At the start of the COVID-19 pandemic, childcare centers shuttered, retirement homes struggled, and health concerns soared, forcing millions to leave the workforce to care for children or parents. Years later, because of their caretaking responsibilities, as many as 6.6 million Americans still have not returned to work. While the lack of childcare options is a significant issue, four times as many Americans stay home to care for spouses, siblings, parents, or grandparents compared to those out of work caring for children. 

Before the pandemic, institutions managed to provide reliable care to children and adults so that Americans–women in particular–could remain in the workforce. Still, the industry was beginning to show signs of stress. Once the pandemic arrived, the ability to staff reliable care institutions floundered. 

As of June 2022, sixty percent of nursing homes were limiting new patients due to staffing shortages. Almost 90 percent of nursing homes faced moderate to high staffing shortages despite an equal share offering increased wages and bonuses. Nearly three-fourths of surveyed nursing home providers expressed concern about closing their facilities due to staffing shortages. 

Not only is the staffing crisis putting the future of nursing homes at risk, but the care that nursing home residents receive has deteriorated due to staff shortages. More than half of U.S. nursing homes fail to comply with basic staffing guidelines over 80 percent of the time. Most nursing home respondents indicate that these staffing shortages persist due to a lack of qualified or even interested candidates

In childcare, the outlook is comparably dire. As of February 2022, the childcare services workforce was down more than 11 percent compared to February 2020, despite significant recovery from early pandemic losses. Although there has since been some growth, as of February 2023, the workforce is still nearly 6 percent smaller than in February 2020 (amounting to a loss of nearly 60,000 employees)

In Alabama, 90 percent of surveyed childcare centers were experiencing a staff shortage, meaning that 40 percent have resorted to serving fewer children, 27 percent have a longer waitlist, 20 percent are unable to open classrooms, and 23 percent have reduced operating hours. Across the country, 60 to 96 percent of other states’ childcare centers reported staffing shortages with similar impacts on services. In turn, these service limitations force American women and families to seek alternatives, including options that keep qualified workers out of the labor market in favor of providing care at home. 

Immigrants have a proven track record of filling an outsized role in the care work labor force. They are essential to the workforce we have now. Small policy changes can bring American women back to the workplace and increase the quality and accessibility of care in this country. 

Immigrants represent only about 14 percent of the U.S. population but over 18 percent of the early care and education workforce (about 321,000 immigrants). An estimated 142,000 undocumented immigrants serve as childcare workers, personal care aides, and home health aides. In the nursing home and home care industries, immigrants make up 1925 percent of the nurses and aides on staff. Not to mention that more than 30 percent of nursing home housekeeping and maintenance workers are immigrants. 

What’s more, there is evidence suggesting that immigrants have a positive impact on the labor market. For instance, from 1980 to 2017, immigrants increased the supply of elderly home care in the U.S., reduced the cost of elder care, and improved the quality of care for Americans in the area. 

Furthermore, research demonstrates that when there are more immigrants in an area, high-income women are more likely to work outside the home due to the increased availability of childcare, eldercare, and household services. This enables these women to join or rejoin the workforce, which is essential to filling the many other vacancies in our labor market today. 

The U.S. can enable immigrants to fill the many vacant caretaking jobs by establishing circular migration pathways for trained caretakers from Central America, by expanding the definition of an au pair to include those who care for our elderly in addition to our children, and by providing prompt work authorization to the populations already within the United States who are eager to join the workforce. 

If the shortage of care workers remains unaddressed, we will likely see a decreased quality of care for patients and children, accompanied by increased costs. The shortages will likely worsen as staff work longer hours or care for more patients and children at once, leading to burnout and staff departures. With said staff departures, care accessibility will decrease as centers are forced to close due to shortages, and as a result, other parts of the American labor force will suffer. As the U.S. grapples with an astounding 9.6 million vacant jobs, women or other working Americans may be forced to exit the workforce to care for their children or relatives, a devastating consequence of political inaction on immigration. 

While these outcomes would be disastrous for the U.S. labor market, they are preventable. Timely action on immigration can reassure Americans that their loved ones will be cared for without causing further harm to American workforce participation levels.