LAwmakers in California may finally be offering a raise to the state’s woefully underpaid health care workforce. The lawmaker is debating a bill introduced by State Senator Mara Elena Durazo that would raise the minimum wage for a wide range of health care workers to $25 an hour by June 1, 2025.
This would be particularly beneficial to women of color, who are disproportionately represented in the health care sector, particularly in lower-paying jobs. Passage of the bill would provide a much-needed and well-deserved income boost for employees across the healthcare industry: from nurses to janitors and food service workers, and for employees in hospitals, nursing facilities, dialysis centers and other organizations. Researchers at the University of California, Berkeley Labor Center predict the bill would affect 469,000 to 1.5 million workers.
This bill would have a significant impact on the ability of Black women and their families to afford the exorbitant costs of living in one of the most expensive states in the country. Research by The Maven Collective, a progressive think tank we both work for that centers race and gender in its quest for economic justice, shows that in Alameda, Contra Costa, Los Angeles, Riverside, San Francisco and San Bernardino counties , the healthcare sector is the second most common field for families headed by black women. Health care jobs in the six counties average about $3,000 a month (before tax) pay. This is far less than what it costs to cover basic needs. In San Francisco, for example, our research shows housing costs more than $3,000 a month, and child care adds another $3,000. In fact, a family of two adults and two children (one preschooler and one school-age child) would need to earn more than $12,000 a month to keep up with the cost of living.
This single bill will not cure the affordability crisis, but it is an important step towards recognizing the value and dignity of these workers who hold up our economy and our families. Besides being the right thing to do, it’s also the smart thing to do. Research shows that higher wages reduce turnover, which translates into better patient outcomes and experiences. For example, a 2018 study reported that a 10 percentage point increase in nursing home nurse turnover resulted in an increase in deaths from 8.3% to 17.4%. And research conducted during the pandemic suggests that high turnover among nurses in nursing homes may have led to increased mortality rates.
This bill is unique because it includes not only workers hired directly by healthcare companies, but also all paid work performed on the premises of any healthcare facility. There is ample evidence that Black women working in health care are relegated to the more physically demanding and dangerous jobs such as home health aides and nurses. These jobs that are among the highest paying and offer little or no benefits impact the bodies of workers. Research shows that home health care workers have some of the highest workplace injury rates in the country.
The bill would increase costs for health care facilities, but those higher wage costs would be offset by savings in other areas such as staff turnover and declining reliance on safety net programs. The UC Berkeley Labor Center estimates that higher wages will result in a median 3.2 percent change in operating costs, with variations among different types of facilities. Hospitals, some of the bill’s most vocal opponents, would see an increase in operating costs of just 1.1%, while home health services would see an 11.6% increase in operating costs. This is because home health care workers are among the lowest paid workers in the state and therefore their pay raise would be greater than that of many other workers.
By the third year of the policies, when hourly wages reach a full $25, the state budget is estimated to see anywhere from $467 million in net savings to $303 million in net costs. Where the state lands on this band depends on the level of state increases to payments to medical providers, along with how many workers and dependents transition to private insurance.
This bill that passed the state Senate on May 31 and will be heard by the Assembly Labor and Employment Committee on July 12 is an effort to prioritize people over profits. Yes, it will cost money. Should. It’s time we decided to reallocate profits to the workers who support our healthcare system. This would set a precedent for the rest of the country and could prompt other states to follow suit. Scaling up wage increases in the broader healthcare sector would be transformative. People of color account for 58% of nursing assistants, 63% of home health assistants and 52% of residential assistants. However, they make up only 39% of the workforce. In 2021 the median hourly wage for home health aides and personal care assistants in California was just over $14; for certified nurse assistants the average hourly wage was $18. Among black and Latino workers in these direct care positions, about half earned less than $15 an hour. A $25 minimum wage would be a significant step in the right direction for these workers.
Women of color have been the backbone of our healthcare system since the early days of the country. For two centuries they have been unpaid or underpaid, undervalued and disrespected despite the critical role they play in our economy, our communities and our families. This bill represents one step in a long journey to pay Black women their worth, and by extension, all workers in this industry.
Andrea Flynn is a senior fellow in health equity at the Maven Collaborative. She also teaches courses on reproductive and sexual health, public policy, and economic inequality at Columbia University’s Mailman School of Public Health. Yvonne Yen Liu is the director of research at the Maven Collaborative. She has more than 20 years of experience in applied research, including health policy and labor market research.
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