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Economists: Family immigration a key source of healthcare workers

According to the Bureau of Labor Statistics, seven of the 10 fastest-growing occupations require no college degree. The top two fastest-growing occupations are among them: home health and personal care aides. By 2026, those two occupations are expected to grow by 1.2 million positions.

The Pew Research Center projects that over half of baby boomers will need long-term care -- and much of it will be provided in the home. Approximately 10,000 of them are turning 65 every single day. And home-care agencies are already struggling to recruit workers.

"If one of our aides is sick or has an emergency, it's very difficult to find a backup," said the president of a Boston-area care provider.

Who will fill these positions? As of last year, 26 percent of U.S. personal care and home health aides were foreign born, according to an economist from the Conference Board. That number rises in more urban areas. In California, New Jersey and Massachusetts, almost half are foreign born. In New York it's 62 percent.

These immigrants typically aren't eligible for employment-based visas, although most are legally in the U.S. Many of them come to the States through family ties with U.S. citizens and lawful permanent residents.

Unfortunately, despite worker shortages the wages for these jobs are relatively low. The New York Times recently interviewed one Los Angeles aide who earns $12 an hour, or about $29,000 plus benefits. The woman supplements her income by working for private clients in her off hours.

Some proponents of a more restrictive immigration system argue that low-skilled immigrant workers like these push down wages. Many of those who encourage immigration to the U.S. disagree. Rather than pushing down wages in an otherwise higher-paying field, they argue, these immigrants enter lower-paying fields because that's where they're most likely to be hired.

Senior care agencies say that they couldn't afford to raise wages even if it meant they could attract more workers. They are often dependent on fixed Medicare and Medicaid reimbursement rates. Many are worried that congressional attempts to restrict family-based immigration will eliminate many of the workers they rely on.

"Where are all these workers going to come from?" said the owner of a Houston-based group of facilities that employ around 4,000 people in multiple states.

In immigration policy, we often divide immigrants into those with work-based visas and those with family-based ones. It's important to remember that many family-based immigrants are eligible to work -- and they often fill positions that are desperately needed.

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