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Many who care for the sick and old lack health insurance

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The nation’s fastest-growing occupation, home health care workers and nursing assistants, is unlikely to keep pace with demand, given the stagnant wages and lack of benefits that come with the work.

That’s one conclusion easily drawn from reports released Tuesday by the Paraprofessional Healthcare Institute (PHI). The organization found a quarter of home care workers and 20 percent of nursing assistants have no health insurance versus less than one in 10 workers nationwide, according to PHI’s findings.

This is the case even though the study also found higher rates of health insurance coverage among home health care workers and nursing assistants since the implementation of the Affordable Care Act (ACA). From 2010 to 2014, coverage rose 14 percent for home care workers and 11 percent for nursing assistants.

Adding to the gap in health insurance coverage with these jobs is the larger risk of getting hurt while at work. Nursing assistants, for instance, suffer job-related injuries at 3.5 times the rate for the average U.S. worker, PHI noted.

“The poor quality of home care and nursing assistant jobs is exacerbating a growing care gap, in which insufficient numbers of workers are available to meet growing demand,” PHI President Jodi Sturgeon said in a statement. “Investments in job quality will be critical to attract workers to meet demand in a tightening labor market.”  

The aging of America’s baby boomers has led to a surge in demand for home care workers to look after the nation’s elderly, as well as the disabled and chronically ill. The number of workers employed by home care agencies has more than doubled in the last decade to 1.4 million from just over 700,000, PHI estimated. 

Another 800,000 work in consumer-directed Medicaid programs, bringing the total of home care workers to more than 2 million. The industry will create more than 600,000 jobs in the next decade, more than any other occupation in the U.S.

Despite the high demand, home care aide is a low-paying job, earning a median hourly wage of $10.11 for work that’s often part-time or part-year, resulting in average annual pay of $13,300, PHI found. One in four home care workers live in poverty, and more than half rely on some form of public assistance.

Wages are slightly better for the more than 600,000 nursing assistants working in U.S. nursing homes. They earn a median hourly wage of $11.87, or $19,000 a year, a separate PHI report found. A little over half have employer-sponsored insurance, one in five rely on public coverage, most often Medicaid, and the rest buy individual insurance directly.