Our Position

Affordable health coverage, along with better wages, is essential to improving the lives of direct-care workers and their families. In addition, providing access to health insurance is critical to workforce recruitment and stability, and ensuring quality care for elders and people with disabilities.

What We’re Doing

• Monitoring state efforts to improve direct-care workers’ access to affordable health insurance.
• Advocating, through our HCHCW campaign, for better health insurance for all direct-care workers at the national and state levels.
• Creating policy options for improving coverage through payment policy reform.

Background

Ironically, many direct-care workers do not have access to health care themselves. One in every four nursing home workers and a third of home care workers lack health insurance coverage. And access to health insurance is particularly problematic for the 43 percent of direct-care workers who work less than full-time.

Direct-care workers find themselves uninsured for a number of reasons: they are not offered coverage by their employers, they are ineligible for health benefits because they are part time or new hires, they cannot afford to participate in their employer’s health insurance plan, or they are self-employed. In addition, direct-care workers tend to have high injury rates and are more likely to be living with chronic health conditions. This makes their insurance coverage more expensive and less affordable to both workers and their employers.

While securing health coverage can be difficult for many direct-care workers, we know that this coverage can play a powerful role in recruitment and retention. Researchers have found a strong, positive link between health insurance benefits and retention for direct-care workers. In fact, several recent studies show that, for these workers, the provision of health insurance may play a stronger role than wages alone in promoting retention and recruitment.