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My Turn: Medicaid expansion would help my staff, my child-care business

Last summer, late in the day, when most of the staff and children were outside on our playground at the Cinnamon Street Early Education and Child Care Center in Newport, a 4-year-old girl in our care was jumping down the steps of one of the climbing gyms.

She stumbled and would have fallen and hit her face if our pre-school teacher hadn’t reacted quickly and caught her. We all breathed a sigh of relief – including her parents who had just arrived to take her home.

As executive director of a child care center, my days are full of busy, energetic babies, toddlers and children – and a staff who take very seriously their responsibility to keep those little ones safe and healthy.

It’s unfortunate that my staff – and the roughly 10,000 to 15,000 other child-care center professionals in the state – don’t get this same protection when it comes to their own health.

Like many employers in New Hampshire, I was disappointed when the Legislature did not accept federal money to extend health coverage to employees like mine. But the opportunity is still there – and New Hampshire should take it.

Until the recession, I was able to offer insurance and pay half the cost of the premiums for my full-time staff. But many of the parents who rely on us were hard hit in the economic downturn, and health premium costs continued to rise by double-digit rates.

I reached a point where my small business could no longer afford the rising cost of health insurance. In fact, like my staff, I am now uninsured.

Child care is not a high-paying field. The average hourly wage is not much more than $9 per hour, even though many – roughly 22 percent nationally – have a bachelor’s degree or more, according to research conducted by Kristin Smith at the Carsey Institute. Still, my employees work hard at a caring profession, and I rely on them to make my business successful.

I have one employee who has asthma. When she first came to work for me, she had health coverage through her parents’ policy but lost it when she turned 26. I worried about her every winter during cold and flu season and again every allergy season. She couldn’t afford to get the preventive care she needed and so had no choice but to risk a health crisis that, at any time, could land her in the emergency room.

More recently, she became pregnant and as an expectant mom, she qualifies for health care under the existing Medicaid program. For now, I can rest easy that she’s getting the treatment she needs. But currently, Medicaid coverage for pregnant woman and new mothers is temporary.

Not long after the baby is born, she will lose her access to affordable care unless this state accepts the federal funding to extend Medicaid in New Hampshire.

The federal government has agreed to pay 100 percent of the costs for benefits for the newly eligible through Dec. 31, 2016. After that, New Hampshire will gradually contribute a small percentage, but never more than 10 percent, and much, if not all of that cost, will be offset by savings elsewhere in the state budget.

My business is not the only one that will benefit from improved access to health care for our employees. Of the thousands of people who work in restaurants and food service, few have access to affordable health coverage. People who work in construction, in retail, in landscaping or delivery services would all benefit from the coverage.

But child care professionals are the group that means the most to me. For my business to be successful, I need my staff to stay healthy. I need them to be alert and at their best, prepared for moments, like on the playground, when someone slips.

In child care centers across New Hampshire, these dedicated professionals take care of our children at their youngest and most vulnerable, enabling parents to work and support their families. Surely it’s not too much to ask that they be given the means to protect their own health?

(Patti Harford is executive director of the Cinnamon Street Early Education and Child Care Center in Newport.)

Thanks for this letter, Ms. Herford. I agree with you that Medicaid should be expanded in NH. But after that, I think small business owners would be well-served to set their sights on single-payer health insurance. Imagine if no businesses had to deal with the question of whether they could afford to provide their staff with insurance? What if some of the money that currently goes into health insurance could go into hiring new staff instead?

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