Gov. Mark Parkinson

Overwhelmed at the prospect of offering health insurance for every employee, several nursing home operators are asking the Obama administration for exemption from certain provisions of the Affordable Care Act.

Starting in 2014, the Affordable Care Act requires businesses with more than 50 employees to offer affordable health insurance or risk paying a $200,000 penalty. Nursing home operators, who derive much of their revenue from Medicare and Medicaid, say that they don’t earn enough in federal reimbursements to provide employees with health insurance benefits, The New York Times reported on the front page Monday. Currently, one in three nursing home employees who provide direct patient care are uninsured. These operators argue that offering employees health insurance would require them to pass along price increases to their residents, many of whom are sick and disabled.

American Health Care Association President Mark Parkinson says that even in facilities that do offer employees health insurance, the plans often are limited in their coverage. Additionally, premiums for these plans are higher than many lower-wage employees can afford. AHCA is pursuing several legislative options, including giving nursing homes more time to comply with the required coverage, or allowing nursing homes to take tax deductions for the penalties.

But critics say nursing homes should pay for employee health insurance, based on principle and pragmatism.

“It’s scandalous to have nursing home employees taking care of people when they themselves lack coverage and go without care,” Charlene A. Harrington, a professor at the School of Nursing at the University of California, San Francisco, and a frequent critic of nursing home staffing levels, said in The New York Times article. “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.”