Care management workers in the US are being told they must pay their own way out of work, as part of a $1.5 trillion healthcare overhaul.
The move is part of the Affordable Care Act, or Obamacare, which President Donald Trump has said will help millions of people get jobs and keep the US economy strong.
Care managers are being asked to cover up to 50% of their annual salary and cover the costs of their care and other activities, such as babysitting and home care.
They are also required to get approval from the US Department of Labor for their work.
“There is no incentive for us to go to work for free,” said Maria Sanchez, a former care manager at a New York nursing home who was laid off in July.
“We need the ability to work.”
A report released this week by the government’s watchdog agency, the Office of Personnel Management, found that healthcare jobs were not being filled because of the healthcare overhaul, which takes effect in 2020.
The unemployment rate for workers with at least five years of experience in the healthcare industry has been above 8% for the past year.
The OPM said it was investigating the agency’s findings and would recommend how to improve conditions for care workers.
“The government is aware of the significant challenges in caring for the country’s growing number of Americans who rely on care workers for personal care services,” OPM Director Katherine Faulders said in a statement.
“This new federal rule will help address the challenges facing the healthcare workforce while ensuring the workforce has the ability and resources to support its health needs.”
The healthcare industry in the United States accounts for almost 2% of the economy, with a workforce of about 21 million.
The health and human services sector accounts for about 11% of jobs, while retail, food services, healthcare and public administration are the other three sectors.
The healthcare sector also employs more people than any other industry in America, according to a US Census Bureau report.
The government estimates that healthcare workers in 2017 made about $2.7 trillion in total compensation.
But, the government said, they made less than a third of what they were making before the healthcare reform law was passed.
“As a result, millions of care managers are not receiving the basic pay and benefits they need to provide for their families,” said Kathleen Sebelius, acting secretary of the US department of health and humans services, in a release.
“They are being paid in a manner that is far below the level that was needed to support them and their families.”
The OPP said that, over the past two years, a total of 6,098 workers were laid off, a number that had risen by nearly 4,000.
The agency estimated that nearly 9.5 million people were expected to lose their jobs.