‘Ripple effect:’ In US, anti-immigrant policy strains child and eldercare

When she saw the Trump sign in the yard, Camila knew she would have to watch out.

It was February 2025, and Camila* had shown up at a home in North Texas to meet the new family for whom she would nanny.

The 22-year-old college student doesn’t have legal documentation, but that’s never been an issue. In her experience, many families like to pay their childcare workers in cash. Still, this new family posed an interesting challenge. The interior of the home was filled with more Trump paraphernalia. “Trump everything, everywhere,” Camila says. It turned out the father works for Fox News.

“It was very ironic,” Camila told Al Jazeera. “If I were to say, ‘Hey, this is my legal situation,’ it could have gone one of two ways. Maybe they wouldn’t care, or maybe they would’ve told me to get out. And who knows what would’ve happened then.”

She ultimately decided not to tell them and just focused on her job of caring for their children. The uncomfortable encounter and the “chill” it gave Camila evoke a larger problem.

In the US, immigrant labour, including undocumented workers, has long propped up the childcare, home care and elder care industries. Yet amid the anti-immigrant policy and posture in US President Donald Trump’s second administration, including the threat of “mass deportations”, those ailing industries face new threats that experts say could have a “ripple effect” on millions of Americans.

“People are not showing up for work because they’re concerned about raids happening in their workplace,” said Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care.

And children, she added, “have been really worried about their parents and whether or not they’re going to be coming home at the end of the day”.

‘Attacked from every angle’

Economists have documented the devastating effect mass deportations would have on the economy, and organisations like the American Immigration Council map the trillions of dollars immigrants contribute to the US in taxes and spending power.

But some industries are uniquely vulnerable to shifts in immigration policy.

For instance, about one in five US childcare workers are immigrants, and some studies indicate that nearly 30 percent of direct care workers are immigrants. As multiple experts emphasised to Al Jazeera, these roles have a far-reaching effect on communities across the country.

“There are going to be ripple effects based on some of the policies that we’re seeing being put into place,” Smetanka said. The policies, she continued, “are impacting the ability of immigrants to not only come to this country, but get their citizenship, to feel safe in staying and working in this country, and to provide the services that are necessary in those communities”.

Early in his second term, Trump rescinded the “sensitive areas” guidance that has prevented immigration raids from occurring in schools, churches and places of employment. The government is also denying or delaying H-1B visa permits, which continues a decade-long trend of diminishing access to a programme that helps immigrants find work.

“We want people, by the way, to come into our country, but we want them to come in through a legal process,” President Trump said in his April 2 tariffs announcement. “We need people to run these plants and to help the auto workers and the teamsters and the non-union people and everybody else, but we need people.”

Despite this rhetoric, the president’s administration has limited legal pathways by freezing the US refugee resettlement programme. Then, in an interview on April 15, Trump proposed a new pathway by which “great people” could be eligible to re-enter the US and attain permanent citizenship status if they first leave the country, then receive sponsorship from an employer.

The president has also proposed the creation of a “gold card” visa that would cost applicants $5m.

Colleen Putzel-Kavanaugh, a policy analyst for the Migration Policy Institute, said the policy’s core objective “seems to be to bring wealth to the US”.

To evaluate if the legal pathways for immigrants are getting stronger, one would have to look at not just the number of visas granted but also “who those visas are reaching, if strengthening legal pathways reduces irregular migration, or the timeframe in which visas are processed”.

In other words, admitting more immigrants through a “legal process” Trump referred to in his April 2 speech would involve making visas easier to attain, something he failed to do in his first term, where so-called legal migration diminished.

Further still, the revocation of temporary protected status has school administrators, nursing home leaders and daycare operators wondering who they can hire and how they can protect them.

Wendy Cervantes says these changes have been made so that immigrant families are “attacked from every angle”.

Cervantes is the director of immigration and immigrant families at The Center for Law and Social Policy, and her team recently held a webinar to provide technical assistance for childcare providers across the US. She said more than 1,000 people showed up, driven by the “stress and fear” created by the new administration’s approach to immigration.

“People aren’t just worried about parents any more; they’re worried about staff, too,” she told Al Jazeera.

As a result, administrators in fields like childcare are learning about the intricacies of warrants: Which kind of documentation is needed, and what information an immigration officer needs to provide to be legally allowed on the premises.

“This knowledge at least gives them some measure of agency,” she said. “But that’s a really scary place to be in.”

‘I want to stay’

One of Cervantes’s goals is similar to that of the economists tracking the effect of deportations: She wants people to realise how much their lives are shaped by immigrants.

This is especially true for anyone whose family has some connection to the childcare, home care or elder care sectors. Roughly 20 percent of all US seniors live in rural communities, and in the last five years, 40 new counties have become nursing home deserts: Areas where nursing care is needed but unavailable, forcing residents to drive long distances for much-needed care.

According to Smetanka, when a nursing home closes, it leaves a gaping hole in the community. Dozens lose jobs, and patients – who likely had few options to begin with – are left scrambling to find a new home. It’s difficult to quantify the economic and psychological effect this has on a family or a community at large, just as, for Cervantes, it’s difficult to quantify the damage done to a child’s psyche when they’re afraid of being deported.

Despite all of this, Smetanka says it’s important to remember how much immigrants want to remain in the US and keep working in places like nursing homes. The average hourly pay for direct care workers increased by less than $3 between 2014 and 2023, but healthcare fields remain widely popular among immigrants.

Sarah Valdez, an immigration lawyer based in Austin, Texas, puts it bluntly, “You [won’t be able to] replace the 10 people you deported with 10 American-born workers.”

Camila, the nanny from North Texas, is one of those people who is willing to work long hours, without complaint, and for little pay. Nannying may not be her long-term career, but she chose the field because she needed to pay for her school, and she loves working with kids.

In many cases, she feels as if she spends as much time with her clients as their parents do. Her typical day involves getting up at 6am and working until about 10pm, while finding time for classwork and studies in any free time she can manage. She’s helped multiple children cope with divorce and sudden deaths in the family, among many other life situations.

“With everything happening in the world, I don’t know what’s next for me,” she said. “I’m just taking it day by day, week by week. But I know I want to stay. I’m just glad to be here right now.”

*Camila’s name has been changed to protect her identity.