By Bridgit Bowden
Wisconsin Public Radio
Corrine Hendrickson runs a daycare out of her home in New Glarus, and on a Friday morning in May, she was quick to wash dishes, play with dinosaurs and remind the children that it’s dangerous to throw toys – all at the same time.
Hendrickson has to work nonstop. She has permission to care for eight children alone in a two-room annex at the back of her house. She loves the work, but says the child care industry is in crisis. The costs to families are too high and the pay is too low to keep staff at the same time.
“We are all overwhelmed and stressed,” she said, and one piece of that puzzle is health care.
It’s extremely rare for caregivers to have health insurance through their employer. She gets her insurance through her husband’s job, which she says is especially common in home-based childcare.
“Some of us are tied to our marriages because we need this health insurance,” she said.
Some child care workers stay on their parents’ insurance but leave the industry when they retire after their 26th birthday, Hendrickson said. Some find plans on the state’s health insurance marketplace, others get coverage through Medicaid.
“Because they really are the working poor,” said Beth Swedeen, executive director of the Wisconsin Board for People with Developmental Disabilities, of people in care professions, including child, disability and elder care. “They are low-wage workers who, even if they work full time, are eligible for programs.”
Reader wonders if expanding Medicaid could alleviate nursing shortage
This election year, Wisconsin Public Radio (WPR) is asking people what elected officials could do to improve their communities. Medicaid expansion and health care affordability are on many people’s minds. We found that health care accessibility and affordability are especially important to Wisconsin’s caregivers.
Noah, the 26-year-old son of New Londoner Mary Swifka, has Down syndrome and works with a nurse practitioner 32 hours a week. Swifka, who first turned to WPR for health care support while he was nursing, said it gives him a sense of independence.
“It’s important to give him the opportunity to do things outside of his home and without mom and dad,” she said.
But she knows how low wages are for caregivers and how difficult it can be to find health insurance. Noah’s caregiver is covered by Medicaid, she says.
According to the Kaiser Family Foundation, both home health care and daycare are among the top 10 industries with the largest number of working Medicaid beneficiaries.
To qualify for Wisconsin’s largest Medicaid program, BadgerCare Plus, you must earn at least the federal poverty level, which is about $1,200 a month for a single-person household. That’s a problem for some caregivers, Swedeen says.
“Many workers only work a certain number of hours per week because if they work more hours they will lose their Medicaid coverage – the only health insurance they can get and afford,” Swedeen said.
Swifka said she has seen how difficult it is to find and retain good caregivers for people with disabilities, and health care is one reason why.
Kaylin Neustifter, assistant director of Chiemsee Castle Daycare in Oshkosh, has experienced the same problem in child care. Some of the facility’s staff have had to cut back on their hours to stay at BadgerCare, she said, which can cause scheduling issues.
“This then impacts the business in general because there are people who say, ‘Sorry, I can only work three days a week because otherwise I’ll go over the limit,'” she said.
Neustifter earns too much to qualify for BadgerCare, so he goes without insurance other than family planning insurance through another Medicaid program with a higher income limit.
The average hourly wage for child care workers nationwide is just $14.60. Neustifter is aware of this and is surprised that more of them are not eligible for full health insurance through Medicaid.
“Daycare is not a field where you get paid incredibly high wages anyway,” she said. “So it’s hard to believe that we wouldn’t be qualified… we would have to make even less.”
The center’s director, Ciera Cramer, said the low wages and lack of benefits in the industry led to a vicious cycle of constant staff shortages. There were more requests from the public than there was space, she said.
“But if we could hire more staff, we could increase enrollment,” she said.
Medicaid expansion could play a role, some advocates say
Wisconsin is one of 10 states that has not accepted federal funding to expand Medicaid. If it did, people earning up to 138 percent of the federal poverty level could receive BadgerCare. Some say that would allow caregivers to work more without fear of losing their health insurance.
Democratic Governor Tony Evers has proposed expanding Medicaid in all of his budgets since his election in 2018.
But Republican House Speaker Robin Vos has said that would be out of the question. It is unnecessary, he said, because people living at or below the federal poverty line can already be covered by Medicaid in Wisconsin, which is not the case in other states without health insurance expansion.
Robin Rudowitz, director of the Kaiser Family Foundation’s Medicaid and Uninsured program, said many people who earn too much for BadgerCare will have to qualify for subsidized plans through the Marketplace.
“Many people in this income bracket are eligible for comprehensive coverage with no premium,” she said. “But there may be additional out-of-pocket costs that may be different from Medicaid coverage.”
But Rudowitz said there can be obstacles. And data shows that 35 percent of uninsured people nationwide are eligible for subsidized plans on the Marketplace.
The healthcare marketplace is the right solution for some, but others face obstacles
Neustifter has looked at the market place, but says the process was too chaotic.
“I felt like I was getting stuff sent to me from all sorts of places,” she said. “I also don’t go to the doctor unless I feel like something is absolutely necessary… I’m pretty lucky with my health.”
But for people like Al Trautman, a plan on the Marketplace made the most sense. She works in respite care with special needs children in Milwaukee. She used to be with BadgerCare, but she was tired of having to keep her hours low enough to remain eligible.
“It always seemed like I was kind of on the edge of the abyss,” she said. “Trying to make a little extra money to get ahead didn’t really get me anywhere, it just put me at greater risk of getting into even greater financial trouble.”
Now she says her Marketplace plan is a good fit for her needs and she can work as many hours as she wants.
“It gives me a lot more freedom to do all these crazy, different jobs that I do and that I enjoy and that families need help with,” she said.
Still, she said people in the care industry deserve better opportunities and that thought will stay with her as she decides who to vote for this year.
— This story was produced as part of the NEW (Northeast Wisconsin) News Lab, a consortium of six news organizations. Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to their newsletters for original stories and Friday’s news roundup.
