Immigration changes may raise long-term care costs

Louis Barajas, a certified financial planner with over three decades of experience, knows firsthand about the rising cost of health care and the shrinking availability of long-term care workers for millions of seniors and people with disabilities. 

“It’s been putting a lot of pressure on the American family’s money,” said Barajas, CEO of International Private Wealth Advisors, a wealth management firm in Santa Ana, California.

Along with his brother, Barajas is helping their almost 90-year-old father care for their 81-year-old mother.

“She’s just suffered four strokes, and so she’s been hospitalized, and she’s at home right now, and we are trying to find a caretaker for her,” he said. “It has been the most complicated thing.” 

His parents, who immigrated to the U.S. from Mexico in the late 1950s, don’t have long-term care insurance, and their personal funds are limited, he said. Also, finding a professional caregiver has not been easy.

It’ll likely only get harder — and more expensive — for families to fill these roles, health policy experts say, as the Trump Administration’s immigration enforcement ratchets up, visa rules become more restrictive, and a recent Supreme Court decision to end the temporary protected status of Syrian and Haitian immigrants takes effect.

“Having reduced immigrant participation in the healthcare workforce and the overall workforce is going to exacerbate existing worker shortages,” said Drishti Pillai, director of immigrant health policy at KFF, a nonpartisan health policy research group.

In the last few years, immigrant workers have made major inroads into the American economy. In June, foreign-born workers accounted for 18.8% of the U.S. civilian labor force, according to the U.S. Bureau of Labor Statistics’ monthly employment report. 

The health care industry has been a major employer of immigrants. One in six health care workers — about 3.3 million people — are immigrants, making up 17% of the health care workforce overall, according to a new KFF analysis of Current Population Survey monthly data and the American Community Survey. Immigrants account for three out of 10 — or 30% — of direct care workers in long-term settings, including assisted living centers, nursing homes, and home health care. 

The BLS data do not include the legal status of foreign-born workers. Yet, KFF research shows that the number of naturalized citizens employed rose from January 2025 to April 2026, helping offset the decline in noncitizen immigrant workers. Over the period, non-citizen immigrant workers declined by about 600,000, or 4%, from 15.4 million to 14.8 million, according to a new KFF analysis of Current Population Survey monthly data and the American Community Survey. 

In other words, a more restrictive immigration stance is not just a policy change, but presents a health care issue that could be devastating to millions of American families, said Pillai, who co-authored the KFF report. Tightening supply constraints, along with increased demand from an aging U.S. population, would naturally drive up costs for more scarce resources, she suggested.

“The worker shortages that already exist in the long-term care workforce are going to become exacerbated, so it will be, you know, like a double whammy,” Pillai said. “If there aren’t enough workers to fill these roles, then that can lead to higher costs for these services.”

Throughout his career, Hispanic professionals and blue-collar workers have made up the majority of his clients, including some working in healthcare, said Barajas, author of the new book “Finances Con Corazón: The Latino Journey to Financial Dignity.” 

“Over the last couple of years, a lot of people were kind of scared at what might happen to them, especially on their immigration status,” he said, and as a result, some of them are “no longer working in that industry, or maybe doing something else”, or “have gone back to their country.”

A labor shortage of care workers could increase the cost of care and the financial burden for many families, said Barajas, who is also a member of the CNBC Financial Advisor Council. 

The cost of long-term care depends on the type of services needed. In-home help for 44 hours of care a week rose to about $80,080 last year, according to a March report from CareScout, a subsidiary of Genworth Financial. The 2025 national median hourly rate for non-medical caregiver services increased 3% year over year to $35 per hour.

“Home health care agencies are seeing a rise in costs, and as a result, those costs are being passed on to consumers,” said Abbe Udochi, CEO of Concierge Healthcare Counseling, an aging life care agency in Westchester County, New York. 

Costs may be even higher depending on the state. “Private home health care agencies in New York are charging about $40 an hour on average, and patients of one Connecticut agency are paying $70 an hour,” Udochi said.

The daily rate in 2025 was $355 or $129,575 annually for a private room in a nursing home, according to CareScout. For an assisted living facility, the annual cost was $74,400.

To ease the financial strain, look into whether you qualify for and can afford long-term care insurance now, and compare that with how much you can stash away each month if you must pay for care on your own, Barajas said. But don’t just focus on the current balances in bank and investment accounts.

Instead he suggested, individuals and families “need to be thinking about money as a tool to make sure that they live a better life, have a better quality of life,” he said, “and that tool is going to be used to take care of their health.”

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