[Congressional Record Volume 164, Number 24 (Wednesday, February 7, 2018)]
[Extensions of Remarks]
[Pages E157-E158]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        CRAIN'S CHICAGO BUSINESS

                                 ______
                                 

                       HON. JANICE D. SCHAKOWSKY

                              of illinois

                    in the house of representatives

                      Wednesday, February 7, 2018

  Ms. SCHAKOWSKY. Mr. Speaker, on February 6, 2018, Crain's Chicago 
Business published an op-ed, ``The looming crisis in health care'' by 
Sara McElmurry, a nonresident fellow for immigration at Chicago Council 
on Global Affairs. The piece highlights the effect that cancellation of 
Temporary Protected Status (TPS) and failure to extend Deferred Action 
for Childhood Arrivals (DACA) would have on Midwesterners' access to 
home care. I urge my colleagues to read this op-ed and consider the 
human consequences of anti-immigrant policies.
  Mr. Speaker, I include in the Record the following:

             [From Crain's Chicago Business, Feb. 6, 2018]

                   The Looming Crisis in Health Care

                          (By Sara McElmurry)

       When the White House unveiled a hard-line plan last week to 
     choke off immigration, it issued a threat to a crucial 
     pipeline of Midwestern workers: home health care aides.
       In the crosshairs is a region that's graying at a rapid 
     clip yet stubbornly conflicted about immigrants--a region 
     where foreign-born workers punch well above their weight. 
     Immigrants are currently 24 percent of the nation's home 
     health aides. And while they make up 13 percent of the U.S. 
     population, more immigrants are in their prime working age 
     and have a higher rate of job participation compared to their 
     native-born peers, representing 17 percent of the overall 
     workforce, according to a new report by the Chicago Council 
     on Global Affairs.
       Examining the mushrooming demand in one industry--home 
     health--illustrates the crisis to come. Analysts expect 1.1 
     million of these jobs to come online by 2026 as America's 
     population of seniors rises to 71.5 million by 2030. Chicago, 
     Columbus, Minneapolis and Cleveland are already four of the 
     top five metropolitan areas with the highest employment 
     levels for the occupation. But in a region that has lost 
     nearly a quarter of its native-born working-age population 
     since 2000, where will the Midwest find new workers to meet 
     the demand?
       Home health aides log long, physically demanding hours 
     taking care of people who cannot care for themselves and 
     helping families who need extra hands to care for loved ones. 
     They bathe and feed ailing clients, check vitals, monitor 
     medications, and change bedpans and bedsheets. These jobs are 
     certainly not glamorous and decidedly hard to fill, given the 
     physically--and emotionally--challenging duties.
       While many home health aides complete on-the-job training 
     and hold professional certificates, the positions often 
     require only a high school degree and no previous work 
     experience, making them an accessible entry point into the 
     U.S. labor force for immigrants and refugees.
       Yet these so-called ``low-skilled'' workers will prove 
     difficult to replace if the pipeline of immigrants suddenly 
     slows. Home health aides earn a mean $23,840 annually in 
     Illinois. Improved pay and benefits should be top of 
     employers' to-do lists but may prove futile in attracting 
     aging U.S.-born workers, particularly Midwesterners, who are 
     closing in on retirement themselves.
       Yet the U.S. immigration system is increasingly hostile to 
     the foreign-born talent needed to fill the gaps. The fast-
     approaching end to Deferred Action for Childhood Arrivals on 
     March 5, coupled with the Trump administration's cancellation 
     of many Temporary Protected Status programs, could hit health 
     care hard. One in five DACA recipients is employed in health 
     care, and many TPS holders--especially among the 50,000 
     Haitians who received TPS after an earthquake leveled the 
     island in 2010--work in home health care.
       Moving forward, many would-be home health aides will not 
     meet the lofty criteria of the points-based immigration 
     systems being championed by the White House. And if the 
     administration is successful in implementing its plans to 
     curb family-based immigration, end the ``diversity'' visa 
     lottery and dismantle other elements of our immigration 
     system as outlined in last week's State of the Union address, 
     the pool of foreign-born health workers will be further 
     compromised.
       In recent years, the Midwest has led the charge to bring 
     more immigrant workers into health care. Local nonprofits 
     like Chicago's Institute del Progreso Latino have pioneered 
     immigrant-friendly pipeline programs that provide language 
     skills and certifications for in-demand health care careers. 
     Several Midwestern states, including Illinois, have made 
     higher education more accessible for immigrants by offering 
     in-state tuition rates at public institutions. Missouri and 
     Minnesota have created licenses and policies that help more 
     qualified immigrants enter tough-to-fill health care jobs.
       These innovative local programs are ripe to be scaled 
     nationally. But instead, the federal government's immigration 
     crackdown threatens their success by pushing out current 
     work-authorized immigrants and limiting the channels for new 
     workers to enter the country to replace them.

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