Invisible Care Gap: Caregivers without Health Coverage

The Invisible Care Gap (report cover)

Download the report (pdf 1.9MB)

Report Shows High Rates of Injury, Inadequate Health Coverage May Result in Caregiver Shortage

As part of National Women’s Health Week, PHI’ Health Care for Health Care Workers Campaign will deliver a sobering report -– Invisible Care Gap: Caregivers without Health Coverage — on the health insurance status of our nation’s caregiving workforce, 90% of which is female. Based on the most recent data from the U.S. Bureau of the Census and Bureau of Labor Statistics, the report reveals that:

  • Nurse aides have the highest rates of workplace injuries and illnesses in the country, making it America’s most dangerous job.
  • Nearly 30% of direct-care workers have no health insurance coverage, twice the rate of the general population.
  • The country’s fastest-growing workforce—jobs providing in-home personal care services—is the least likely to have health coverage.
  • Direct-care wages are so low (median hourly wage of $9.56/hr) that nearly 30% live in or near poverty and few can afford high cost of insurance premiums.

Update: A podcast is now available on this topic.

6 Responses to “Invisible Care Gap: Caregivers without Health Coverage”


  1. 1 Joanna Barnes

    I’m very interested in working in this type of field. I know that most for the institutes trains you to do the workbut If they don’t how do I go about quailifing for the direct care job. I’ve been working with people for a long time and I enjoy help others help themselves. You can contact me @ (860) 881-6024 thank you for your time.

  2. 2 Lou Ellen Strong

    Premiums to maintain the current health insurance benefits for our staff will increase 10.45% July 1, 2008. This equals a $50 monthly increase for single coverage and $100 to add one child or spounse. Family coverage will go up $158!!! Direct Care Workers cannot afford this and neither can our agency when state funding will remain flat next year. Our only option will be to reduce benefits by increasing prescription co pays and lowering the co-insurace %.
    Thanks for helping to carry this important message to legislators, etc.

  3. 3 Mary Ruebens

    I work for an OMRDD agency in upstate NY. We are unionized & we have 100% FULLY EMPLOYER paid healthcare. We have fought long & hard at each of our contract negotiations each 3 years to keep this EXTREMLY valuable fringe benefit. In the hard financial years of our agency we took very modest or no wage increase to keep this benefit. We have reasonable Dr. & prescription Co-pays & about 2 years ago our state OMRDD system implemented a healthcare enhancement system, Health Reimbursement Arrangement that is OMRDD paid & sponsored no Employer dollars are used for this. Most agencies went to an HRA card works like a credit card at Pharmacies & Dr. offices. The employee swipes the card like a credit card for any IRS covered medical expense i.e. anything your health insurance covers now, & even over the counter items & some other items the health Insurance wouldn’t pay for. The system will not cover non-medical expenses say like a beverage or a snack or something the person then would pay out of pocket for this. For eligible expenses see IRS publication 213D. The one thing we have always taught our members is if we can get money into health care the money goes further. I canbe contacted through the webvsite for any details.

  4. 4 Sara

    For caregivers who do not have health insurance, I’d like to pass on information about a valuable resource that is provided by Georgetown University’s Health Policy Institute:

    Consumer Guides to Getting and Keeping Health Insurance in Every State and the District of Columbia, http://www.healthinsuranceinfo.net

    For each state, there’s a roughly 35-page FREE guide to your rights and to the limits on your protections as a health insurance consumer, whether you’re looking at individual policies, COBRA, state continuation coverage, or joining a state’s high-risk pool.

    While these guides don’t address the question of better guaranteeing employer-provided insurance, they can help you if you find yourself in a job without insurance or if your insurer tries to drop you, to figure out what options you’ve got under state and federal law.

  5. 5 Veronica Henderson

    I noticed that it was stated that the median wage for DSP’s is $9.25.I have not seen many jobs in Chicago that even pay $9.00/hr. Most of the jobs here start out at $8.oo/hr.Health care insurance? who can afford $50.00 every 2 weeks on that type of salary.These two reasons alone, are why employers can’t keep good,hard working DSP’s.

  6. 6 Paula Seaman

    What are the legalities for wages from an agency for live-in caregivers ? I work 4 days, live in–Often the client’s family visits for an extended stay- If they come in before my shift for the day ends I was getting my whole days pay. I had understood I was getting paid for 15 hours and not paid for 8 hours of sleep (sleep all 8hrs never happens!) So If the client’s family came after I had worked my 15 hours, my pay would be the same. The client would get charged the same. And when the client was leaving ,if they needed me early, I would get paid hourly , for the hours I worked before my usual start time. The agency just informed me I will not get paid because there are times the family comes in early and I get my full days pay. However that only happened once, & I have gone to work early , anywhere from 3 to 5 hours and have stayed for an extra 5 hours when there was a flight delay. They said it evens out-I am not the only aid working there-how do they figure?

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