Scores of immigrant families are grappling with potential job loss and closing of businesses in the wake of the Trump administration’s plan to rescind a regulation granting work permits to the spouses of certain H-1B workers.

But the effects go even further, as those who were able to secure the work permits made life-changing decisions based on them.

The availability of the work permit allowed Praneetha Korlepara to finally buy a house with her husband. The two, from India, previously lived in separate areas of the U.S. because they both had H-1B specialty occupation visas and couldn’t get employers in...