ACA Expanded Health Coverage for Direct Care Workers, New Data Shows

March 6, 2017

For direct care workers, access to affordable coverage improved significantly under the Affordable Care Act (ACA), according to a new issue brief (pdf) published by PHI. The first published analysis of the impact of the ACA on coverage for the nation’s vast caregiving workforce,  the brief shows that half a million U.S. direct care workers gained health coverage between 2010 and 2014. During the same time period, the uninsured rate fell by 26 percent, from 28 percent in 2010 to 21 percent in 2014.

Medicaid Expansion Spurred Coverage Growth
Significantly, the PHI analysis finds that expanded Medicaid coverage contributed the most to falling uninsured rates among direct care workers: there was a 30 percent increase in direct care workers covered under Medicaid, from 17 percent in 2010 to 22 percent in 2014. Growth in public coverage was the result of new federal financing that encouraged 31 states and the District of Columbia to expand Medicaid eligibility to parents and childless adults who live below 138 percent of the federal poverty level (FPL). In states that expanded Medicaid, the uninsured rate fell by 33 percent, as compared to 21 percent in states that did not expand Medicaid.

Home Care Workers Greatest Beneficiaries of Expanded Coverage
The brief also found home care workers, 37 percent of whom live below 138 percent of the federal poverty level, made the most significant gains, with the uninsured rate dropping from 35 percent to 26 percent.

“PHI believes that affordable health coverage is critical to the health and well-being of direct care workers and to meeting the care needs of older Americans and people living with disabilities,” said Jodi M. Sturgeon, president of PHI. “When direct care workers can access health care, they don’t have to leave their jobs because of untreated illnesses or injuries, and they’re more capable of meeting the daily needs of those they support.”

60 Caregiver Issues Campaign
The Impact of the Affordable Care Act on Health Coverage for Direct Care Workers (pdf) is the third issue in PHI’s #60CaregiverIssues campaign, a national public education campaign aiming to tackle the growing crisis in paid caregiving. 

--by Stephen Campbell, PHI Policy Research Associate


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