Two new reports analyze the low rate of health care coverage among personal and home care aides in New York state and recommend ways to improve the situation.
Health Insurance Coverage of New York’s Home Care Aides: Findings from a 2008 Survey of Home Care Employers Outside New York City (PDF) reports on a survey of home care agencies in upstate New York and Long Island, where little was known about health care coverage rates. Unusually progressive state policies and high levels of unionization have historically given more home care workers access to affordable health care coverage in New York than in most parts of the United States, the report notes, but several factors have combined to decrease coverage rates in recent years.
Only a quarter of the aides in the agencies surveyed were enrolled in employer-sponsored health care plans. More than half the aides either worked for agencies that did not offer health insurance (25%) or did not meet their employer’s plan’s eligibility requirements (29%), which included long waiting periods and minimum weekly work hours. The remaining 21% were eligible for an employee health plan but were not enrolled, often because the cost was too high.
“As is evident from these reports, the home care workforce — which provides services to nearly a half-million New Yorkers — still lacks access to comprehensive, affordable coverage,” says Carol Rodat, PHI’s New York policy director, who coauthored both reports. “Although New York is to be commended for its leadership role in coverage, there is still no single approach that will cover all the home care aides; moreover, the current insurance patchwork leaves thousands either underinsured or uninsured.”
The survey was supplemented by employer and direct care worker focus groups, all three of which were conducted by PHI and The Center for Health Workforce Studies at the State University of New York in Albany’s School of Public Health.
Is New York Prepared to Care? (pdf) reviews the findings of that report and assesses three health insurance initiatives targeted at specific parts of the state’s home care workforce to create an overview of the health coverage status of New York’s home care workers. The report was prepared by PHI’s Health Care for Health Care Workers initiative in conjunction with Manatt Health Solutions.
It recommends that the state do two things to improve coverage rates:
- Continue to fund — and address the weaknesses in — the state-led initiatives studied.
- Create a Home Care Workers Insurance Fund that would rely on contributions from the state, employers and workers to help both large and small employers and their workers access affordable insurance.
It also recommends a number of immediate reforms the state could enact to improve the situation in the short term.
“New York has programs that can be improved, but for the smaller employer, a Home Care Workers Insurance Fund can function for employers, workers and their clients who depend on consistent care,” says Rodat.
PHI’s press release about the reports
Elise Nakhnikian
Communications Director
Direct Care Alliance
