Immigrants and Health Care: What Our History Tells Us About Solving Today’s Shortages

Kit Taintor | June 24, 2026

As the United States approaches its 250th anniversary, this Immigrant Heritage Month is a fitting moment to reflect on who we are as a nation and how we got here.

Immigrants are the common thread through nearly every chapter of American progress. Time and again, our history shows that the nation grows stronger and more innovative when it welcomes and integrates immigrant talent and eagerness to contribute—and pays a price when anxieties prevail.

From industrialization and the post-war boom to today’s Information Age, immigrants have been a linchpin of progress. Chinese immigrants made up 90 percent of the workforce that built the transcontinental railroad, opening up economic development across the West. Immigrants from China, Latin America, and across Europe fueled the mining industry, from the Gold Rush in California to coal mining in Appalachia. In 1920, first- and second-generation immigrants made up more than one-third of the U.S. population, driving the industrial surge that propelled the U.S. past Great Britain as the world’s leading manufacturing nation. After World War II, immigrant scientists and engineers powered the space race and the beginning of the computer age. In recent decades, immigrants have continued to drive innovation, making up 16 percent of inventors and 23 percent of all patent recipients between 1990 and 2016. When America has faced tough questions, immigrants have helped to provide the answers.

Our history offers another lesson as well: While immigrants have repeatedly helped to meet the nation’s workforce needs, the systems surrounding them have not always reflected the value they bring. Building a stronger workforce and economy today means ensuring that talent is not only welcomed, but also fully recognized, valued, and empowered to contribute.

The story—as well as potential—of immigrant contributions to economic and social progress is especially clear in the field of health care, where the U.S. now faces acute worker shortages nationwide. We have the tool that has delivered progress time and again, yet we are underutilizing it. As our population ages and our health care system faces mounting pressure, a commonsense path forward is clear: Modernize our immigration system, unlock talent already in our communities, and attract the health care professionals our country desperately needs.

A Foundation Built by Immigrants

Much of modern medicine in the U.S. was pioneered by immigrants. Jewish physicians who fled persecution during and after World War II arrived in the U.S. and were often excluded from established institutions. Instead, they founded their own, and many of those institutions became hubs of innovation. The Albert Einstein College of Medicine in New York, as an example, continues to contribute vital research and innovation. Of all Americans who have won Nobel Prizes in Chemistry, Medicine, and Physics, 35 percent were immigrants, a proportion that is likely an underestimate, since it does not include laureates like Albert Einstein who immigrated after receiving their prizes.

The U.S. has also turned to immigrants to fill critical health care shortages at pivotal moments. In the early 1900s, the U.S. established nursing schools in the Philippines to train nurses, and in many cases, those nurses arrived in the U.S. for further training and employment. After World War II, and again after Medicare and Medicaid expanded access to care, hospitals sponsored Filipino nurses to fill workforce gaps. During the AIDS crisis, when many other health care workers refused to provide care, Filipino nurses stepped in. Whenever the U.S. faced constraints in its health care system, immigrants were central to our way forward—and remain so.

Shortages Today

This history matters because the crisis we face now is urgent. The U.S. population is declining, and baby boomers, the largest generation, are both retiring from roles in medicine and simultaneously accessing a health care system plagued by shortages. This is especially true in areas like residential nursing care and home health care. Additionally, the COVID-19 pandemic fueled a “great resignation,” with 18 percent of health care workers leaving their jobs between 2020 and 2021. The U.S. is now projected to have a physician shortage of 86,000 doctors by 2036, and that shortage is not evenly distributed. It falls hardest on rural and underserved communities that are already stretched thin.

Immigrants are a mainstay of the existing health care workforce. They make up more than a quarter of all physicians and surgeons, and account for 16 percent of all registered nurses, with many practicing in rural and underserved areas. These health care workers were recognized as critical to the country’s pandemic response. Their dedication and expertise encouraged more than half of all states to remove barriers so that internationally trained physicians (ITPs) could obtain licensure without having to repeat training. As of 2026, 27 states and territories have passed alternative pathways to licensure and added more experienced physicians to workforces.

Despite this progress, policies and outdated systems in the U.S. continue to make it difficult for immigrant health care workers to contribute.

Systems that Fall Short in Recognizing Talent

The U.S. population is not growing quickly enough to replace itself, and even comprehensive investment in the domestic workforce pipeline cannot close projected gaps on its own. Empowering immigrant workers in health care and building talent pipelines that include immigrants would benefit everyone. We all need a strong workforce that can provide adequate care to an aging nation made up of our parents, our grandparents, and ourselves. Today, more than 2 million immigrants in the U.S., including 270,000 with health care degrees, remain unemployed or underemployed. These are people who are trained and already living in communities that need their skills. The systems meant to connect these skills to those communities are often missing or so outdated that they fail to achieve their goals.

In practice, this means that ITPs who are already here are often required to repeat training and exams. Immigrant nurses face similar challenges, with yearslong backlogs for employment visas. Most recently, policy changes that revoked some immigrants’ work authorization have constrained capacity in an industry already under stress: Immigrant workers make up one-third of direct caregivers in the U.S., and the sector needs an additional 860,000 workers over the next decade just to meet the care demands of an aging population. Some facilities have already turned away clients due to a lack of staff. The U.S. recognizes that it needs international talent, but then erects barriers that keep international talent at bay.

Fixing a Broken System

When it comes to immigration and health care, our history charts a clear path forward, built on approaches that work—as the U.S. has already proved.

We need an immigration system supported by infrastructure and commonsense policies that match immigrant talent to jobs. Just as communities consider how to train the U.S.-born workforce for community needs, they also need to consider immigrants and immigration as part of their overall workforce and economic development strategy. Communities that invest in systems to integrate immigrant talent will find that, at its core, immigration strengthens our economy and addresses problems that the U.S.-born population alone cannot solve. It is a workforce strategy and a public health necessity.

As we reflect on 250 years as a nation, we learn valuable lessons from our past and clear evidence of what we’re capable of when we choose well. We must honor the best of what we have achieved thus far by building practical, values-based, humane systems that unlock existing talent, value immigrant workers, attract the workforce we require, and connect both the systems and the immigrant workers to the communities and patients that need them most.