Health Care for Health Care Workers

Direct-care workers can “serve as a face of uninsured women,” Tameshia Bridges of the PHI Health Care for Health Care Workers campaign told a roomful of health care reform advocates at a Families USA conference.

Bridges and Lisa Codispoti of the National Women’s Law Center paired up to present their January 26 workshop, Putting Women in the Picture: The Face of Women in the Health Care Crisis (pdf). “This was a good opportunity to partner with a national women’s organization to highlight how direct-care issues are really women’s issues,” says Bridges.

Attendees included “people from all over, from Oregon to Florida, most of them from state-based health care reform advocacy campaigns,” says Bridges. “They asked really good questions. I think we gave them a framework to look at how women are impacted by health care reforms.”

The presentation also led to an invitation to present on the same issue at the Raising Women’s Voices to be held this April by the Avery Institute for Social Change, MergerWatch, and the National Women’s Health Network.

The embattled Michigan First health insurance plan passed another hurdle on October 4 when the senate unanimously approved three bills to create the Michigan Health Ensure Affordable and Reliable Treatment (MI-HEART) exchange, which would facilitate implementation of the plan. Michigan First would ensure many of the state’s one million-plus residents without insurance.

HCHCW staff participated in an April workgroup to provide input into the creation of a board that would help administer the Michigan First Health Care Plan. Called the MI-HEART Exchange, the board would run the program, operating as an independent body within the Department of Community Health.

The workgroup, which was chaired by Senator Tom George (R-Kalamazoo), analyzed SB 278 (pdf), the law that would create the exchange. The group included legislative staff, physicians, and representatives from health plans, insurance companies, and hospitals. HCHCW was the only advocacy organization represented.

HCHCW staff provided detailed comments (pdf) and recommendations (pdf) on the draft legislation. As a result, the following HCHCW recommendations were included in the new draft:

• Appointing a representative from a low-income health care advocacy organization to the Exchange board.
• Adopting a phased-in approach, offering coverage to individuals for six months before including small businesses, to allow the plan administrators time to address any challenges that may surface.
• Establishing criteria for the selection of health plans that participate in the program.
• Allowing covered individuals whose work hours are decreased to retain their coverage. This protects home care workers, whose fluctuating hours often leave them with too little work in a given month to qualify for most health insurance plans.

SB 278 S-2 was passed out of the Senate Health Policy Committee in early May and is awaiting a vote by the full Senate.

Nearly a third of Michigan’s Home Help providers are uninsured, according to When Michigan Caregivers Lack Coverage (pdf), a survey of the Home Help workforce, which provides home care services to Medicaid recipients.

The survey was conducted by HCHCW Michigan and funded by the Michigan Quality Home Care Coalition. Among its findings are the following:

• The uninsurance rate among Home Help providers is almost three times as high as that of the state’s general population.
• A third of the providers who have insurance are covered by Medicaid and/or Medicare. Another third get it through a second job or a spouse.
• Home help providers pay significant out-of-pocket health care expenses despite low household incomes. More than half (56 percent) report household incomes of less than $30,000 a year.
• Half of those without health insurance say they have chosen not to seen a doctor when they needed one.