PRESS RELEASE
For Immediate Release
October 27, 2009

Contact: Deane Beebe
Media Relations Director
dbeebe@PHInational.org
718.928.2033 / 718.812.5586

Experience of Massachusetts Eldercare and Disability Service Providers Suggests Public Options Essential to Health Coverage

New York, NY — Less than one-fifth of Massachusetts direct-care workers — nursing home assistants, home health care aides, and personal care attendants — are enrolled in employer-sponsored health insurance plans, primarily because they are too costly, according to a new study on the impact of Massachusetts health reform on the state’s largest and fastest-growing employment sector.

A new study from PHI, a national nonprofit organization working to strengthen the eldercare and disability services workforce, done in collaboration with Amy Lischko, DSc, assistant professor in the Department of Public Health and Community Medicine at Tufts University School of Medicine, found that most employers in this sector offered employer-based insurance but their direct-care employees did not enroll.

Many workers are caught in a bind. If they are offered employer-sponsored health coverage, direct-care workers, whose wages primarily come from public programs such as Medicare and Medicaid, cannot access Massachusetts’ less-expensive subsidized health insurance programs. As a result, many choose to work part-time and enroll in either MassHealth or Commonwealth Care.

“This disincentive to work undermines state efforts to build a quality, stable direct-care workforce,” says PHI Massachusetts Policy Director Amy Robins. “Direct-care work is among the state’s fastest-growing job sectors, yet full-time workers really can’t afford employer-based insurance.”

Massachusetts employs nearly 100,000 direct-care workers, and direct care is among the top 10 fastest-growing occupations.

“While considering proposals to expand access to health care coverage, Congress must heed what we learned from the Massachusetts model: it has done nothing to lower the cost of employer-sponsored health coverage, making it prohibitive for low-wage, direct-care workers and their employers,” said Carol Regan, author of the report and PHI government affairs director.

“Congress must create public and publicly subsidized options to ensure that low-wage, direct-care workers have access to quality, affordable health care coverage. It’s the right thing to do and will also help meet the nation’s rapidly growing demand for this critical workforce that provides eldercare and services to people with disabilities,” Regan said.

Nationally, there are currently 3 million direct-care workers. That number is projected to grow to 4 million by 2016, becoming our nation’s single largest occupational group. Direct-care workers lack health coverage at twice the rate of the nation’s general population.

Coverage for Caregivers: Lessons from Massachusetts Health Reform, based on a survey of nursing home and home care providers conducted three years after Massachusetts legislated health reform, reports that eldercare and disability service sector employers use eligibility requirements to limit access to employer-sponsored coverage and to help employees access Commonwealth Care.

Nearly half of all direct-care workers were ineligible for employer-sponsored coverage due to their part-time work status or a waiting period. Nursing home assistants were more likely to be eligible for employer-sponsored insurance coverage — 70 percent — compared with only 39 percent of home care workers. Only 12 percent of home care workers have employer-sponsored insurance coverage.

In Coverage for Caregivers: Lessons from Massachusetts Health Reform, researchers recommend that for Congress to significantly improve access to quality, affordable insurance for direct-care workers and their employers, the following provisions should be included in health reform legislation:

• Support the inclusion of a national, publicly operated health insurance option.
• Allow all eldercare/disability service employers access to the proposed insurance “exchanges” or “gateways” regardless of size.
• Ensure adequate federal subsidies to low- and moderate-income workers and their families.
• Expand Medicaid to include all individuals earning up to at least 133 percent of the federal poverty level.

More information on the recommended federal and state action steps, as well additional key findings, are included in Coverage for Caregivers: Lessons from Massachusetts Health Reform, Findings from a Survey of Eldercare and Disability Services Employers.

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PHI (www.PHInational.org) works to improve the lives of people who need home and residential care — and the lives of the workers who provide that care. Using our workplace and policy expertise, we help consumers, workers, employers and policymakers improve eldercare and disability services by creating quality direct-care jobs. Our goal is to ensure caring, stable relationships between consumers and workers, so that both may live with dignity, respect, and independence. For more information about PHI PolicyWorks and our Health Care for Health Care Workers campaign, visit: www.PHInational.org/policy and www.coverageiscritical.org.