An idiosyncrasy in American health care, several home care agencies and nursing homes do not offer health care insurance to their employees, or the wages that they pay are so low that the employees are not able to afford any coverage that may be offered.
The numbers are unambiguous. One out of every four workers providing hands-on care for residents in nursing homes do not have health care insurance. Among those providing care to individuals still living at home, only one in three are 
not covered by health care insurance.
The problem should be remedied with the new health care law that guarantees access to affordable health care coverage for everyone. However, a number of home care agencies and nursing homes, alarmed by the expense of offering health care insurance to hundreds of thousands of workers, have begun to lobby for some sort of special treatment or exemption.
Problems with Medicare Reimbursement Rates
Mark Parkinson, the president of the American Health Care Association, which is the biggest nursing home trade group, believes the problem lies with reimbursement rates for Medicare and Medicaid, which government agencies have the responsibility of setting, do not provide enough funds to allow them to offer health insurance coverage to their employees. Parkinson said, “We do not have much ability to increase prices because we are so dependent on Medicaid and Medicare.”
In addition, Parkinson admitted the fact that even when the nursing homes do provide health care coverage for their employees, the benefits often have considerable limitations. He says that the coverage “is probably not up to what will be required [by federal law].”
Medicaid provides coverage to more than sixty percent of residents in nursing home facilities. Medicaid rates are set by the state, and with so many states plagued with problematic budgets payments have been significantly reduced to nursing homes.
Beginning in 2014, employers with fifty or more employees working full time will be required by law to offer affordable health care benefits or risk being charged a penalty.
photo credit: simaje
