Tag Archive for ‘solutions’ at Health Care for Health Care Workers

Medicaid and Medicare are often referred to as central pillars of America’s health care safety net. A recent analysis of U.S. Census data on the uninsured (pdf) by Raising Women’s Voices, shows that the availability of public coverage has contributed to the decline in uninsured Americans from 47 million in 2006 to 45.7 million in 2007. For many women, public coverage is more than a safety net - it is a vital source of health insurance coverage, with almost 29% of women relying on public coverage to meet their health care needs.

We see this trend among direct-care workers as well. About one-third of direct-care workers live in a household that receives Medicaid benefits. It is often the children of direct-care workers that receive coverage through the State Children’s Health Insurance Program (SCHIP). And, in some states that have broad eligibility standards, workers themselves are covered by Medicaid or other public coverage.

Expanding access to public coverage has been one key strategy for the Health Care for Health Care Workers campaign. With the cost of health insurance coverage rising and the wages of workers not keeping pace, employer-sponsored health insurance remains out of reach for many direct-care workers. While we also advocate for strategies that make employer sponsored insurance more affordable, in many cases public programs provide necessary coverage when workers have nowhere else to turn to meet their health care needs.

As states look at expanding or making changes to public programs, it is important that they remember the health care needs of direct-care workers. The income standards need to be high enough and available to people without children so that more workers can be eligible for this coverage. We have heard many times that workers are often not eligible for public programs because – with an average wage of $9.56/hour - they make too much money or they do not have children.

Public coverage programs also need to provide comprehensive coverage with the services that direct-care workers need - like disease management to help monitor diabetes or physical therapy to help a worker get back on her feet after an injury.

Finally, coverage has to be accessible. Just providing people with a card is not enough. Public programs have to have enough doctors, dentists, hospitals, and other providers in their networks so that people can get the care when they need it.

We are excited to be working in states as advocates to sure that public coverage is affordable, comprehensive, and accessible to workers. It is a critical foundation that many rely and it needs to be made stronger.

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

Now that the two conventions are over and the platforms for the Republican (pdf) and Democratic (pdf) parties have been approved, it’s clear that health care is a national priority for this election — and, hopefully, beyond. But which party’s plans would do the most to help direct-care workers?

Both health care plans would help direct-care workers by focusing on such things as chronic disease management, ensuring portability, and eliminating pre-existing condition exclusions. But the Democratic platform provides more specific provisions aimed at guaranteeing access to affordable insurance.

The Democratic Platform

The underlying principles set out in the Democratic platform’s section on health care begins with making sure every man, woman and child has access to quality, affordable health care. It also includes:

Affordable quality health care is essential to making workers productive and businesses competitive;
Affordable coverage should be subsidized through tax credits and other means;
Health care coverage should be a shared responsibility between the worker, employers, insurers, providers and government;
Disparities in health coverage should be ended among minorities and low-income people;
Americans should have a choice between keeping their private coverage and public health plans; and
Government should ensure that all Americans should have meaningful and affordable coverage.

The Democratic plan also addresses the need to build a strong health care workforce, specifically mentioning direct-care workers as part of that workforce.

The Republican Platform

The Republican platform calls for:

Disease prevention programs and health information technology to improve care;
Individual choice of plans and providers;
Malpractice reform;
Rewarding good providers;
Cost containment through competition;
Funding medical research;
Providing tax credits to families to purchase insurance, including Health Savings Accounts and high-deductible health plans; and
Financing expanded coverage by taxing employee benefits.

Conclusions

While many details are yet to be worked out for both of these platforms, the principles outlined in the Democratic platform line up best with what HCHCW has found works best in expanding coverage to low-income direct-care workers and their families. Specifically, HCHCW has found, health care plans must be:

Accessible to all individuals regardless of their family, their employment status, or how many hours they work;
Affordable for workers and their employers, with limited cost sharing for workers earning low wages; and
Adequate, with a full range of benefits and individual services to protect older workers, whose with chronic health conditions, and injured workers

For more information on the essential elements of a health care plan for the direct-care workforce, read Expanding Coverage for Caregivers: A Checklist for State Health Care Reform (pdf).

Allison Lee
National Campaign Manager
alee@phinational.org

Health Care for Health Care Workers