Monthly Archive for September, 2008

Every fall the federal government releases its annual report on income, poverty, and health insurance coverage in the United States.  This year it held good and bad news when it came to health insurance coverage.

The good news is that the number of people without health insurance decreased since 2007, from 47 million to 45.7 million.  The bad news is that while the decline is good, 45.7 million Americans without coverage is still a staggering number of people going without basic health insurance coverage.  Why the decline?  It’s because of critical public insurance programs such as the State Children’s Health Insurance Plan (S-CHIP) and Medicaid.  The number of people covered by these government health insurance plans increased to 83 million, up from 80.3 million in 2006.

However, the percentage of people covered by employment-based health insurance decreased slightly from 59.7 percent in 2006 to 59.3 percent in 2007.  Without the public programs as a safety net for America’s working families and children, the number of uninsured would have risen again as it has over the past years.

This is important for advocates of insurance coverage for low-wage workers and their families, including direct care workers.  Fewer employers are offering coverage to direct care workers, as PHI-Health Care for Health Care Workers recent report, The Invisible Care Gap: Caregivers Without Coverage (pdf), documents. Many workers live in households that depend on public benefits which have filled important gaps in coverage for those without employer insurance.

The need to guarantee affordable health coverage to all American families couldn’t be greater, and we can expect to hear more about it during this election season.

Carol Regan
National Director
Health Care for Health Care Workers
cregan@phinational.org

This week Pennsylvania legislators will decide whether or not to increase access to affordable health care  for 250,000 Pennsylvanians – including many direct-care workers – who have no health insurance. 

We need your help today.   Senate Republicans have not yet agreed to the plan passed by the House and agreed to by the Governor.  Time is running out. If agreement is not reached by Friday, October 3rd, the clock will run out on this legislative session and this opportunity will be lost.

What can you do?  Call or email your State Senator and ask him/her to support PA-ABC – the bill that will provide affordable health insurance for thousands of Pennsylvanians.  Remind your State Senator that the funding set aside for this bill can only be used for health care – nothing else.  You can find the name and contact information for your State Senator at http://www.pasen.gov/ Just enter your zip code in the upper right-hand corner of the page. 

CALL or EMAIL your State Senator today!
Ask your Senator to support the bill to provide affordable health insurance to thousands of Pennsylvanians

Background: Pennsylvania currently has a subsidized health insurance program called adultBasic – but right now enrollment is full and there is a long waiting list.  The Pennsylvania House and Governor Rendell have proposed to increase enrollment in adultBasic to 250,000 individuals over the next five years.  The premium amount would depend on your income.  The money to fund this program will come from a combination of existing tobacco taxes, contributions by Blue Cross/Blue Shield health insurance companies, the $500 million surplus in an existing state health fund, and federal matching funds.  No new taxes would be involved and this funding can only be used for health care.

As someone who works in long term care and provides care for hundreds and thousands of consumers, you know how crucial it is to have accessible and affordable health care. Perhaps you or someone you know has delayed treatment for a serious medical condition because of lack of health insurance. You can make a difference. We urge you to call or email your Senator today!

Health care reform is likely to be one of the top issues for the next President and Congress.   Rising costs, declining quality, and millions without coverage are problems that can no longer be addressed by band aids, and business, labor, consumers and elected officials from both parties are saying “enough!”

So what are the presidential candidates talking about when they say they have a plan to fix our health care system?

Families USA, a is a national nonprofit, non-partisan organization dedicated to the achievement of high-quality, affordable health care for all Americans, and a voice for health care consumers for over 25 years has recently published a report that examines the key differences between the positions of Barack Obama and John McCain.   If health care matters to you and you want more information about what the candidates stand for, this may be helpful for you: Comparing the Candidates’ Positions on Health Care.

And we’d like to hear what YOU think.  Please, take a minute to let us know what health care means to you as a direct care worker; as a long-term care employer; as a consumer of long-term care services; or as an advocate or policymaker who cares about health reform.   You can post a comment or email me directly at cregan@phinational.org.

Carol Regan
Director
PHI’s Health Care for Health Care Workers Campaign
cregan@phinational.org

Last week, the Pennsylvania Health Access Network, of which HCHCW-PA is member, held a rally in Harrisburg to call on the Pennsylvania State Senate to pass bills that would provide health insurance coverage to thousands of uninsured Pensylvania residents – including many direct-care workers.

Lori Michael, the owner of a home nursing care company in Schuylkill County and an advocate for HCHCW, cited unaffordable health coverage as a major business issue.  Lori spoke about the impact the lack of affordable health insurance has on her ability to retain and recruit direct-care workers to serve the ever growing client base.  “People in Pennsylvania want to age at home,” said Lori Michael, owner of Lori’s Angels in Schuylkill Haven. “We want to help them do that. We need help from state government.”   The rally and Lori’s comments were covered in the Scranton Times and on PCN network.

PA State Senators are back in session and poised to take up health reform over the next two weeks.  If you live in PA, take time now to call your take Senator and urge them to pass health care reform legislation this year.  To find your Senator, visit http://www.pasen.gov/

As part of the Put Michigan People First Coalition, PHI-HCHCW received the President’s Recognition Award from the Michigan Association of Health Plans.  This award was presented to us for being,” one of the key advocates for the “Put Michigan People First Coalition” which has made a positive impact on promoting consumer advocacy as well as accessibility and affordability to health care coverage in Michigan.”

As part of the Coalition, HCHCW has been working to make sure that the needs of direct-care workers are not forgotten in the individual market reform debate.   The Coalition has and will continue to advocate that the following components be present in the legislation that is finally passed later this year:

• Continues the non-profit status of Blue Cross Blue Shield of Michigan and its social mission as Michigan’s insurer of last resort, accepting all who apply.
• Retains the six-month waiting period before insurance benefits begin for people with existing conditions and extends this concept for all health insurance companies in Michigan.
• Excludes the creation of a “high-risk” pool that would result in increased health insurance premium costs for those who are older and sicker.
• Protects consumers with appropriate regulatory oversight by the attorney general and the Office of Financial and Insurance Regulation (OFIR).
• Implements no significant changes to Blue Cross’ rating methodology that would include the consideration of health status.

If you would like to write your legislator about this issue, please contact Tameshia Bridges at (517) 372-8310 or tbridges@phinational.org for more information.

Tameshia Bridges
Michigan Senior Workforce Advocate
PHI/HCHCW
tbridges@phinational.org

Medicaid and Medicare are often referred to as central pillars of America’s health care safety net.  A recent analysis of U.S. Census data on the uninsured (pdf) by Raising Women’s Voices, shows that the availability of public coverage has contributed to the decline in uninsured Americans from 47 million in 2006 to 45.7 million in 2007.  For many women, public coverage is more than a safety net – it is a vital source of health insurance coverage, with almost 29% of women relying on public coverage to meet their health care needs.

We see this trend among direct-care workers as well.  About one-third of direct-care workers live in a household that receives Medicaid benefits.  It is often the children of direct-care workers that receive coverage through the State Children’s Health Insurance Program (SCHIP).  And, in some states that have broad eligibility standards,  workers themselves are covered by Medicaid or other public coverage.

Expanding access to public coverage has been one key strategy for the Health Care for Health Care Workers campaign.  With the cost of health insurance coverage rising and the wages of workers not keeping pace, employer-sponsored health insurance remains out of reach for many direct-care workers.  While we also advocate for strategies that make employer sponsored insurance more affordable, in many cases public programs provide necessary coverage when workers have nowhere else to turn to meet their health care needs.

As states look at expanding or making changes to public programs, it is important that they remember the health care needs of direct-care workers.  The income standards need to be high enough and available to people without children so that more workers can be eligible for this coverage.  We have heard many times that workers are often not eligible for public programs because – with an average wage of $9.56/hour – they make too much money or they do not have children.

Public coverage programs also need to provide comprehensive coverage with the services that direct-care workers need - like disease management to help monitor diabetes or physical therapy to help a worker get back on her feet after an injury.

Finally, coverage has to be accessible. Just providing people with a card is not enough. Public programs have to have enough doctors, dentists, hospitals, and other providers in their networks so that people can get the care when they need it.

We are excited to be working in states as advocates to sure that public coverage is affordable, comprehensive, and accessible to workers. It is a critical foundation that many rely and it needs to be made stronger.

Tameshia Bridges
Senior Workforce Advocate
PHI/HCHCW
tbridges@phinational.org

Now that the two conventions are over and the platforms for the Republican (pdf) and Democratic (pdf) parties have been approved, it’s clear that health care is a national priority for this election — and, hopefully, beyond.  But which party’s plans would do the most to help direct-care workers?

Both health care plans would help direct-care workers by focusing on such things as chronic disease management, ensuring portability, and eliminating pre-existing condition exclusions.  But the Democratic platform provides more specific provisions aimed at guaranteeing access to affordable insurance.

The Democratic Platform

The underlying principles set out in the Democratic platform’s section on health care begins with making sure every man, woman and child has access to quality, affordable health care. It also includes:

• Affordable quality health care is essential to making workers productive and businesses competitive;
• Affordable coverage should be subsidized through tax credits and other means;
• Health care coverage should be a shared responsibility between the worker, employers, insurers, providers and government;
• Disparities in health coverage should be ended among minorities and low-income people;
• Americans should have a choice between keeping their private coverage and public health plans; and
• Government should ensure that all Americans should have meaningful and affordable coverage.

The Democratic plan also addresses the need to build a strong health care workforce, specifically mentioning direct-care workers as part of that workforce.

The Republican Platform

The Republican platform calls for:

• Disease prevention programs and health information technology to improve care;
• Individual choice of plans and providers;
• Malpractice reform;
• Rewarding good providers;
• Cost containment through competition;
• Funding medical research;
• Providing tax credits to families to purchase insurance, including Health Savings Accounts and high-deductible health plans; and
• Financing expanded coverage by taxing employee benefits.

Conclusions

While many details are yet to be worked out for both of these platforms, the principles outlined in the Democratic platform line up best with what HCHCW has found works best in expanding coverage to low-income direct-care workers and their families. Specifically, HCHCW has found, health care plans must be:

1. Accessible to all individuals regardless of their family, their employment status, or how many hours they work;
2. Affordable for workers and their employers, with limited cost sharing for workers earning low wages; and
3. Adequate, with a full range of benefits and individual services to protect older workers,  whose with chronic health conditions, and injured workers

For more information on the essential elements of a health care plan for the direct-care workforce, read Expanding Coverage for Caregivers: A Checklist for State Health Care Reform (pdf).

Allison Lee
National Campaign Manager
alee@phinational.org

On September 3, long-term care providers interested in health care reform met with State Senator James Rhoades (pictured) to discuss the health care legislation awaiting passage in the Pennsylvania Senate.

The meeting was organized by a long-term care provider in Schuylkill County, who is concerned about the lack of affordable, accessible health care for her employees. She and other providers joined health care reform advocates from HCHCW and elsewhere to ask the senator to support health care for all Pennsylvanians.  

The group asked the senator to ensure that health care reform legislation accomplish the following goals: 

• Provide financial incentives for small business owners to provide employee coverage by using “community rating” to assess risk and “rate bands” when setting premiums;
• Address the need to provide home care workers and other low-wage earners whose hours are unstable or part-time with access to affordable quality health insurance; and
• Allow direct-care workers to obtain health insurance through the state, which would allow them to continue to work for agencies or the consumer hire program without having to increase Medicaid reimbursement rates for those services.  

Tracy Lawless
PA State Campaign Coordinator, PHI’s HCHCW campaign
tlawless@phinational.org

The emerging crisis in the health and long term care workforce was up for discussion on August 20, when members of the Iowa Legislature and the Iowa Congressional delegation held a Healthcare Roundtable in Des Moines. The focus of the roundtable was coordinating state and federal efforts to expanding health care coverage.

I was there along with Di Findley of the Iowa CareGivers Association (ICA), Iowa’s HCHCW partner, to talk to the elected officials about the health coverage needs of direct-care workers. We also talked about the need to give attention to the crisis in the direct-care workforce. As a result of the conversations, ICA has scheduled follow-up meetings with several elected leaders in attendance.

Other topics disucssed include ERISA rules, Medicaid and Medicare reimbursement levels, S-Chip expansion, the need for federal electronic medical record standards, approaches to cost containment, medical homes, and chronic disease management.

John Hale
Policy Director, Iowa CareGivers Association
hale_johnd@msn.com