Because national health reform must work for America’s direct-care workforce
Cindy
Marva
Linda
John
Helen
LindaUnable to afford health insurance, Cindy Ramer, a certified nursing assistant from Iowa, was forced to declare bankruptcy after accumulating enormous debt paying for her husband’s medical care.
Her husband has since died, but Cindy still lacks medical coverage.
“I don’t think it’s fair that I’m caring for people and helping them with their health care, and I don’t have adequate, affordable health care of my own,” she says.

Marva Diggins, Direct-Care Worker, Bronx, New York
Marva Diggins spends her days caring for a client in her late 80s. Marva loves her job and knows how important it is.
But Marva has diabetes, high cholesterol, and hypertension, and her health insurance plan has an annual cap of $6,500. After injuring herself in a fall, she declined to see a doctor for fear that she would exceed her plan’s expense limit.
Thousands of direct-care workers have inadequate health benefits, just like Marva. That’s why health reform must ensure that all Americans have comprehensive and affordable health coverage.
- Learn more about Marva’s story and how YOU can take action
- Download this page as a full-color handout (pdf)
When Linda Holden’s husband suffered a serious stroke, she quit her job to care for him full-time and had to give up her employer-sponsored insurance.
Fortunately for Linda, her home state of Vermont operates a robust government-sponsored health coverage program. “I know I’m lucky,” she said.
Most Americans are not so lucky, however. That’s why any meaningful health reform bill must include a national public health insurance option.
John Booker has been a direct-care worker for 30 years. He has never had employer-sponsored health insurance, and does not earn enough money to purchase private coverage.
John knows that if he or his wife ever encountered a serious health crisis, he would not be able to afford the necessary care. “It would essentially ruin us,” he says.
A national insurance exchange — a large insurance purchasing pool — would help allow workers like John and thousands of other low-income direct-care workers to obtain access to an affordable insurance plan and subsidies to pay for coverage.
Direct-care worker Helen Hanson couldn’t get affordable health coverage through her employer, so she bought a $3,200/year family plan in the open market.
Then she learned the hard way that her plan had a $10,000 deductible… per family member. “I canceled the insurance immediately,” says Helen. “It just wasn’t worth it.”
- Learn more about Helen’s story and how YOU can take action
- Download this page as a full-color handout (pdf)

Linda Bettinazzi, President and CEO, Visiting Nurse Association of Indiana County, Pennsylvania
The Pennsylvania home health care company Linda Bettinazzi runs is charged about $6,800 per worker for health insurance — $2,000 more than the national average for single coverage. One reason: nearly every one of her 175 employees is a woman.
“There is something inherently wrong in charging more just because my workers are all women,” said Linda. “There’s a great sense of unfairness,” she added, “and it makes me angry.”
- Learn more about Linda’s story and how YOU can take action
- Download this page as a full-color handout (pdf)
By 2016, direct-care workers will number 4 million, America’s single largest occupation. Health care reform that is good for direct-care workers is good for America.
Read more stories from direct-care workers.

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