Op-Ed: Washington State’s Investment in Caregiver Health Care: A Model for Expanding High-Quality, Affordable Health Care – State of Reform

We all deserve the peace of mind that comes with high-quality, affordable health care. Ongoing preventive care has been shown to support better health outcomes over time. And it prevents unexpected or emergency care expenses from turning into catastrophic debt.

Yet too many people—especially those on low and moderate wages—don’t have access to the health services they need. This is particularly true for Black, Indigenous and Colored (BIPOC) and immigrants, who are more likely to work in lower paid jobs.

But it doesn’t have to be that way.

SEIU 775 Benefits Group, in collaboration with our partners, provides high-quality, affordable health coverage and holistic, tailored, comprehensive health benefits to caregivers in Washington State. This is especially important to note because caregivers—predominantly women and often people of color—have historically been excluded from many workplace benefits that other professionals take for granted.

As such, our model may offer a framework for expanding access to comprehensive care and improving health outcomes for more low- and moderate-wage workers.

Partnerships to support high-quality and affordable health care

Washington State’s commitment to the health and well-being of caregivers is unique. Our strong labor partnership—made up of caregiver employers and their union, SEIU 775—and important investments from our state legislature means that regardless of their employer, caregivers can count on our health insurance and benefits.

As a result, more than 52,000 caregivers have access to our health and wellness benefits, with nearly 23,000 enrolled in one of the SEIU 775 Benefits Group health plans. We are dedicated to keeping costs low and quality high.

As a value-based purchaser of health care, our health plan partners Kaiser Permanente and Aetna are incentivized to work with us to achieve better health outcomes for caregivers. For a monthly co-pay of only $25 per month, caregivers can access health care with no or low co-pays for a wide range of services.

And this year, we’re excited to add full dental care for caregivers’ children for just $10 a month. With further investment from the state, this dependent coverage can be expanded to ensure that caregivers’ children have access to full health care services.

Data-driven health benefits designed to keep caregivers healthy and care affordable

As a self-insured purchaser of health care services, we bear the risk of financial gains and losses in our plans. To manage costs, it is critical that we fully understand our caregiver population.

It is not uncommon to hear from our caregivers that this is the first time they have been insured or received workplace health benefits.

And many BIPOC and immigrant caregivers may distrust health care systems due to past negative experiences or a lack of culturally appropriate care. These deep structural inequities can lead to multiple unaddressed or undiagnosed health problems and limited understanding of how to navigate the complex health care system.

For example, compared to the general population, caregivers experience:

• Higher prevalence of adverse childhood experiences (ACEs).
• Higher levels of anxiety and depression.
• More likely to be a smoker.
• Notably higher rates of obesity, with nearly half of caregivers affected.
• 4 times higher rate of workplace accidents.

“I have asthma so it’s a constant worry because I need my medicine. The impact insurance has had on my life has been wonderful. I don’t have to worry about how I’m going to take my medicine.” – Kathryn M., caregiver

This information helps us strategically build benefits and programs that provide caregivers with interventions that minimize the need for expensive surgeries and procedures and build good health over time, such as:

Facilitating preventive examinations: Colon cancer is the second most common cause of cancer-related death and is highly preventable if detected early, with people who are obese and smoke at increased risk. Historically, few caregivers have taken advantage of their health plans’ fully covered colonoscopies, citing the difficulty of taking time off from work. In response, we’ve worked with our providers to send home fecal immunochemistry tests, or “FIT” kits, to caregivers over the age of 50 so they can easily send a stool sample for testing. For the past 3 years, almost half of eligible caregivers participated, and 4% with positive tests were referred for colonoscopy.

Emotional health support: High ACE scores and the emotional demands of caregivers put them at greater risk for depression. But they often feel stigmatized or afraid to seek support. One benefit we offer, Ginger, puts emotional support at their fingertips through a smartphone app. Of those users who screened positive for depression when they signed up for ginger, 76% showed improvement in symptoms within 6 weeks. This support in the moment can help prevent mental health problems from snowballing and foster greater long-term resilience.

Preventing injury: We also implemented Caregiver Kicks, a program that provides caregivers with a brand new pair of slip-resistant shoes each year for free. A pair of high-quality shoes can be a big out-of-pocket expense. Providing caregivers with high-quality footwear greatly minimizes the risk of slipping, tripping or falling while at work.

Encouraging regular doctor visits: Keeping in touch with a health care provider and seeing them regularly keeps people healthier by ensuring that health conditions are monitored and preventive examinations are performed. Our annual “See Your Doctor for Free” marketing campaign targets insured caregivers. It breaks down processes they may not be familiar with—like finding a doctor or making an appointment—and encourages them to choose and see a primary care physician.

It is exciting to design and deliver innovative health benefits to caregivers. But caregivers are just one group of workers doing critical work that keeps our communities and economy functioning. Too many care professionals, laborers, gig workers and part-timers don’t have this kind of access.

In the early 2000s, caregivers in Washington were also without health insurance. But partnership, advocacy, and investment have made access to high-quality, affordable health care possible for caregivers. Roadmaps like ours offer a blueprint for closing the growing gap in health care access and outcomes between white-collar workers and those who work for wages.

It’s up to all of us to build the infrastructure and political will for a stronger, fairer health care system that truly values ​​the well-being of everyone in our communities.

This post was written by Abby Solomon, CEO of the SEIU 775 Benefits Group.

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