Last week, the Social Security and Medicare Trustees released a doom-and-gloom report concerning the financial future of these cornerstone programs. The report’s only bright spot — that the U.S. may have pushed off insolvency by a single year — is little consolation as our country faces the triumvirate of an aging population, the lowest birthrate since the census has kept track and rising federal debt.
These generational realities call for solutions at scale. Renewing America’s commitment to thoughtful immigration policy is precisely the lifeline that Medicare and Social Security so desperately need. Welcoming more newcomers promises to replenish the American workforce and create a larger pool of contributors to the beleaguered systems vital to supporting older Americans.
While false xenophobic narratives around immigration suggest that our country is full, the reality is that immigration, far from being a drain on resources, would help ensure that Social Security and Medicare remain viable, sustainable programs. What nativists consistently miss is that immigrants offer direct economic and tax contributions, demographic rejuvenation and the health care workforce to adequately care for an aging population.
In terms of economic contributions, immigrants represent a diverse pool of talent and skills for our workforce, which in turn stimulates economic growth.
In fact, according to the nonpartisan Congressional Budget Office, immigration will help bolster the U.S. economy by about $7 trillion over the next decade and generate approximately $1 trillion in federal tax dollars. Fiscal benefits are not limited to high-skilled immigrants on labor visas either; according to a new Department of Health and Human Services study, refugees and asylees alone made a net positive contribution of nearly $124 billion dollars to local, state, and federal tax coffers from 2005 to 2019.
Addressing labor shortages, which have resulted in 8.5 million vacancies, would also bolster the tax base that funds Medicare and Social Security. In fact, immigrants are 80 percent more likely to start businesses, thereby creating jobs, spurring innovation and strengthening our broader economy.
Additionally, immigrants directly contribute to both programs through payroll taxes, including undocumented immigrants who contribute billions of dollars to a benefits system they will likely never be eligible to access themselves.
With an aging population and native-born birth rates at an all-time low, immigration also offers much-needed demographic rejuvenation, which is essential for both Medicare and Social Security to survive. By welcoming more immigrants, we revitalize the workforce and support a larger pool of contributors to these programs.
Study after study has shown that immigrants tend to be younger, work for longer and boast higher birth rates, helping offset the current demographic imbalances our country grapples with.
Beyond funding for the social safety net, the U.S. also must address the inadequate supply of direct healthcare workers. According to government estimates, in less than a decade, the country could face a shortage of nearly 200,000 nurses and 124,000 physicians. Immigrants are essential to making the math work, with foreign-born workers already making outsized contributions among certain healthcare occupations, comprising 26 percent of physicians and surgeons and 40 percent of home health aides.
Especially in the wake of the exodus of healthcare workers during the pandemic, immigrants have a critical role to play in alleviating the staffing shortages every hospital and nursing home faces today.
According to a 2022 American Health Care Association survey, 61 percent of nursing home providers reported limiting new admissions due to staffing shortages. Immigrant healthcare workers are well positioned to fill these gaps, and in so doing they bring diverse cultural perspectives and language skills that can improve access to care and health outcomes for underserved communities as well.
While insolvency challenges are daunting, measured and strategic immigration solutions are readily available. Removing dependents and children from the numbers of employment-based immigrants who count toward visa caps, for example, would admit more people of working age. Other solutions include regularizing marginalized communities such as Dreamers and other undocumented workers and clearing bureaucratic backlogs that hamper our country’s ability to recruit talent in a timely manner.
Congress should also seek to expand immigration pathways for direct health care workers. One such possibility is a Brookings Institute proposal to create a dedicated visa category for healthcare workers, whose current labor pathway options are either capped, temporary or seasonal. Under the proposal, employers would petition for workers to come to the U.S. for three years, renewable for a second term, and allow these healthcare visa holders to eventually petition for permanent residency.
Amid this fiscal reckoning, reforming our immigration system is key to bringing Social Security and Medicare one serious step closer to sustainable solvency. But such immigration reforms will require real leadership rather than the political grandstanding that has become par for the course in Congress.
Lawmakers would be wise to consider voter sentiment when it comes to these programs; only 17 percent support raising the retirement age, while 65 percent of Americans think the U.S. should make it easier for anyone seeking a better life to enter legally.
It’s long past time for elected officials to recognize that our country’s competitive advantage lies in the enduring desire of people to build a future here. There is a price we pay for stubborn, knee-jerk opposition to newcomers, and unless policymakers take action, older Americans will be unfairly forced to bear that cost.
Krish O’Mara Vignarajah is the president and CEO of Global Refuge.