On June 25, the Supreme Court ruled 6-3 that the Trump administration can end Temporary Protected Status for about 350,000 Haitians.
On Aug. 5, U.S. District Judge Ana C. Reyes confirmed that her order blocking it was no longer in effect. Haiti’s TPS, and the work permits tied to it, ended July 27.
Affected immigrants include home health aides, nursing assistants, and other paid caregivers, and the agencies that employ them are already describing what losing those workers could do to families who buy care.
No study has measured the effect yet. What is documented is how heavily paid care leans on immigrant workers, and what a family pays for the hours it can get.
Three in 10 caregivers are immigrants
In 2024, the country had 2.3 million direct care workers, and 3 in 10 were immigrants, compared with 18% of all adult workers, according to KFF’s analysis of Census Bureau data.
Home care leans hardest on them. Immigrants make up 33% of home care workers, including 14% who are noncitizens, and home care accounts for 66% of all direct care jobs.
Not every immigrant aide holds Temporary Protected Status. As many as 58,000 U.S. health aides were born in Haiti, about 2% of all health aides, according to American Immigration Council figures reported by Home Health Care News.
What providers expect
A senior living provider and LeadingAge Southeast told the Supreme Court in an April 2026 brief that ending the status would strain facilities already short-staffed and disrupt trusted caregiver relationships, which matter most in memory care.
After the ruling, Mollie Gurian, a vice president at LeadingAge, a nonprofit association of aging-services providers, told Home Health Care News that providers short on aides may have to turn away new referrals or cut visits to current clients, leaving hospitals unable to arrange home care at discharge. She expects New York City to be among the hardest hit.
Seth Sternberg, CEO of home care company Honor, said a change of caregiver is especially hard on people with dementia. These are industry forecasts, not measured outcomes.
What home care costs now
CareScout’s 2025 Cost of Care Survey put the national median for a non-medical caregiver at $35 an hour, up 3% from a year earlier. At 44 hours a week, that is $80,080 a year. Assisted living ran $6,200 a month, and a semi-private nursing home room cost $315 a day, or $114,975 a year.
Those rates reflect 2025, before the ruling, and a shortage does not automatically raise them. The arithmetic of a gap is simple, though. Every 10 hours a week a family covers itself instead of buying care works out to about $18,200 a year at the median rate, paid in time instead of cash.
Questions to ask your agency now
Families that use an agency can ask whether the aide assigned to a loved one is an agency employee, how quickly the agency could send a replacement, and how much notice it gives before changing or ending visits. Get the answers in writing, along with the agency’s cancellation terms.
Families that fill gaps themselves often find the hours add up fast, a pattern known as caregiver creep. You can pay a sibling who steps in, but find out how that can put a parent’s Medicaid at risk.
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