The well being care sector is a shiny spot within the economic system this 12 months, driving almost half of the nation’s employment positive aspects, however economists and consultants say immigration crackdowns and looming Medicaid cuts pose a menace to future job progress.
Employers added 487,000 jobs from January to August, based on the most recent nonfarm payroll information from the Bureau of Labor Statistics. The well being care sector accounted for 48% of that lackluster progress, 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 concerning the economic 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, based on the Commonwealth Fund.
Lately, well being care job progress has been most pronounced within the residence well being sector, rising by almost 300,000 jobs to 1.82 million employees from August 2019 to August 2025, as thousands and thousands of older residents rent employees to go to and maintain them, Mahoney stated. Job progress has additionally been sturdy at hospitals and docs’ places of work. 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 isn’t at all times good for the economic system. As an illustration, a rising variety of directors in well being care might increase well being care prices with out offering a lot profit to sufferers. But, well being care jobs are thought-about steady and sometimes recession-proof, and the well being care trade is now the prime employer in most states. Even with job progress within the sector, many locations stay determined for well being care employees to fulfill rising demand.
However 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 might 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 Certainly Hiring Lab. “It has a large share of non-native labor force, so it’s going to be impacted more.”
About 18% of Individuals employed in well being care had been born overseas, based on 2023 Census Bureau information. 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 information exhibits.
A lot of these employees are right here legally; the Census Bureau doesn’t monitor what number of noncitizens live within the U.S. with authorization. However even these with authorized standing, together with everlasting residents, could also be weak to deportation. The federal authorities deported about 200,000 folks from February by means of August, a major improve from prior months, based on information obtained by The Guardian.
On the identical time, some well being care employees might 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 america from March to Could fell by about 23,000, or 14%, from the identical interval final 12 months, State Division information exhibits. As well as, reported unauthorized border crossing makes an attempt have plummeted.
Shrivastava stated Certainly’s job posting information exhibits continued sturdy demand for docs amongst employers prepared to assist with the visa sponsorship course of. However it’s not clear if folks will take them up on the gives.
In the meantime, Congress this summer time handed what Republicans referred to 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, based on a KFF evaluation of information from the Congressional Funds Workplace.
Medicaid reductions are projected to trigger thousands and thousands to be with out medical health insurance within the coming years. Hospitals, nursing properties, and group well being facilities should take in extra of the associated fee of treating uninsured folks by lowering companies and workers, or else shut altogether.
The cuts might have a major influence on the job market. California alone might see as much as 217,000 fewer jobs, of which two-thirds could be within the well being care sector, based on an evaluation by the College of California-Berkeley Labor Middle 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 Well being Care Program on the Labor Middle. “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 latest firing of the official who headed the Labor Division’s statistical department, resulting in issues that jobs information 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 information confirmed a vital decline in job openings within the well being care and social help sector in July. Certainly’s job posting information additionally exhibits a decline in some well being care fields, however Laura Ullrich, director of financial analysis in North America on the Certainly Hiring Lab, famous that, total, 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, based on BLS projections.
Many well being care jobs require years of upper schooling however end in excessive pay, with household physicians usually making greater than $240,000 a 12 months and registered nurses usually taking in about $94,000 a 12 months.
Joshua Lejano, president of the Sacramento State chapter of the California Nursing College students’ Affiliation, 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 because 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.
Well being 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 information exhibits.
The expansion in well being care jobs has been particularly useful for ladies, Ullrich stated. Practically 80% of well being care and social help employees are feminine, based on a latest Certainly research. 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 Individuals usually don’t view well being care as a luxurious good: They pay for it in good occasions and unhealthy. Medical insurance prices are on monitor for his or her greatest bounce in at the very least 5 years. Additionally, well being care spending usually facilities on previous and really previous folks, a bunch rising dramatically as child boomers age. The variety of Individuals 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 College-Sacramento.
This text was produced by KFF Well being Information, which publishes California Healthline, an editorially unbiased service of the California Well being Care Basis.
