Mark Parkinson, president of the American Health Care Association, the largest trade group for nursing homes, says the problem is that reimbursement rates for Medicaid and Medicare, set by government agencies, do not pay them enough to offer their employees medical coverage. “We do not have much ability to increase prices because we are so dependent on Medicaid and Medicare” for revenue, he said.
Supporters of the law say several provisions will help low-wage workers who are uninsured or have bare-bones coverage. The law will expand Medicaid to cover people under 65 with income less than 133 percent of the federal poverty level, and it will offer subsidies to make insurance more affordable to those with incomes from 133 percent to 400 percent of the poverty level ($24,645 to $74,120 a year for a family of three). “This assistance could significantly increase coverage among direct-care workers because 80 percent of them have income less than 400 percent of the poverty level,” said Dorie K. Seavey, director of policy research at the Paraprofessional Healthcare Institute.