Lori Dwyer

Nothing could be more nightmarish than having a sick child or a parent in crisis — and not being able to get them the immediate care they need.

In Maine, this nightmare could become real, as many health care providers in Maine are cutting back because they cannot find workers. Rural areas have been hit the hardest by the shortage of health care professionals.

This is not a new problem in Maine, but the pandemic has made it much worse.

There is a potential solution: hardworking and talented immigrants live in our communities and are already making crucial contributions. Allowing these Mainers, many of whom have spent most of their lives here, to earn citizenship could help us move out of the labor crisis.

In Maine and across the country, Dreamers, temporary protected status-holders, and immigrant essential workers are the backbone of the health care sector. An estimated 236,300 undocumented immigrants nationwide work as health care practitioners or in support occupations, from registered nurses to home health aides. Another 109,900 essential workers who lack permanent legal status work in health care settings as service managers, receptionists, housekeepers, janitors, and cooks.

Immigrants without permanent legal status are already part of our communities. They are making life-saving contributions and, in many cases, putting their own health at risk during the pandemic. All they ask in return is the dignity and safety that comes with legal status and citizenship. If Maine’s congressional delegation is serious about meeting Mainers’ health care needs, especially in rural areas, they will fight to ensure passage of common sense pathways to earned citizenship in 2022. Maine can’t wait.


Politically, this should be a no-brainer. A bipartisan poll of voters in battleground states, commissioned by the American Business Immigration Coalition, found 3-to-1 support for including pathways to citizenship in the bill. Support was widespread across the political spectrum, including majorities of Trump voters and self-identified conservatives, in light of immigrants’ economic contributions.

As the leader of Penobscot Community Health Care — serving more than 60,000 patients a year in Penobscot, Somerset and Waldo counties, 70% of whom are seniors or have lower incomes — I know how hard it is to recruit health care workers at every skill level – medical, dental, mental health, social work, and other specialty providers. My 850 colleagues work tirelessly every day to meet PCHC’s mission to provide health care and related services to everyone, especially the most vulnerable Mainers, regardless of ability to pay.

But we urgently need to fill over 100 existing vacancies and expand our workforce to meet rising community health care and housing needs. And staffing pressures are accelerating with good policy changes, such as the extension of MaineCare to include preventive dental coverage for adults. While thousands of Mainers will have much-needed access to preventive dental care, PCHC and all dental providers in the state will need additional staff to meet the need.

In fact, PCHC has quadrupled its recruiting budget over the past three years, now investing $1 million annually to attract qualified employees. Seventy-five percent of our physicians are at or near retirement age, which means this problem is going to get worse over the next five years.

Maine has long been the oldest state in the nation, with more than 20% of our population older than 65. As Maine’s population continues to age, and Baby Boomer health care professionals retire, immigrants provide a hardworking and skilled workforce that can help solve our labor shortage and grow our state’s economy. In addition, immigrant health care providers diversify our workforce, which leads to innovation, stronger collective intelligence, and the benefits of varied perspectives.

Our current immigration system imposes trauma on good and decent people. I have personally watched families experience the agony of living with uncertainty in legal limbo. The human costs alone are reason enough to provide a path to earned legal status and citizenship.

Welcoming immigrants to our state is not simply about loving one’s neighbor or doing what is morally right, although both of those principles reflect our Maine values. It is also about making sure you and your loved ones get the care you need when you need it.

Lori Dwyer, J.D. is the president and CEO of Penobscot Community Healthcare, the largest federally qualified health center in Maine and a member of the Maine Business Immigration Coalition, a partner of the American Business Immigration Coalition.

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