The home health industry, which has come under fire for not providing health insurance to its largely low-income workforce, wants to be permanently exempted from the healthcare reform law's employer mandate. It argues that requiring home-care providers to provide insurance for their workers would significantly decrease access to home health services around the country.
The National Association for Home Care & Hospice, which represents 33,000 home-care and hospice providers, is lobbying for a permanent exemption from the mandate, so that home-care providers are not required to pay the annual $2,000 per employee penalty assessed on employers that don't offer qualifying coverage to their full-time workers. The NAHC argues that its members receive low reimbursement rates from Medicare and Medicaid and can't afford to provide coverage to their workers. Instead, the group is seeking federal subsidies for its workers to buy coverage on the state insurance exchanges.
An NAHC survey found that 62% of home health providers do not provide qualifying coverage to the workers and would face the penalty, which the Obama administration has delayed for all employers of 50 or more full-time workers until 2015.
But labor unions and advocates for home-care workers argue that home-care employers should provide coverage to their workers, who suffer a high rate of workplace-related injuries and medical conditions. They strongly oppose the NAHC's request for an exemption from the employer mandate, noting that home-care providers on average earned a 14.8% margin on Medicare patients in 2011, according to the Medicare Payment Advisory Commission.