Matt Yarnell

As we move into 2016, one piece of good news is that more and more low-income people are gaining access to health insurance through the Affordable Care Act. With over 11 million people estimated to have enrolled during the 2015 open enrollment period, more than 17 million are now insured through the ACA.

But it’s not all good news for low-wage workers when it comes to health insurance. For many, the price of premiums and co-pays can be so expensive that getting sick can still send you spiraling into medical debt.

The New York Times ran an article outlining this problem on Jan. 5, which illustrates the problem. Unfortunately, medical debt is a common obstacle faced by nursing home workers who often encounter mounting medical challenges after years of wear and tear on their bodies from the physically demanding work. Knee replacements, chronic back pain, and tendonitis are often the topic of conversation when older workers break for lunch.

There is a current trend of employers hiking workers’ share of premiums and increasing co-pays so much that using insurance is nearly as expensive as going without. In 2015, our union surveyed nursing home workers and found that nearly 40% did not receive health insurance through their employer and the biggest reason was the cost of insurance, followed by the inadequacy of benefits.

Given the high injury rates among nursing home workers, going without insurance is a decision that is not made lightly.

And while the premium cost to employees for single coverage is burdensome for low-income workers, the cost for any dependent coverage can be a crushing expense. I’ve spoken with many nursing home workers who have told me that it feels like they are working just to pay for health insurance for their spouse or children.

Additionally, most employers and insurance companies continue to shift costs to workers with higher out-of-pocket monthly deductions, copays, deductibles and co-insurances. This causes workers to put off addressing their own healthcare issues, leading to catastrophic claims that are bad for everyone.

The issue of income insecurity is now front and center for nursing home workers. The work is too important and too difficult for anyone working full time to be living in poverty. Making the cost of buying and using health insurance more affordable has to be part of this equation.

Long-term care providers are under tremendous pressure to deliver the highest quality care. It’s the front-line caregivers who are most responsible for this outcome. When workers are struggling to just pay the bills or are going without healthcare, it diminishes their ability to provide the best care. Providers have to pay living wages and provide affordable healthcare if they expect the best care from their employees.

The days of working just to pay for healthcare have to end.

Matt Yarnell is the Executive Vice President of SEIU Healthcare Pennsylvania, the state’s largest union for healthcare workers.