Despite the overall success of Massachusetts’ health care reform, too many of the state’s direct care workers still cannot afford employer-sponsored health insurance, according to a new study from PHI and the Department of Public Health and Community Medicine at Tufts University School of Medicine.
According to Coverage for Caregivers: Lessons from Massachusetts Health Reform, (PDF) only one in every five direct care workers in the state have enrolled in an employer’s health care plan. Statewide, nearly three-quarters (71 percent) of working-age adults are covered through their employers.
Direct care workers often opt out of their employers’ plans because the premiums and copays are too costly. Instead, many work part-time in order to qualify for the state’s insurance plan, which costs less than most employer plans.“This disincentive to work undermines state efforts to build a quality, stable direct-care workforce,” said PHI Massachusetts Policy Director Amy Robins.
The report also found that almost half of all direct care workers and about 60 percent of home care workers in the state were not eligible for employer-sponsored plans, often because of their part-time status or because of an eligibility waiting period. The situation is particularly difficult for home care workers. Only 12 percent of them are enrolled in employer-sponsored plans, and they pay nearly 50 percent more than CNAs in nursing homes pay for their coverage.
The authors conclude that public and publicly subsidized insurance programs are essential to meet the needs of direct care workers and their employers. They also recommend a number of ways that both federal and state legislators and policymakers can make insurance more affordable and accessible.
Elise Nakhnikian
Communications Director
Direct Care Alliance
