Despite their importance to health care services, one in three personal and home care aides lacks insurance and those that do have coverage are in danger of losing eligibility every time they lose hours. Two new reports published by PHI and funded by the New York State Health Foundation (NYSHealth) call on policymakers to address the health care needs of this rapidly growing workforce.
Is New York Prepared to Care? (pdf) and its companion report, Health Insurance Coverage of New York’s Home Care Aides: Findings from a 2008 Survey of Home Care Employers Outside New York City (pdf), provide the first thorough evaluation of programs intended to provide health coverage for New York’s home care workers. The authors conclude that this vital workforce—which provides services to nearly a half-million New Yorkers—still lacks access to comprehensive, affordable coverage. The job of home care aide is the state’s third fastest-growing occupation, with 100,000 new workers needed by 2016 to provide services to growing numbers of elders and people with disabilities. New York’s projected need for home care aides—already the largest group of workers within the health care sector—exceeds the projections for RNs, or K-12 teachers.
“Home care workers often fall through the cracks, because they are not offered or cannot afford to participate in employer-sponsored plans yet they are not eligible for public coverage,” says PHI’s New York Policy Director Carol Rodat (listen to podcast). “Moreover, when their clients are hospitalized or hours are cut, the workers lose their eligibility for coverage. New York policymakers have tried to address this problem – and they are to be commended; however, Medicaid add-ons and other initiatives have created a, patchwork of solutions isn’t working.”
PHI first surveyed employers outside of metropolitan New York City where little was known about rates of coverage. The survey revealed that although many employers offered coverage, it is not a viable option for most employers or their workers. Among upstate and Long Island home care workers: 25 percent work for agencies that do not offer health insurance to their aides, 29 percent work for agencies that offer coverage but are ineligible, and only 25 percent are enrolled in employer-sponsored plans.
PHI completed the picture of coverage for this workforce by evaluating state-sponsored initiatives and the experience of the workforce with the Family Health Plus Buy-In – New York’s latest response for this workforce – from the perspective of employers and workers, arriving at a two-step formula for continued and expanded coverage:
- Policymakers should prevent erosion of coverage for the workers by continuing to fund—and addressing the weaknesses in–the state-led initiatives. Coverage provided through the large labor-management funds in New York City should be supported and access to the Family Health Plus Buy-In – New York’s most recent program for this workforce–should be streamlined and enhanced.
- The state should create a Home Care Workers Insurance Fund that would rely on contributions from the state, employers and workers for comprehensive, affordable coverage. This new Fund would help large and small employers and their workers access affordable insurance, and maintain the continuity of coverage that is so important to access to health services.
“The lack of viable health insurance options for New York’s home care workers is yet another example of why we must improve existing coverage programs and identify new, creative solutions to get more people covered,” said David Sandman, Senior Vice President of the New York State Health Foundation.
As demand for home and community-based services grow, New York must implement policies to support a committed, stable, and skilled home care workforce that can meet the needs of elders and people with disabilities. Health coverage is critical to the health of this workforce and their clients and families.
Contact
Karen Kahn
Director of Communications
978.740.9844
kkahn@PHInational.org
Carol Rodat
New York Policy Director
718.402.7226
crodat@PHInational.org
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