabilities.
The Trump administration has consistently prioritized aggressive and arbitrary immigration enforcement, with the ultimate goal of deporting 1 million people every year of his term—regardless of their contributions to their communities and the U.S. economy. While the Department of Homeland Security’s pace currently falls short, increased enforcement would curtail business operations and reduce employer demand for both immigrant and U.S.-born workers. Over four years, 1 million annual deportations could cause total employment in the United States to fall by 5.9 million jobs, with particularly severe losses in construction and child care industries.
The direct care sector is also highly vulnerable to these enforcement actions. Amanda Kreider and Rachel Werner’s recent research indicates that job losses will significantly affect workers who provide long-term care in home- and community-based settings. The direct care sector—which includes home health aides, personal care aides, orderlies, psychiatric aides, and some nursing assistants—relies heavily on immigrant labor. Immigrants constitute nearly 30% of the direct care workforce, compared with 20% of overall employment. Among home health aides who assist with daily living and healthcare tasks, four in 10 workers are immigrants.
Kreider and Werner found that previous increases in immigration enforcement caused the direct care sector to shrink. If these patterns hold under the current enforcement regime, four million deportations over four years could cause direct care employment to fall by 394,000 (see Figure A).
Trump's deportations will shrink the direct care industry: Job losses after 4 million deportations
| Job losses | |
|---|---|
| Immigrant | 274,000 |
| U.S.-born | 120,000 |
| Total | 394,000 |
Note: Job losses after four years of one million annual deportations, following Zipperer (2025).
Source: Author's analysis of Kreider and Warner (2025).
The majority of this employment decline—274,000 jobs—will result from the loss of immigrant workers. However, in addition to removing a supply of labor, deportations also make the labor market more precarious for immigrant workers. When immigrants face heightened risk of arrest, detention, or deportation, their ability to change jobs becomes severely constrained. With reduced labor market leverage, employers can worsen working conditions and suppress wages for all workers in the sector, not just those directly affected by deportations.
Contrary to the misconception that deportations will increase job opportunities for U.S-born workers, existing research consistently demonstrates that increased immigration enforcement reduces the employment for both immigrant and U.S.-born workers. Deteriorating pay and conditions for direct care workers would make U.S.-born workers unlikely to step in to replace the shortfall of immigrant workers, consistent with what studies have found when immigration enforcement decreased the size of the construction and child care sectors. In direct care, about 30% of the employment decline—the equivalent of around 120,000 jobs—will affect U.S.-born workers.
While employment reductions will be widespread, they will hit certain states particularly hard due to the geographic concentration of noncitizen immigrants in the direct care sector (see Table 1). New York faces especially severe challenges. Immigrants comprise two-thirds of the state’s direct care workforce, and more than one-third of all noncitizens working in direct care nationwide live in New York. If the Trump administration achieves its deportation goals, New York’s direct care sector could shrink by 45%.
Deportations will cause widespread direct care job losses: State-level job losses after 4 million deportations
| State | Immigrant | U.S.-born | Total (level) | Total (percent) |
|---|---|---|---|---|
| New York | 98,000 | 43,000 | 141,000 | 45% |
| California | 37,000 | 16,000 | 53,000 | 20% |
| Texas | 27,000 | 12,000 | 39,000 | 22% |
| Florida | 17,000 | 7,000 | 24,000 | 21% |
| Massachusetts | 13,000 | 6,000 | 18,000 | 38% |
| Washington | 13,000 | 6,000 | 19,000 | 36% |
| Illinois | 9,000 | 4,000 | 12,000 | 14% |
| Pennsylvania | 8,000 | 4,000 | 12,000 | 8% |
| New Jersey | 6,000 | 2,000 | 8,000 | 12% |
| Minnesota | 5,000 | 2,000 | 7,000 | 12% |
| Hawaii | 4,000 | 2,000 | 5,000 | 53% |
| Virginia | 4,000 | 2,000 | 6,000 | 10% |
Notes: Job losses after four years of one million annual deportations, following Zipperer (2025). State estimates assume national deportations are distributed by the noncitizen share of national direct care employment.
Source: Author's analysis of Kreider and Warner (2025).
These large employment losses would translate directly into reduced availability of direct care services. Kreider and Werner found that past escalations of immigration enforcement led to substantial increases in the number of older adults living without any help at home. Among the Medicaid population, formal nonfamily caregiving declined while family-based caregiving increased, reflecting the contraction of the formal direct care sector.
This shift from formal to family-based care suggests that job losses in the direct care sector will have large spillover effects across the economy, greatly increasing their potential harm to even U.S.-born workers. As direct care supply becomes constrained due to deportations, some family members may need to leave their jobs or reduce their work hours to assume new caretaking responsibilities. Indeed, other research has shown that increases in immigration enforcement caused U.S.-born mothers to work fewer hours due to declining availability of household services like cleaning and child care. Family members may well be forced to choose between their careers and caring for aging and disabled relatives.
The Trump administration’s deportation agenda threatens to trigger a cascading crisis in senior and disability care that will harm families across the economic spectrum. Even in the absence of deportations, caretaking needs will accelerate as the older population grows tremendously, especially in the next five years. If the direct care workforce contracts by nearly 400,000 workers due to deportations, millions of older adults and people with disabilities will be left without the professional assistance they need to remain safely in their homes. Rather than creating jobs for U.S.-born workers as proponents claim, mass deportations eliminate employment opportunities for citizens and immigrants alike while dismantling a care infrastructure that seniors, people with disabilities, and families depend on.
Enjoyed this post?
Sign up for EPI's newsletter so you never miss our research and insights on ways to make the economy work better for everyone.