BS Summary: This article contains 35 faulty reasoning types, including Post Hoc (False Cause), Appeal to Emotion, and Anecdotal, with Negativity Bias as the most egregious example at 22.8% saturation with 521 hits. Analysis detected 3,961 faulty-reasoning hits from 2,281 analyzed words, generating a BS Score of 54.6% and a BS Rank of 57% (8,401 of 19,233 articles). This article is worse (more manipulative) than 56.30% of the article peer group.
Representatives of health care workers’ unions listen as Archbishop Thomas Wenski, of the Archdiocese of Miami, speaks urging the Trump administration to maintain TPS protection for Haitians, January 27, 2026, in Miami.
They come from Haiti, Mexico, the Dominican Republic, Uganda, Jamaica, the Philippines, and dozens of other nations.
They serve people who may be aging, frail, sick, disabled, dying; often frightened, sometimes angry and unappreciative.
They bathe their clients, change adult diapers, supervise medications, and provide companionship in relationships that are intimate as well as professional.
Their compassion can be ennobling.
These are the people Donald Trump hates.
America today faces a worsening shortage of care workers, as the population ages, needs expand, and deportations increase.
Too few people are willing to work for low pay in nursing homes, hospice care, home care, and as personal care attendants for people with disabilities.
These jobs start at $20 an hour or less, and max out at around $25 for experienced people.
Anyone who has personally encountered care workers notices that despite the low pay, they tend to be both skilled and kind.
The label, care , is exactly the right term.
In my own experience with loved ones reliant on nurses and aides, most care workers are deeply caring.
One of my sources for this story ran into a nursing home worker he knew and asked her how it was going.
She explained that she was now working as a checkout clerk.
“I can make more money and I don’t take the work home,” she said.
Care work is heavily funded by government, except for a minority of affluent clients who can self-pay.
Hospice care is financed by Medicare.
Long-term nursing home care is mostly reimbursed by Medicaid.
Care that supports independent living for people with disabilities is funded by Medicaid or the VA.
Home care is underwritten by several agencies.
All of these sources of public funding are barely adequate to the need, and that severely limits the room for better pay.
And all are under further threat from Trump budget cuts as well as mass deportations.
In heavily Democratic states, the strategy of the labor movement and other advocates has been to press allies in government to allocate more budget for reimbursements, typically through Medicaid, which in turn can translate into better pay.
Unions also organize workers directly.
This has had only limited success because of other financial demands on Medicaid.
SEIU has focused on nursing home workers.
In Massachusetts, modest increases in Medicaid funding have created a bit more space to press for higher wages.
SEIU’s big health local 1199 has organized certified nursing assistants in about 9 percent of Massachusetts nursing homes.
According to Massachusetts SEIU leaders, CNAs in unionized nursing homes start at around $22-$23 an hour.
That union premium makes life better for these workers but is far from sufficient to increase worker supply.
But now there’s a whole other problem care workers must contend with.
People hold Haitian flags and signs during a rally in support of immigrants living in the United States with Temporary Protected Status, July 9, 2026, in San Diego.
Credit: Gregory Bull/AP Photo
TRUMP’S WAR ON IMMIGRANTS has cut deeply into the care workforce.
The strategy of using ICE to intimidate immigrant workers into self-deporting, even when they currently have legal work status, is all too effective.
New York City Mayor Zohran Mamdani recently told an interviewer , “I went to a Dominican barbershop in Harlem, and the owner was telling me that everyone in the barbershop had [legal] status.
And yet most of them were terrified to come to work because they know that for so much of ICE’s operations, it has little to do with legality.
It has to do [with] profiling, and it has to do with a vision of creating the largest deportation machine this country has ever seen.”
Separately, Trump has been systematically ending a legal immigration system called Temporary Protected Status.
When Trump’s second term began, TPS was protecting some 1.3 million people facing various perils in their home countries.
However, Trump has already ended TPS for people from Afghanistan, Cameroon, Honduras, Liberia, Nepal, Nicaragua, and for most Venezuelans.
Venezuelans, with more than 600,000 protected refugees in the U.S., had accounted for almost half of the people with TPS.
That number has been cut to fewer than 60,000.
El Salvador, with more than 170,000 people with TPS, could well be next.
“I have lived here for 28 years,” says José Palma, a Salvadoran who serves as coordinator of the National TPS Alliance .
“I could be deported on 60 days’ notice.”
In effect, Trump has converted TPS from a humanitarian program into an extension of U.S. foreign policy.
“If you are supporting a brutal regime such as El Salvador’s, why would you want to accept refugees from that regime,” says Alexandra Piñeros Shields, a leading Massachusetts immigrant rights activist and an associate professor at Brandeis University.
The Supreme Court’s June 25 decision in Mullin v.
Doe gave the president even more power to arbitrarily end TPS.
Roughly 331,000 Haitians in the U.S. with protected status are now at risk of summary deportation.
Some 30 percent of Haitians are estimated to work in the care economy.
Because of technicalities in the Court ruling, which requires lower courts to rescind earlier orders safeguarding Haitians, a decision by the administration has been delayed until this Friday, July 24.
But according to Ruthzee Louijeune, a Haitian American who serves on Boston’s city council, “People have been already kicked out of their apartments and at least one nursing care agency has started terminating employees,” on the assumption that TPS will soon end.
There is a slight chance that Haitians will get a longer reprieve.
The House has passed a bill protecting Haitian TPS.
Ten Republicans, including three from South Florida with its large Haitian community, voted with Democrats.
The Senate could act on the bill as soon as this week.
There is also pushback from industries that employ Haitians.
Haitians were granted TPS by the Obama administration in 2010 after a devastating earthquake killed over 100,000 people.
Since then, the political situation in Haiti has worsened, and the country is basically run by armed gangs.
The U.S.
State Department classifies Haiti with a Level 4 Do Not Travel advisory.
This is the most severe classification, issued due to widespread violent crime, kidnappings, civil unrest, terrorism, and lack of health care infrastructure.
Nonetheless, the first Trump administration tried to end TPS for Haitians.
Because of the extreme conditions in Haiti, that effort was blocked by lower courts.
But with the recent Supreme Court ruling, the protection is now gone.
Despite the pushback, advocates are not optimistic that Trump will relent.
Stephen Miller’s agenda is simply to demonize immigrants, except for white South Africans.
In his decision in the Mullin case , Justice Samuel Alito tiptoed around the plain racial implications of targeting Haitians while favoring South Africans.
“None of the cited statements by either the President or the Secretary [on Haiti] was overtly racial, and in substance all expressed policy views that could rest on race-neutral justifications,” he wrote.
Ai-jen Poo, the founder of the National Domestic Workers Alliance and the coalition Caring Across Generations, told me, “The end of Haitian TPS will be devastating for hundreds of thousands of families who rely upon Haitian care workers.
Providers will close their doors, jobs will be lost—for citizens as well as immigrants.
The entire industry was already buckling under the pressures of cuts to Medicaid, and high workforce turnover due to low wages.
At a moment when the need for care is surging, particularly on the part of our growing aging population, we should be expanding and strengthening our care workforce, not gutting it with cruel and misguided policy.”
THESE SHORTAGES IMPACT different kinds of care workers and their clients in somewhat different ways, all of which add up to more pressure on the people left to do the work and reduced services for clients.
In the case of hospice care, the result is a kind of rationing.
Hospice care is now mostly in-home end-of-life care.
The goal is to allow death with dignity.
Visiting registered nurses offer palliative care, while direct care workers help stressed family caregivers with such activities as bathing, toileting, feeding, and occasional respite.
They also provide companionship to the dying person, in situations where family relationships are sometimes fraught.
According to Sarah Creed, the vice president of nursing operations at Good Shepherd Community Care, Boston’s oldest nonprofit hospice, “It’s gotten worse in the last year and a half.
We have not been able to find enough people.”
Creed told me that the fear of being deported may be decreasing the potential workforce pool.
“We make sure that people get the care they need,” Creed said.
“It just means that sometimes nurses are the ones providing personal care for a period of time, which adds to their workload.
Sometimes, if aides are unavailable, nurses provide bathing and other forms of care, adding to the stresses on RNs.”
At some hospices, there are waiting lists for care.
Aides who provide hospice care work as many as 60 hours a week, sometimes staying overnight, on top of very long commutes.
The places where they can afford to live are typically far from metro Boston.
In the case of people with disabilities, there is a whole other system, but similar shortages.
Ever since the disability rights movement of the 1960s, the philosophy has been individually directed independent living.
“Fundamental to independent living is the right to have agency,” says Bill Henning of the Boston Center for Independent Living.
This means that people with disabilities who qualify for Medicaid payments to hire personal care attendants (PCAs) must find them, catch as catch can.
There is no central registry of PCAs, and the disability rights movement wants it that way.
“We have some tremendously dedicated PCAs,” says Henning.
“You can see people’s humanity.”
But not enough of them.
Some people with disabilities rely on spouses or partners, who can qualify to be paid PCAs, which is fine as long as the relationship holds up.
Others find PCAs by word of mouth, even on Craigslist.
The system more or less works until low pay and deportations create shortages.
According to Henning, shortages are already severe and will worsen if Haitians are deported.
Child care is unique in that it is both chronically underpaid and unaffordable.
The few oases of high-quality programs that blend day care with learning require education credentials and compensate workers on a par with kindergarten teachers.
The rest treat day care as babysitting and pay accordingly.
LONG-TERM, THERE ARE two solutions.
First, we need massive investment in caregiving work, so that different categories of care are not reliant on a patchwork of chronically inadequate funding.
Second, the war on immigrants needs to end.
Tragically, the Biden administration proposed a transformative, trillion-dollar federal investment in caregiving, as part of the Build Back Better Act.
But those provisions were stripped from the bill after then-Sen.
Joe Manchin (D-WV) refused to support them.
The bill would have provided free, high-quality preschool for all three- and four-year-olds, limiting child care costs to no more than 7 percent of income.
It would have also significantly increased funding for home care through Medicaid.
Even this proposal was only a start on adequate federal support that could increase earnings for care workers as well as expanding services.
A successor Democratic administration could pick up where the Biden proposal left off.
After Trump finally leaves office, Congress could also resume its efforts to enact comprehensive immigration reform, which was fast-tracked for passage in early 2018 until Trump decided that he’d prefer to use immigration as a political cudgel and persuaded key Republicans to oppose it.
Comprehensive immigration reform would regularize the status of long-term undocumented residents who have stayed out of trouble, give legal status to “Dreamers” who were brought to the U.S. as children, and crack down on employers who hire people not entitled to work.
Absent Trump, enough Republicans would still support this formula.
We also need major reform of TPS, which is badly flawed.
TPS, passed in 1990, was Congress’s response to litigation that resulted from the Reagan administration’s refusal to carry out the terms of the Refugee Act of 1980, which was sponsored by Ted Kennedy and signed into law by President Jimmy Carter.
That law created a refugee resettlement program, and recognized any individual with a “well-rounded fear of persecution” as a bona fide refugee.
But despite civil wars in El Salvador and Guatemala, the Reagan administration classified Salvadoran and Guatemalan refugees as “economic immigrants” rather than political asylum seekers.
That enabled the administration to deport Salvadorans and Guatemalans before allowing them to file asylum cases.
In response to litigation challenging Reagan’s actions, the Bush administration and Congress invented TPS as part of the Immigration Act of 1990.
But instead of requiring the executive branch to follow the law, the TPS provisions give broad discretion to the attorney general and to immigration judges who report to the Justice Department rather than being part of the independent judiciary.
The latest Supreme Court decision in Mullin v.
Doe confirms bad law and reinforces executive discretion.
Congress should revise the law so that admission of asylum seekers and refugees is mandatory, not optional; and shift judicial review to the independent judiciary established in the Constitution.
America has plenty of immigrants who want to work in the care economy.
We should welcome that workforce and pay them decently.
The post The Crisis of Care Work appeared first on The American Prospect .
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