An estimated 2 million home health care workers in the United States provide much needed aid and care to Americans who live at home. But despite the care they render and the savings they make possible by helping their clients' and their families avoid the use of nursing homes, these workers' wages are exempted from the Fair Labor Standards Act, which guarantees covered workers both a federal minimum wage and a right to overtime pay. President Obama has proposed to bring these home care aides under the Fair Labor Standards' umbrella to assure them fairer treatment. Predictably, Republicans and business oppose Obama's proposal.
President Obama's proposal, which could become effective in mid-February after a 60-day comment period, is imminently sensible. Home health care aides were unfairly exempted from the Fair Labor Standards Act in 1974 in a lamentable ruling that categorized them as "companionship" workers on par with part-time baby-sitters.
That disparate treatment may have been seen as acceptable then, when the use of home health care workers was relatively novel, and its emergence as a bona fide industry was not foreseen. But with the mushrooming expense of nursing home care and the stringent tightening of Medicaid funding for use of nursing homes since then, the home health care industry has soared.
Roughly six million of the 40 million Americans now above 65 years of age employ some level of home health care. That number is expected to double by 2030. Nine out of 10 home-health-care workers, moreover, are now employed by agencies at wages that typically range from $8.50 to $12 an hour. That's above the current federal minimum wage of $7.25 an hour, but it's not much for the vital care they provide, nor does it reflect the savings in nursing home care.
Many home care aides, moreover, work up to 60 hours or more a week without overtime compensation, while many of the agencies that offer home-health care profit handsomely on the business. It's no wonder the home-health-care industry is complaining, and that Republicans reliably support them.
The industry claims that higher wage costs, especially for over-time, will raise the cost of home-care aides, driving up costs both for individual families and nursing homes generally. Some of the higher costs, they say, will fall one government programs, like Medicaid and Medicare, which presently pay for roughly 75 percent of current home-health-care costs. Some other critics contend that overtime wage requirements could reduce the volume of hours that some home-care workers want to work.
Labor Department studies rebut those claims. They predict the wage-cost impact to be just a fraction of one percent -- from 0.06 percent to 0.29 percent of federal and state home health care costs. Moreover, the department expects the new wage standards to thwart to a race to the bottom -- a scenario in which in-home-care agencies keep trying to undercut their costs vs. their competitors' costs by driving down wages.
With current hourly rates for home-care aides already generally above minimum wages, Labor's analysis seems feasible. If agencies need more employees to avoid overtime costs, that will boost the number of workers overall.
In fact, there is no rational reason -- save the ever-present quest for higher profits for employers, and the support of their Republican puppets -- to deny home health care workers the right to a minimum wage and overtime pay. Republicans who don't understand that simply provide further proof that they are out of touch with the vast majority of Americans who regularly work hard and long hours to make ends meet, and who deserve fair treatment.