By Phillip Reese, KFF Health News

The health care sector is a bright spot in the economy this year, driving nearly half of the nation’s employment gains, but economists and experts say immigration crackdowns and looming Medicaid cuts pose a threat to future job growth.

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Employers added 487,000 jobs from January to August, according to the latest nonfarm payroll data from the Bureau of Labor Statistics. The health care sector accounted for 48% of that lackluster growth, expanding by about 232,000 jobs, even though the sector employs only about 11% of workers.

“On the labor side, health care growth is driving the economy,” said Stanford economics professor Neale Mahoney.

Economists say President Donald Trump’s immigration crackdown and cuts to public insurance programs threaten to dampen that growth. They could add unease about the economy and cause headwinds for the GOP in next year’s midterm elections. The health care sector is unusually dependent on foreign-born workers, while a new law trimming federal spending on the $900-billion-a-year Medicaid program is projected, based on a preliminary version of the bill, to trigger the loss of 1.2 million jobs nationwide, according to the Commonwealth Fund.

In recent years, health care job growth has been most pronounced in the home health sector, rising by nearly 300,000 jobs to 1.82 million workers from August 2019 to August 2025, as millions of older residents hire workers to visit and take care of them, Mahoney said. Job growth has also been strong at hospitals and doctors’ offices. Nursing homes and residential care homes posted weaker numbers from 2019 to 2025 amid an increase in the number of people using caregiving at home.

Some research indicates that health care job growth is not always good for the economy. For instance, a growing number of administrators in health care may raise health care costs without providing much benefit to patients. Yet, health care jobs are considered stable and often recession-proof, and the health care industry is now the top employer in most states. Even with job growth in the sector, many places remain desperate for health care workers to meet rising demand.

But several economists said recent federal policy changes on immigration and Medicaid might drag down job growth.

If immigration crackdowns by the Trump administration continue, it could get tough for health care organizations to find enough people to hire. “Health care as an industry is pretty reliant on immigrant labor,” said Allison Shrivastava, an economist with the Indeed Hiring Lab. “It has a large share of non-native labor force, so it’s going to be impacted more.”

About 18% of Americans employed in health care were born abroad, according to 2023 Census Bureau data. And about 5% of health care workers were not citizens, including about 60,000 doctors and surgeons, 117,000 registered nurses, and 155,000 home health or personal care aides, census data shows.

Many of those workers are here legally; the Census Bureau does not track how many noncitizens are living in the U.S. with authorization. But even those with legal status, including permanent residents, may be vulnerable to deportation. The federal government deported about 200,000 people from February through August, a significant increase from prior months, according to data obtained by The Guardian.

At the same time, some health care workers may choose not to study in or move to America if they perceive it as hostile to immigrants. The number of immigrant visas issued by the United States from March to May fell by about 23,000, or 14%, from the same period last year, State Department data shows. In addition, reported unauthorized border crossing attempts have plummeted.

Shrivastava said Indeed’s job posting data shows continued strong demand for doctors among employers willing to help with the visa sponsorship process. But it’s not clear if people will take them up on the offers.

Meanwhile, Congress this summer passed what Republicans called the “One Big Beautiful Bill Act,” which was quickly signed by Trump. That bill makes about $910 billion in cuts to federal Medicaid spending over 10 years, according to a KFF analysis of data from the Congressional Budget Office.

Medicaid reductions are projected to cause millions to be without health insurance in the coming years. Hospitals, nursing homes, and community health centers will have to absorb more of the cost of treating uninsured people by reducing services and employees, or else close altogether.

The cuts could have a significant impact on the job market. California alone could see up to 217,000 fewer jobs, of which two-thirds would be in the health care sector, according to an analysis by the University of California-Berkeley Labor Center conducted before the bill was finalized and signed.

“It doesn’t mean necessarily that 200,000 people are going to lose their job,” said Miranda Dietz, interim director of the Health Care Program at the Labor Center. “Some people will lose their job, and in some cases, the job growth won’t be as fast as anticipated.”

Complicating the picture is Trump’s recent firing of the official who headed the Labor Department’s statistical branch, leading to concerns that jobs data will not be free from political influence.

It’s not clear when — or if — immigration actions and Medicaid cuts will affect hiring in the health care sector, but there are signs of potential softening. Federal data showed a significant decline in job openings in the health care and social assistance sector in July. Indeed’s job posting data also shows a decline in some health care fields, but Laura Ullrich, director of economic research in North America at the Indeed Hiring Lab, noted that, overall, postings remain above prepandemic levels.

For now, job growth is expected to remain high, particularly among nurse practitioners, physician assistants, and home health aides, according to BLS projections.

Many health care jobs require years of higher education but result in high pay, with family physicians typically making more than $240,000 a year and registered nurses typically taking in about $94,000 a year.

Joshua Lejano, president of the Sacramento State chapter of the California Nursing Students’ Association, said he is “cautiously optimistic” that he will quickly land a job as a registered nurse when he graduates in December. He said he is completing nursing clinical rotations that give him real-world experience that will condition him for long shifts.

Lejano said hospitals in his area are expanding capacity while some veteran nurses are leaving the profession due to burnout from the covid pandemic, creating openings. “Right now, I think the big thing is just staying on top of all the application cycles,” he said.

Health care jobs that don’t require as much training tend to pay much less. Median annual earnings for the U.S.’ roughly 4.4 million home health and personal care aides were about $35,000 last year, roughly equivalent to pay for waiters and waitresses, federal data shows.

The growth in health care jobs has been especially beneficial for women, Ullrich said. Nearly 80% of health care and social assistance workers are female, according to a recent Indeed study. The research found that female workers accounted for more than a million new health care jobs in the last two years.

The sector is resilient, Shrivastava said, because Americans generally do not view health care as a luxury good: They pay for it in good times and bad. Health insurance costs are on track for their biggest jump in at least five years. Also, health care spending often centers on old and very old people, a group growing dramatically as baby boomers age. The number of Americans 65 or older rose from 34 million in 1995 to 61 million in 2024.

“So many of these health care jobs are to support the growing population of older Americans,” Ullrich said. “So that’s not surprising that we’re seeing growth there. But I think what is surprising is how lopsided it is.”

Phillip Reese is a data reporting specialist and an associate professor of journalism at California State University-Sacramento.

This article was produced by KFF Health News , which publishes California Healthline , an editorially independent service of the California Health Care Foundation .

©2025 KFF Health News. Distributed by Tribune Content Agency, LLC.

By MIKE SCHNEIDER, Associated Press

Federal officials on Friday confirmed that Florida has been reimbursed $608 million for the costs of building and running an immigration detention center in the Florida Everglades, exposing it to the risk of being ordered to close for a second time.

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The U.S. Department of Homeland Security said in an email that the state of Florida was awarded its full reimbursement request.

The reimbursement exposes the state of Florida to being forced to unwind operations at the remote facility for a second time because of a federal judge’s injunction in August. The Miami judge agreed with environmental groups who had sued that the site wasn’t given a proper environmental review before it was converted into an immigration detention center and gave Florida two months to wind down operations.

The judge’s injunction, however, was put on hold for the time being by an appellate court panel in Atlanta that said the state-run facility didn’t need to undergo a federally required environmental impact study because Florida had yet to receive federal money for the project.

“If the federal defendants ultimately decide to approve that request and reimburse Florida for its expenditures related to the facility, they may need to first conduct an EIS (environmental impact statement),” the three-judge appellate court panel wrote last month.

The appellate panel decision allowed the detention center to stay open and put a stop to wind-down efforts.

President Donald Trump toured the facility in July and suggested it could be a model for future lockups nationwide as his administration pushes to expand the infrastructure needed to increase deportations.

Environmental groups that had sued the federal and state governments said the confirmation of the reimbursement showed that the Florida-built facility was a federal project “from the jump.”

“This is a federal project being built with federal funds that’s required by federal law to go through a complete environmental review,” Elise Bennett, Florida and Caribbean director at the Center for Biological Diversity, said in a statement. “We’ll do everything we can to stop this lawless, destructive and wasteful debacle.”

Bill Guerin rarely minces his words, and the Minnesota Wild general manager didn’t pick last week to start. When announcing the signing of star forward Kirill Kaprizov to a record eight-year contract worth $17 million per season, Guerin was asked if it was the most important deal in the 25-year history of the franchise.

“Yes, very much so,” he said.

There are not many questions about the impact Kaprizov can have on the ice. He is renowned as the most dynamic and talented player employed by the Wild since they entered the league as a 2000 expansion team. Since he joined the team for the 2020-21 seasons, he has been the team’s leading scorer (185 goals, 386 points).

If there are questions about the deal, they come not regarding goals and assists, but in the realm of dollars and cents, and what having the NHL’s biggest contract ever on their books will mean for the Wild. History tells us that taking big swings and making big investments in the future is exciting, and can be risky.

Fiscal fireworks

Prior to last week, unquestionably the biggest off-ice moment in Wild history came on July 4, 2012. On that hot, steamy Independence Day, then-Wild general manager Chuck Fletcher landed the two biggest fish available in the NHL free agent waters when forward Zach Parise and defenseman Ryan Suter agreed to identical 13-year, $98 million contracts.

Those salaries, with their average annual value of $7.5 million, were high for the time, but not ridiculously so — especially for a team that had missed the playoffs in each of the preceding four years and was clearly in need of a notable spark. The trouble with numbers stemmed from the lengths of the contracts, which in theory had them playing in Minnesota until 2025.

To most, it seemed like a good idea at the time, and in the short term, the Wild became an every year playoff team thanks in large part to the work of that duo. They even got to the second round of the playoffs, twice, and won two second-round games for the first time since 2003.

But there were no parades to commemorate the achievement, and by the summer of 2021 — with the players aging, their production slipping, and talk of a tense locker room — Guerin bought out what remained of their contracts. They were off the roster, but not off the books.

The four years that remained on those contracts followed the franchise in the form of a salary cap hit, and during the ensuing trade deadlines and free agency periods in 2022, 2023 and 2024, Guerin lacked the cap space to do much of anything.

The new money

In November 1989, the Minnesota Twins made, at the time, the biggest salary splash in the history of Major League Baseball by making outfielder Kirby Puckett the league’s first $3 million player. The milestone didn’t even last a full year, as Oakland slugger Jose Canseco was making $4 million a season by June 1990.

Similarly, Kaprizov’s contract will not be a record forever, with the likes of Jack Eichel, Kyle Connor and Connor McDavid all due for new deals within the coming year. And while the combined contracts of Parise and Suter claimed roughly one-fourth of the Wild’s salary cap space in the 2012-13 season, when teams could spend no more than $70 million on players, the cap for the current season is $95.5 million — and it’s expected to be $104 million in 2026.

That means Kaprizov’s salary, as history-making as it is, will comprise roughly 15 percent of the team’s salary cap. And unlike the constraints on Guerin when he was still paying Parise and Suter, he made it clear that Minnesota is still solidly in the game for free agents and trades as they plan to build around the Russian star.

“It doesn’t stop here. That’s something that we talked about. We want to win. We want to do the things that you have to do in order to win,” Guerin said. “So, you know, somewhere down the line, start to add pieces or change where necessary, or whatever. … We haven’t been able to be in the game because of our cap situation, but now that’s passed.”

That was a refrain Wild fans also heard back in July 2012. When Parise and Suter were introduced, they talked of being the first of many big name free agents who would want to work, live and win in Minnesota. Parise even suggested that they would be “recruiters,” spreading the word that the Wild sweater would be the hot fashion item for the top players of the 2010s.

It didn’t happen for various reasons, not least of which was that under the salary cap of the time, the Wild simply didn’t have the money to significantly build around their new stars. Perhaps the biggest-name free agent the Wild signed during the Parise/Suter era was former Gophers star Thomas Vanek before being bought out. But he lives here in retirement and was one of the coaches that helped Stillwater High School make a run to the boys state title game last season.

With those history lessons learned, there seems to be a determination, and financial flexibility, to do it better this time around.

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Rent increases on stabilized units took effect this week. Tenants and mayoral hopeful Zohran Mamdani rallied to protest the change, which they hope will be the last for four years.

Rent stabilized tenants marched to Gracie Mansion on Manhattan’s Upper East Side to protest rent hikes Tuesday evening. (Adi Talwar/City Limits)

Eric Adams’ re-election campaign is over, according to a video announcement from the mayor from Gracie Mansion Sunday afternoon. But his administration’s policies continue to shape New Yorkers’ lives.

On Wednesday, rent increases from New York City’s Rent Guidelines board took effect. That means rents for the city’s 1 million rent stabilized units can go up no more than 3 percent for new one-year leases, and 4.5 percent for two-year leases.

Tenants, alongside mayoral hopeful Zohran Mamdani, took to the streets to protest the rent hike, which they hope will be the last for four years.

“This policy of raising the rent year after year like we’ve seen from this administration… that is a policy that will come to an end when I am the mayor,” Mamdani said, while standing before a rent stabilized building in the Bronx at another rally Wednesday. 

If Mamdani wins, he’s promised to freeze rent-stabilized rents for four years. The mayor appoints the Rent Guideline Board members that set allowable increases.

“People are lining up at food pantries because they can’t eat and pay the rent. It’s just unbearable. We are suffering. They’re pushing all of us out. 32 years I worked, and now I am worried about becoming homeless,” said Patricia Jewett, a rent stabilized tenant in the Bronx.

Tenants marching to Gracie Mansion on Manhattan’s Upper East Side Tuesday night to protest rent hikes approved by the Rent Guidelines Board, which took effect this week. (Adi Talwar/City Limits)

The cumulative stabilized rent increase under Eric Adams’ administration amounts to 12.6 percent, according to an analysis by the Community Service Society. That would make it the largest on-term increase since the Bloomberg era, when Mayor Michael Bloomberg raised the rent 13.4 percent, 15.6 percent, and 12.5 percent over his three terms.

Building owners have pushed back against Mamdani’s idea of a rent freeze, saying that buildings with a lot of rent stabilized units don’t have enough revenue to keep up with costs, resulting in deferred maintenance.

But, “the relationship between rents paid and repairs delivered is a tenuous one at best,” countered Mamdani.

Here’s what else happened in housing this week—

ICYMI, from City Limits:

Hundreds of privately-run buildings across New York City collect federal subsidies under Project-Based Rental Assistance, which helps some 100,000 low-income tenants afford housing. But the program has major flaws, a three-part City Limits’ investigation found: paperwork errors on behalf of property managers are shockingly common, many buildings have repair and maintenance needs, and it can be hard to know who’s responsible for enforcing the rules.

During the most recent fiscal year, more New Yorkers reported not having heat in their apartments than any time on record. Here’s how to get help if your landlord won’t turn up the thermostat this “heat season,” which kicked off Oct. 1.

The federal government is shut down. But public benefits and federal housing subsidies shouldn’t see disruptions, at least through the month of October, legal experts say.

ICYMI, from other local newsrooms:

Investigators are looking into whether a boiler safety system failure is responsible for the partial collapse at NYCHA’s Mitchel Houses earlier this week, according to THE CITY.

The city hired a batch of new water ecologists to inspect buildings’ cooling towers after a deadly Legionnaires’ disease outbreak in Harlem this summer, Gothamist reports.

Two prominent political clubs are throwing their weight behind the housing-related Charter change measures on the ballot next month, which would reform the city’s land use approvals process, according to City and State.

The New York Times looks at what the city’s next mayor can do to address student homelessness.

The NYPD plans to expand the number of NYCHA campuses where a free internet program is being used to tap into security cameras, according to New York Focus.

To reach the reporter behind this story, contact Patrick@citylimits.org. To reach the editor, contact Jeanmarie@citylimits.org

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The post Tenants Protest Final Rent Hike Under Eric Adams, and What Else Happened this Week in Housing appeared first on City Limits.