Health Insurance Matters: Insurance Coverage and Health Service Use Among Direct Care Workers in the United States.

Area of Science:

• Public Health
• Health Services Research
• Sociology of Health

Background:

• Direct care workers (DCWs) are crucial for supporting vulnerable populations.
• Many DCWs experience barriers to healthcare access, often due to lack of insurance.

Purpose of the Study:

• To examine health insurance coverage and healthcare service use among DCWs.
• To identify disparities in access, utilization, and affordability based on care setting and insurance type.

Main Methods:

• Observational study using pooled National Health Interview Survey (NHIS) data (2014-2018).
• Included 1499 direct care workers across various settings.
• Bivariate and multivariable logistic regression analyses were employed.

Main Results:

• Home care and nursing/residential care aides had lower insurance rates and higher cost barriers than hospital aides.
• Medicaid reliance was higher among these groups.
• Medicaid insurance was associated with improved healthcare access, utilization, and reduced cost barriers.

Conclusions:

• Addressing insurance gaps for DCWs is critical given workforce growth projections.
• Policy and practice interventions are needed to ensure DCW health.
• Supporting DCW health is vital for maintaining quality care for dependent populations.