Brianna's Story

This is the third of a 6 week series entitled, "Summer at the County Fair". It is a synopsis of 6 hours I spent meeting and speaking with people who were visiting a county fair in western PA. Over the next few weeks you will see the human faces that mirror our national statistics regarding the uninsured and underinsured. Thanks to the Pennsylvania Health Access Network (PHAN) for their assistance in this series.

Artwork by: Norman Rockwell

According to our recent census, roughly 800,000 Americanswill be living into their second century, a unique and growing group we dub “centarians”.   Taking care of this growing cohort is Brianna, a 28 year old home health aid from Clarion County,PA.   For 35 hours a week, this mother of 2 lifts, bathes, dresses, feeds and provides medical oversight for her 91 year old patient for $15,000 a year, a salary consistent with many in the profession.   Brianna reports liking her job which is reflective in the fact that she worked for the mentally handicapped prior to her service with the elderly.   In fact, the vast majority of home health aides do report job satisfaction. With 2011 signaling the year the infamous “baby boomers” have officially reached retirement, there is no disputing that our society’s needs for the selfless services of people like Brianna are going to be in greater demand.

The altruism that Brianna and home health aides like her are a priceless commodity as we watch our population rapidly age, but the question our society needs to ask ourselves is what value do we place on them and the vital services they provide? The day I met Brianna, she was riddled with concern. She had just received word that she would no longer be eligible for Medicaid.   Apparently, a home healthaide with 2 children that works 35 hours a week and makes $15,000 a year is too high of an income to qualify for Medicaid.  Unfortunately, Brianna is not alone.  According to a National Health Statistics report released in 2011, 25% of home health aides are not offered health benefits from their employers, of which 18% end up with none at all. This number is significantly above the national average of 15% for the general population. Even more alarming, among health aides, the ones like Brianna that provide home only health aide in private homes as opposed to institutional care, are at even greater risk of being uninsured (34%).

Brianna and those in her situation are left treading the waters of a ruthless system that has no qualms about sucking them down. What incentive is there for them to stay in a profession that appears to be so devalued by our society?   What would happen if the Brianna’s of the world chose to climb out of these waters and swim to a more secure shore. The numbers are evidence to the value we place on those that serve our elderly.  In a profession that is prone to injury, as they service our society’s vulnerable, they themselves are also becoming the most vulnerable.

Fortunately in 2010 with the passage of the Patient Protection and Affordable Care Act, a life preserver was thrown to keep these valuable citizens afloat. Brianna will now be covered because the PPACA will expand Medicaid up to 133% of the Federal Poverty Level.  For those that fall above 133%, there is the individual exchange that will provide premium tax credits if they are below 400% of the Federal Poverty Level.   Additionally, now employers, such as the private home health aide company that Brianna works for, will have to harbor more responsibility by paying a $2000 fine when they don’t provide health insurance for their employees, instead utilize the public system as their “benefits package”.   The PPACA will also take a step in recognizing the toll our rapidly aging population is having on our health care system and health care costs by including a provision which funds Work Force Development and Training Opportunities for Direct-care Workers . Brianna can also expect to enjoy the other standard benefits guaranteed by the Patient Protection and Affordable Care Act such as preventive care, medical loss ratio, basic patient protections and rate review.

As the “centarians” embrace their new century in greater numbers, they will sense the security that permeates from people like Brianna.   Brianna is the ship that will carry them through their golden years.

Source:

Bercovitz A, Moss A, Sengupta M, et al. Anoverview of home health aides: United States, 2007. National health statisticsreports; no 34. Hyattsville, MD: National Center for Health Statistics. 2011.