America stands on the brink of a health care workforce crisis. Within just four years, the nation will face a severe shortage of critical health care workers needed to support our aging population. For example, the number of nursing assistants — a critical role for elder care — is increasing at a rate of only 0.1% annually. They are projected to make up roughly 70% of a 100,000-worker shortfall in health care by 2028.
Health care access and quality are at risk if this shortage remains overlooked. To address it, congressional leaders and President-elect Trump must consider innovative solutions, including one already within reach: leveraging the skilled non-citizen workforce trained in U.S. institutions.
In the past, Trump proposed that immigrant students graduating from U.S. colleges and universities receive green cards to stay and work in the U.S.
We should build on this idea. There are currently more than 1.5 million international students enrolled in U.S. colleges and universities. These students receive the same high-quality training and education as their American peers who go on to become health care professionals. Many have already dedicated years of their lives to the U.S., working under their education visa and thriving in our communities. Sadly, our immigration laws grant only a 60-day grace period to maintain their legal status or they must leave the country following graduation. This forces many talented, well-trained individuals to return home rather than contribute to our workforce for longer seasons.
Graduates from U.S. institutions are able to fill critical roles in health care, through a variety of disciplines. Nursing assistants, home health aides, and other frontline caregivers stand to benefit from a surge of U.S.-trained international workers, particularly as these professions face the demand for care as the population continues to decline. Furthermore, as the existing gaps in elder care, rural health services, and chronic disease management continue to increase, the demand for specialized care is only possible by equipping and retaining these graduates. It’s estimated, for every 31.7 physicians in urban areas, there are 10.9 physicians per 10,000 people in rural areas.
Congress should consider reforms that allow immigrants trained in our education system to bolster sectors where demand is outpacing supply, particularly in health care. Non-citizen, highly skilled health care workers could play a crucial role in addressing these gaps and mitigating the worsening shortage. The U.S. boasts four of the top five medical schools in the world. Retaining students trained at these institutions is a key part of strengthening our health care system. Respected institutions including Johns Hopkins, the Mayo Clinic, and other American academic medical centers benefit greatly from international students who contribute significantly to health care delivery and research.
International health care professionals have proven time and again to be a meaningful spark for the U.S. health care system. In 2021, immigrants made up 18% of the 15.2 million-strong U.S. health care workforce, or approximately 2.8 million workers.
Of course, graduates of the best medical schools in the country will not fix the shortage of home care aides or nursing assistants. But many international students graduate with medical or nursing degrees, and the health care system needs them today. Graduates in other fields might even consider training to fill some of the lower-paid roles, particularly as preparation to enter medical or nursing school in the future.
As this next administration sets its policy agenda, retaining highly trained health care professionals from U.S. institutions should be a top priority.
Congress has a pivotal opportunity to come together and enact necessary reform that benefits all Americans. A key step is shifting the focus to merit-based visa policies to address the country’s pressing labor needs. This is a practical, forward-thinking solution that can have an immediate impact on our health care system.
We have already seen bipartisan interest in this approach. Both Republicans and Democrats in Congress have supported the Healthcare Workforce Resilience Act, which would grant access to thousands of qualified health care professionals abroad — many of whom are U.S.-trained — who could be helping Americans now. Rather than creating new visa categories, the bill smartly reallocates unused visas already authorized by Congress, directing them toward industries facing prolonged shortages.
The American people are looking to our next wave of leaders to bring solutions that enhance their quality of life and address the pressing difficulties of our time. By enacting thoughtful, merit-based immigration reforms, our leaders can ensure that America’s healthcare workforce is strong enough to meet the demands of the future. It’s time for decisive actions from Congress to keep America healthy and prepared.
Tom Price, MD, an orthopedic surgeon, served as the 23rd Secretary of Health and Human Services and is a former Member of Congress – GA-06 (2005-2017).