This study examines the relative wages of citizens and noncitizens employed as healthcare support workers as well as examines the effect of noncitizen support worker employment on the wages of citizen support workers. Relative wage findings reveal noncitizen support workers with less than eight years of US residency receive a noncitizen-citizen wage discount statistically significantly greater than the legal maximum of 5% below the local prevailing wage. These low relative wage levels could contribute to lower wages for citizen support workers, however elasticity of substitution findings suggest noncitizen support workers are not close substitutes for healthcare support workers who are US citizens. In addition, wage effect findings do not reveal a negative influence of noncitizen employment on the wages of native born US citizen support workers, while these findings reveal a relatively small wage decline for naturalized support workers. These findings are consistent with the citizen status job heterogeneity hypothesis. Nonetheless, finding noncitizen-citizen wage differences does not allow for ruling out the possibility of weak enforcement of prevailing wage legislation and possible employment of undocumented workers.