As health care reform seeks to guarantee access to affordable coverage for all Americans, nursing home and home care lobbyists are seeking an exemption to the employee coverage requirement, saying that the industry cannot afford coverage for all employees.
Many nursing home and home care employees do not currently have medical coverage through their employers. According to The New York Times, one in four workers who provide hands-on care to nursing home residents have no health insurance, and one in three workers who provide care to people living at home are uninsured.
Charlene A. Harrington, a professor at the School of Nursing at the University of California, San Francisco, said it is "scandalous" that employees who care for people have no health care themselves. "If employees have health insurance, they are more likely to be treated for illnesses, less likely to pass on infections to nursing home residents and more likely to get early treatment for occupational injuries," she said.
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Mark Parkinson, president of the American Health Care Association, the largest trade group for nursing homes, says they are not able to offer employees health coverage because reimbursement rates for Medicaid and Medicare, set by government agencies, is too low. "We do not have much ability to increase prices because we are so dependent on Medicaid and Medicare" for revenue, he said.
If coverage is offered, the benefits are many times limited, and due to low wages, many employees are not even able to afford coverage, if offered.
In 2014, any employers with 50 or more full-time employees will be required to offer affordable coverage or risk paying a penalty. For a midsize nursing home, that penalty could easily exceed $200,000 a year, according to the Times.
Parkinson, the top lobbyist in Washington for nursing homes, has set forth several ideas to help ease the on nursing homes.
One option he suggests is giving nursing homes more time to comply with the requirement. Another option is waiving or reducing the penalties for nursing homes. Another alternative offered by Parkinson would be allowing nursing homes to take tax deductions for the penalties, which under current law are nondeductible.
Debbie D. Gantz, administrator of the Sunset Estates nursing home in Purcell, Okla., south of Oklahoma City, said "If I could afford to pay for [health coverage], I would. We are a small home. We are not part of a chain. We could not provide health insurance to our employees and still be able to pay all our bills and make the payroll."
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