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Missouri chamber encourages child care providers to offer workers health insurance

Michelle Kondrich
Special to NPR
The number of child care workers has drastically decreased since the beginning of the coronavirus pandemic. Missouri business officials say small businesses pooling their resources to provide workers health insurance could attract more workers.

The Missouri Chamber of Commerce and Lt. Gov. Mike Kehoe are encouraging more child care businesses to offer health insurance to help recruit employees.

The number of child care workers has significantly decreased since the start of the pandemic, chamber officials said, and offering health benefits is one way to attract more people to the profession.

“Child care facilities can't keep workers because of low pay and a lack of benefits,” Chamber President Dan Mehan said. “And we're trying to change that, we're trying to break that stalemate.”

A recent report from the Missouri-based women’s advocacy organization United WE found that hundreds of child care providers in the state have closed since the beginning of the coronavirus pandemic. Existing businesses are struggling to recruit new employees and retain staff.

Many of those workers are leaving because their employers don’t offer health insurance, the report’s authors found during listening sessions and town halls throughout the state. Child care employers are frequently small businesses with fewer than 50 employees and under federal law are not required to provide insurance to employees.

For businesses that do provide benefits, paying for them is expensive. The Missouri chamber is touting its Chamber Benefit Plan, a novel health insurance project, to lower health insurance costs for providers and entice them to offer coverage to their employees.

“This is just one small step,” said Wendy Doyle, executive director of United WE, a women's advocacy organization in Kansas City. “[It’s] an immediate solution that we can bring to the table. We’ve heard loud and clear this is a tremendous barrier to really recruit and retain the workforce. And this is just a small piece to the big puzzle.”

The chamber plan is a multiple-employer welfare agreement. Under the chamber’s health plans, hundreds of small businesses, including child care providers, can jointly join a plan as a single pool, which lowers health care costs and increases negotiating power small businesses wouldn’t otherwise be able to use.

Businesses need to be a member of one of the dozens of Missouri’s chambers of commerce to join the benefit plan.

Employers purchase the health plans and must pay for at least half of workers’ premium costs. There are 26 different plans under the agreement, all with different co-pay and deductible amounts.

“Just because of the nature of the pooling, there's economies of scale,” Doyle said. “So there are some affordability and some savings to potentially benefit a child care provider by offering it through the chamber program.”

Offering benefits is a step in the right direction for a workforce that’s historically not had insurance coverage, said Deidre Anderson, the CEO of EarlystART childhood centers in Kansas City.

However, child care workers are typically paid so little that it’s unlikely insurance will get many people to apply for jobs, she said.

“Certainly offering benefits is a stride in the right direction,” she said. “But until we also continue to work on the wage piece, the benefits are probably not enough."

Anderson said many child care workers don’t select a benefit plan even if employers offer one, and instead use money to buy food or pay rent.

“Often they just don't select it, because of the urgency of the moment in their households,” Anderson said.

Sarah Fentem is the health reporter at St. Louis Public Radio.