One thing we must remember is that health care reform is NOT a partisan issue. There is broad public support for fixing health care sooner rather than later. Though exit polls showed health care behind the economy as a key voter issue, further probing also showed that voters consider health care the top personal economic issue they face.

What is President-elect Obama’s plan? In general, he has proposed a plan for universal coverage that would build on the current system of mixed private and public group insurance. Some of its features are similar to the universal coverage law now being implemented in Massachusetts. All employers, other than small businesses, would be required to offer health insurance to their employees or contribute to the cost.

Eligibility for Medicaid and SCHIP would be expanded. Small businesses, self-employed individuals, and people who do not have coverage through their employers, Medicaid, or SCHIP would be able to purchase a plan through a new insurance market called the National Health Insurance Exchange. Through this exchange, people could choose a private plan or a new public plan similar to that offered to federal employees and members of Congress.

Insurance carriers would be required to offer plans regardless of pre-existing conditions and could not charge premiums based on health status. Small businesses would be eligible for tax credits to offset their premium costs and individuals would be eligible for income-based premium subsidies.

This video from Obama’s campaign provides a good summary of his plan:

For a detailed explanation of his health plan, go to the Obama campaign website or see the Obama-Biden plan at change.gov.

In the weeks to come, we’re anticipating increased discussion about issues around health care reform as Congress members and a wide range of stakeholders begin to weigh in and work on building a consensus for change.

Carol Regan, Director
HCHCW
cregan@phinational.org

The survey included information on whether workers plan to continue working in their present positions and what factors affect their decisions, including job satisfaction, nature of the work environment, training, advancement opportunities, benefits, working conditions, and personal or family demands.

HCHCW reviewed tables[1] on health insurance benefits available on the website and found the following:

• Nearly 16% of nursing assistants have no insurance coverage.
• 89.7% were offered health insurance from their employer; 9.0% were not (1.4% unknown)
• Nearly one in four nurse aides (23.2%) are receiving some type of government health plan (Medicare, Medicaid or other)
• The offering of coverage varied slightly by the affiliation of facility - 91.2% working for chains were offered coverage compared to 87.9% working for independent facilities, and by ownership - 87.3% of those working for proprietary homes, 92.7% working for voluntary non-profit homes and 94.0% working for government or other facilities.
• For all facilities, only 54% of those offered coverage enrolled in the coverage. Enrollment was higher in the northeast - 67.4%, for those working for independent facilities - 59.9%, and for those working for voluntary non-profit and government facilities - 63.1% and 71.8% respectively.

In-depth analyses on different topics are underway by researchers and we can expect to report on those studies in the months ahead.

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

Two years after Massachusetts enacted its landmark health-care reform; four out of five Massachusetts businesses provide health-care coverage to their employees, increasing from 73 percent in spring 2007 to 79 percent in spring 2008.  This law has resulted in over 439,000 people getting insurance coverage since the plan started!

The state’s health-care reform act was enacted in April 2006. To ensure that all of the state’s residents have health insurance, the state expanded its Medicaid program; established a sliding-fee scale for insurance; required residents to purchase health insurance if affordable coverage is available; and required employers with 10 or more workers to contribute to their employees’ coverage or pay into a state fund.

There’s been concern that employers would stop providing coverage to their workers and opt to pay into the state fund, but this new report shows that didn’t happen. This is good news for advocates pushing for public/private reform strategies.

Carol Regan
Director
HCHCW
cregan@phinational.org

What strikes me about this article is that it takes for granted that workers have received a flu vaccine and are protected themselves. One would think considering that workers provide care and support to people who may have low immune systems, getting a flu shot would be a common practice among direct-care workers. But, I wonder if that is really the case.

Given the high numbers of uninsured direct-care workers, where and how are workers getting flu vaccines? Public health departments, community clinics, and other organizations run “flu-shot clinics” throughout flu season where people can get flu shots for $25-$30. I have heard of some long-term care employers offering discounted flu shots for their staff. But, this is a patchwork way of handling something as critical as a flu vaccine and underscores the importance of affordable and comprehensive health insurance coverage for workers.

We would like to hear from you – whether you are an employer or a worker – about how you are handling flu vaccines this season. Comment below or send me an email.

If you are looking for a place to get a flu vaccine, contact your local health department and they should be able to tell you where they are available in your area.

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

Part of this challenge involves asking nurse aides to do the mentally and physically challenging tasks for the same wages as the Wal-Mart greeter and with no health care benefits.  From personal experience, working as an aide, the tasks of bathing, feeding, and caring for the elderly is physically taxing and the emotional sacrifices we make are high.  Most direct care workers do this work because we love to care for the elderly regardless of the difficulty of the work.

The growing elderly population and the shrinking staff will continue to affect long-term care until facilities receive more funds.  I am concerned about the low reimbursement rates for Medicaid residents in long term care facilities.  Increasing Medicaid reimbursement for residents in long term care facilities will allow these facilities to provide the much needed health insurance for the direct care workers that they employ. Providing health insurance will in turn retain more employees.  I believe this is something that needs to happen now in order to avoid major economic problems in the near future.

Latrisha Cowan
Reynoldsville, PA

The worst is the inability to obtain and retain nurse aids.  The constant turnover of staff is a snow ball effect from many issues. One issue, however, truly stands out to me:  Direct care workers lack of health insurance. Direct Care Workers endure much more than the average lay person could ever imagine in an eight hour day.  Direct care workers are born compassionate people who are angels in disguise.  It is that compassion that makes us stay in the health care field.  Most of these workers could go to Sheetz or Wal-mart and make the same amount of money and have health insurance coverage.  But they don’t, they choose to stay because they care.  We as a society, we as a state, and we as a community need to take action to retain these angels in disguise.

The ever growing elderly population needs direct care workers.  The issues need to be dealt with soon before there are no more direct care workers.  I believe that providing direct care workers with affordable and accessible health insurance is a start to solving the direct care worker crisis.

Amy Fenstermaker, RN Supervisor
New Bethlehem, PA

Unfortunately, the time has come where I might possibly need to find a job that offers health benefits. I love my job and do it for the consumers I take care of, regardless of the low wages and lack of benefits. However, I am in desperate need of having my wisdom teeth removed but I simply cannot afford to pay for this procedure on my own. I am not the only one who is faced with this dilemma. Many of us who work in the home-health field are facing the difficult decision of whether or not to keep working without health coverage or find a better position that would offer health benefits. Giving direct care workers health insurance definitely would not only benefit the workers, but would also benefit the elderly population in our state that needs in-home care.

Melissa Prosper
Branchdale, PA

The article in the Philadelphia Inquirer about Karen Goroncy and her lack of health insurance highlighted how it impacts her ability to care for her consumer.  Melva William’s letter to the editor in response to Karen’s story voices her own fears about getting sick and not being able to continue to take care of her ailing mother due to her own lack of health insurance. It is these stories that provide a face for the HCHCW Campaign mission.

It is the passion that workers have about improving wages, benefits, and overall perception of their work and the industry that make a difference in our campaign.  If it had not been for one hundred workers across the state who called their legislators back in March demanding that health care be made affordable and accessible, the health insurance reform legislation “PA ABC” may never have passed the House with such success.  Next session, we’ll need that same passion to try and get an affordable health insurance plan passed by both Houses.

In order to continue these efforts, I am looking to meet direct-care workers who are willing to share their personal stories regarding health insurance, participate in “come care with me days”  where they invite a policy maker to their place of work, and ultimately form a committee of workers from across the state who will work together to advocate for affordable and accessible health insurance the direct-care workforce.

In the next few months, I will be traveling to different nursing homes, assisted living facilities, home health agencies, and the homes of direct-care workers to hold a series of brown bag lunches and small gatherings to talk with workers about the campaign and the variety of activities listed above. With the help of members from the Direct Care Worker Association, I have already scheduled several meetings and brown bag lunches for the fall, as well as collected several new stories to add to the campaign’s story bank.

If you are interested in getting involved, please contact me, Simone Baer, at (412) 450-8080 or by email at sbaer@phinational.org.  I’d love to talk with you about joining us in these activities and how your story can make a difference.

Simone Baer
PA Community Organizer
sbaer@phinational.org

Many Americans are unfamiliar with the individual market because they receive health insurance through an employer. However, since nearly 30% of direct-care workers lack health insurance of any kind, and only about half receive it from their employer, direct-care workers often look to the invidual market.

The report highlights the policies and practices of the market that put women, who are 90% of the direct-care workforce, at a disadvantage when trying to secure affordable, quality health insurance on their own.

For more statistics on the health insurance status of the direct-care workforce, see our May 2008 report: Invisible Care Gap: Caregivers Without Coverage (pdf 1.9MB)

Allison Lee
National Campaign Manager
Health Care for Health Care Workers
alee@phinational.org

• Women are 90 percent of the 3.1 million paid, professional caregivers in long-term care.
• Nearly two thirds (65 percent) of long-term care consumers are women.
• Nearly one in three direct-care workers lack health insurance coverage.

Of the leading occupations for women, caregiving is the sixth largest in the country. As the number of people in need of care increases dramatically over the next decade, the need for direct-care workers will also grow.  By 2016,  America will need 4 million direct-care workers, more than the number of school teachers needed for grades K-12.

The challenge is how to attract women to the caregiving profession - a job that is typically low wage and lacks affordable, quality health insurance.  There is a simple answer: improve the quality of caregiving jobs, making direct-care work a viable career. A quality job is one that offers a livable wage, health insurance, a supportive work environment, and opportunities for advancement.

Allison Lee
National Campaign Manager
Health Care for Health Care Workers
alee@phinational.org