Monthly Archive for December, 2009

Helen Hanson, Home Care Worker, South China, Maine

Like millions of other Americans, Helen Hanson and her husband, of South China, Maine, couldn’t afford to buy comprehensive health insurance. In her job as a direct-care worker caring for Maine’s elders, wages are low, and Helen’s employer couldn’t afford to offer affordable coverage to its employees. Her husband did not have health insurance through his job either.

“We wanted protection from bankruptcy, and paid $3,200 a year for a family plan with a $10,000 deductible,” said Helen. “Because my mother died of cancer in her early 40s, I know the benefits of annual abdominal screenings and yearly mammograms, but these cost me nearly $3,000 per year. Our total family medical bills never reached the $10,000 threshold.”

Then Helen’s husband had an accident that injured his hand. The surgery alone cost $13,000 and Helen thought that finally the insurance would start to cover some of their bills. “I then learned that our deductible was $10,000 per family member, so I canceled the insurance immediately,” she said. “It just wasn’t worth it.”

“In our jobs, we are twice as likely as other Americans to be without insurance,” Helen said. “I’m well aware of the trouble most direct-care workers have in obtaining affordable insurance that provides comprehensive benefits.”

Quality Coverage Can’t Wait

Tens of thousands of direct-care workers are in the same boat as Helen. Whether offered employer-based insurance or not, coverage is simply too costly. To keep prices down, insurers exclude many vital services, or require families to pay deductibles that are frankly exorbitant. From Helen’s point of view, the cost is just too high when weighed against the risk of a family member falling seriously ill.

High-deductible plans like Helen’s are not health plans that workers can count on when they need to go to a doctor, whether it’s for a routine screening test or for care after a serious accident.

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.

For more information, contact:

Carol Regan, PHI Government Affairs Director, 202.223.8355, cregan@PHInational.org

Steve Edelstein, PHI National Policy Director, 718.402.7413, sedelstein@PHInational.org

Also see PHI PolicyWorks, our policy website.

Download

Download this page as a full-color handout (pdf)

This weekend Senate Majority Leader Harry Reid introduced an amended health reform bill. The new bill won the support of 60 senators, thereby overcoming one of the most difficult hurdles on the road to comprehensive health reform.

But the fight for health reform is far from over. That’s why we are asking you to call your senator TODAY.

Between now and Christmas Eve it is important that senators who support reform hear positive messages from their constituents. Please call your senators and ask them to vote YES to keep health reform moving forward.

Where We Are

In the final days of getting this historic bill passed out of the Senate, your voice is needed more than ever. Although the bill is not perfect, it does include several measures (pdf) that would greatly assist low-income direct-care workers, including:

• tougher regulation of insurance industry practices
• better consumer protections
• stronger controls on long-term health care costs
• a two-year extension in funding for the Children’s Health Insurance Program and an expansion of Medicaid to those earning up to 133% of federal poverty level
• millions in demonstration grants for training and career advancement

And most importantly, the Senate bill would extend health coverage to 31 million uninsured Americans.

Next Steps

Senate procedures require several more votes, with a final vote scheduled for this week. All will need the support of 60 senators.

Once the bill passes the Senate, a conference committee will merge it with the House bill, which includes even more provisions that would help direct-care workers, including higher subsidies, affordability protections, and a public insurance option.

The PHI Health Care for Health Care Workers campaign has been bringing you stories of direct-care workers that highlight the key elements of reform. These are issues we will continue to fight for — and ask you to weigh in on — to make sure that these protections for lower-income families are included in the final legislation.

Did you call your senators? We’d love to hear about it! Email HCHCW Director Carol Regan, or add a comment to this post telling us about your experience!

Marva Diggins, Direct-Care Worker, Bronx, New York

Marva Diggins, of the Bronx, New York, bathes, dresses, and prepares meals for her elderly client seven days a week. Her client, who is in her late 80s, has cardiac problems, memory loss, and uses a wheelchair. Marva loves her job as a direct-care worker. She knows that the work she has been doing for 15 years is extraordinarily important — not only to her clients, but to their families as well.

Unfortunately, direct-care work does not pay well, and often does not provide decent benefits. Marva has health insurance, but her plan has an annual cap on medical expenses of $6,500. As a result, when she took a bad fall in the street, she decided to forego a doctor visit.

“I worried that going to the doctor would cause me to exceed the cap on my benefits,” Marva explained. “I am a diabetic and need insulin and testing supplies, and my high cholesterol and hypertension require treatment and it all adds up pretty quickly.”

Marva worries about the cost of health care, because she earns just $9.55 an hour and has to budget her spending carefully. When her rent increased from $575 to $700 a month, she had to cut back on other expenses. Direct-care workers like Marva shouldn’t have to ration their health care in order to stay below an annual cap.

Good Affordable Benefits Can’t Wait

Thousands of direct-care workers have inadequate health coverage — insurance plans with annual caps and high deductibles that limit access to needed medical care. That’s why Congress needs to ensure that reform establishes a solid benefit floor and standardized insurance plans for Marva and all Americans.

• Comprehensive coverage. Direct-care workers are primarily women, and many live with chronic health conditions. Their work is physically demanding, and they experience astonishingly high rates of back injuries, muscle strains and tears. Good benefits must include a full range of services and benefits — without annual limits.
• Affordable coverage. Insurance policies must have reasonable limits on out-of-pocket costs and caps on total health care expenses, not just premiums. Median annual earnings for direct-care workers are $17,000, which means they can afford only minimal contributions towards their insurance.

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.

For more information, contact:

Carol Regan, PHI Government Affairs Director, 202.223.8355, cregan@PHInational.org

Steve Edelstein, PHI National Policy Director, 718.402.7413, sedelstein@PHInational.org

Also see PHI PolicyWorks, our policy website.

Download

Download this page as a full-color handout (pdf)

John Booker, CNA, South Bend, Indiana

John Booker is a direct-care worker living in South Bend, Indiana. Like many direct-care workers serving elders and people with disabilities, he has lived without health coverage throughout his 30-year career as a caregiver. “My wages are low — about $11.00 per hour — and as an independent contractor I cannot afford private insurance,” John said. “My total income is around $18,000 per year, and even when I was working for an agency that offered health coverage, the premiums and co-pays were so high that I couldn’t afford to insure myself and my family.”

Both John and his wife are in their 50’s, and their only option has been the local community health center. The health center charges patients based on their income, but it can cost up to $116 per visit. “Needless to say, even this has proved difficult,” John said, “and I delay going to the clinic until I feel it is absolutely necessary.”

John lives with extremely high blood pressure, and is at high risk for prostate cancer. “There are many times during the year when I can’t afford any of the medication that has been prescribed for me to control my blood pressure,” he said, “and I worry a lot. If something should happen to me, it would essentially ruin us. But also if I should become ill, it would also affect my clients, who depend on me to live their lives.”

Creating an Exchange Can’t Wait

Thousands of direct-care workers like John fall through the cracks of our health insurance system. They do not get employer-based insurance because they work directly for a consumer — a work model that is gaining in popularity. If they are married, they may not qualify for Medicaid based on their family status. And finally, many direct-care workers do not earn enough to buy private insurance on their own.

An insurance exchange would:

• Lower costs. For low-wage workers like John, an exchange — a large purchasing pool — can negotiate on behalf of consumers for more affordable rates from insurance plans. A similar approach is used by the Federal Employees Health Benefits Program to minimize cost growth and review changes in benefit design.
• Increase choice. Exchanges would enable individuals and employers (starting with small employers) to purchase qualified insurance, choosing between a range of private health plans and the public health insurance option.
• Improve access. Individuals not enrolled in qualified employer coverage, Medicare, Medicaid, TRICARE, or VA coverage would be eligible for insurance through the exchange and could qualify for subsidies based on their income.

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.

For more information, contact:

Carol Regan, PHI Government Affairs Director, 202.223.8355, cregan@PHInational.org

Steve Edelstein, PHI National Policy Director, 718.402.7413, sedelstein@PHInational.org

Also see PHI PolicyWorks, our policy website.

Download

Download this page as a full-color handout (pdf)