Trump
The 6-3 Supreme Court decision reverses lower court rulings and could expose 1.3 million TPS holders from 17 countries The White House

The US Supreme Court has cleared the way for President Donald Trump to deport more than 350,000 Haitians and 6,000 Syrians, a 6-3 ruling that strips Temporary Protected Status (TPS) from people who have legally lived and worked in America for more than a decade. The decision lands as an immigration ruling, but it will also significantly impact US hospitals, nursing homes, and the elderly Americans who depend on them.

Justice Samuel Alito, writing for the conservative majority on Thursday, held that the TPS law gives the president unreviewable authority to end protections, with no role for the courts. The ruling reverses lower court decisions that had paused the terminations and could expose 1.3 million immigrants from all 17 designated TPS countries to deportation as the administration moves to roll back protections for 13 of them.

A Hospital Staffing Crisis Disguised as Immigration Policy

The healthcare implications outweigh the political ones for ordinary Americans. Krish O'Mara Vignarajah, president of Global Refuge, said the ruling 'affects 350,000 Haitians and a third of those Haitians work in our healthcare sector. They are caregivers, they are doctors.' That works out to roughly 115,000 frontline workers in nursing homes, hospitals, and home-care settings facing removal.

The numbers behind those jobs are equally stark. Immigrants make up one in four long-term care workers and over 30% of nursing home support staff, according to a report from Representative Ayanna Pressley's office. TPS holders alone account for 15% of all noncitizen healthcare workers, and more than 20% of Haitians in the US work in healthcare.

An Aging Population With Nowhere to Turn

The US is already short on caregivers. The country faces a projected shortage of 3.5 million healthcare workers by 2030, even as the population aged 65 and older is set to grow by 50% by 2050. Pulling out 115,000 Haitian healthcare workers in months will widen that gap.

Operators are bracing for the fallout. At Sinai Residences in Boca Raton, Florida, 26 Haitian staff are expected to lose work authorisation, including certified nursing assistants who earn around $40,000 (£30,300) a year, bathing, feeding, and caring for residents. CEO Rachel Blumberg told Marketplace the loss could lead to closed wings, downsized facilities, and even shuttered nursing homes.

Massachusetts faces some of the steepest losses. About 45,000 Haitian TPS holders live in the state, and the Massachusetts Senior Care Association has estimated that 2,000 direct-care workers are now at risk. Florida holds the largest share nationwide, followed by New York, Massachusetts, Pennsylvania, and Ohio, based on an FWD.us analysis showing nearly 190,000 Haitian TPS holders were employed in early 2025.

A Pointed Dissent and a Veto Risk

Justice Elena Kagan, joined by Sonia Sotomayor and Ketanji Brown Jackson, wrote that Trump's prior statements 'fairly shout, in their racial undertones and overtones alike, that race entered into the president's resolve to remove Haitians from this country.' Alito countered that the comments were 'insufficient to show that the termination of Haiti's TPS designations was based on the race of the Haitian people.'

The House of Representatives recently passed a bill to extend Haiti's TPS for three years, and Senator Ed Markey introduced a companion measure in the Senate on 17 June. Even if it clears Congress, Trump is widely expected to veto it.

What Happens Next for Affected Workers

Attorneys are urging TPS holders to seek other legal pathways before any deportation begins. 'Do not wait until you are being arrested by [Immigration and Customs Enforcement] to think about this,' Katie Kersh of Advocates for Basic Legal Equality said.

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