Community Health Plan of Washington

Uninsured Restaurant Workers

For a restaurant worker, already at the low end of the wage scale and without health insurance, not being able to pay an expensive medical bill creates a serious financial hardship.

“Most restaurants never provide insurance for employees. They are small businesses,” said Lien Ngo, an International Community Health Services Financial Screener.

While many food service workers have no health benefits, one Chinatown International District restaurant is bucking that trend.

If staff at Tai Tung Restaurant get sick or injured, they’re protected.

“We provide insurance. We can only pay so much. It’s up to them (staff) to pay for part of it,” said Tai Tung owner Harry Chan. Some Tai Tung employees receive insurance through their spouse’s employer plans.

Tai Tung opened in 1935 and is one of the oldest restaurants in the Chinatown International District. Many staff have worked there 30 to 40 years. Two years ago, an employee retired after 49 years. With so many older workers, some are on Medicare.

Those who choose not to use Tai Tung’s insurance have signed up for the state’s Basic Health Plan in the past, through ICHS.

The Basic Health Plan, has a waiting list of 100,000 people who have already filled out applications. As of May 2009, Basic Health was no longer accepting applications and is compiling a waiting list instead.

The uninsured can turn to the Community Health Plan (CHP) for help. CHP works through the Washington Health Program (WHP).

WHP is an insurance program with lower rates and gives people an alternative to more costly private insurance.

Both Basic Health and CHP are administered by the Washington State Health Care Authority.

According to CHP, there are one million people in Washington State without health insurance.

Ken Chen worked at two popular mainstream restaurants to pay for school and said employees had no insurance coverage. “They had to buy their own,” he said.

Chen remembers restaurant staff getting cut while working, then bandaging themselves.

He now works as an IT Specialist at Asian Counseling and Referral Service, where full and part-time employees who work at least 20 hours a week receive benefits.

“Health insurance definitely helps. I’m glad this place offers it,” said Chen.

When the Patient Protection and Affordable Care Act (PPACA) goes into effect in 2014, restaurants and other businesses across the nation will be required to provide health insurance to their employees.

PPACA, part of President Barack Obama’s Health Care and Education Reconciliation Act of 2010, has set a goal of insuring 32 million people by 2014, but states will not receive funding until that year.

In 2009, 3,838 people who turned to the ICHS for assistance did not have medical insurance. That figure represented 22 percent of that agency’s patients that year.

Although the agency does not keep records on their patient’s occupations, it is believed that some of the uninsured worked at Chinatown International District eateries.

“We have a lot of restaurant workers. Right now new immigrants are taking restaurant jobs because of language [barriers],” said Linda Eng, an Eligibility Worker for ICHS.

Workers visit ICHS for the treatment of injuries from lifting heavy equipment or problems caused by burns or cuts, as well as other illnesses.

The clinic does not turn anyone away. ICHS patients without insurance can receive the health care they need but must apply for a sliding scale discount program that reduces the cost of their care. Applicants must show a statement with their last 30 days income. Medical fees are based on income and family size.

“Usually most people who come to the clinic qualify for assistance,” said Eng. “They don’t know how to ask for help. If they don’t have the income, we will try to help them.”

The goal of CHP is to give Washington residents a low-cost option for health coverage.

ICHS is part of the CHP coverage plan. State wide, there are 540 primary care clinics, 2,365 primary care physicians, 13,571 specialists and 100 hospitals in the CHP network.

CHP covers people in five programs: Basic Health, Disability Lifeline (GA-U), Healthy Options (includes SCHIP and Basic Health Plus), Washington Health Program and Medicare Advantage Plans.

A low to middle-income worker may not earn enough to pay for private insurance and rates are rising. Some who qualify for Basic Health are being turned away because of budget cuts. They could also earn too much income for state programs.

As workers with small paychecks, those in the restaurant field could pay for expensive private insurance, but would have to sacrifice by cutting back other basic needs like food, to pay for it.

When asked to arrange interviews with restaurant workers for this article, Linh Tran, Family Health Worker at ICHS said clients would be reluctant to talk for cultural reasons.

“I have quite a bit of (clients) with no insurance. They come in for visits. It’s the best and only place they can come for health care,” said Tran.

If an uninsured patient has to be sent to the hospital, they can be left with a huge tab.

“If you go to the hospital, it’s more expensive. They will take care of you, but you are stuck with a big bill,” said Eng.

Fearing the high cost, some people opt out of visiting a hospital for treatment.

“They go to a doctor only when they are very sick,” said Eng.

An option to help this group is to consider the hospital charity programs. ICHS helps patients fill out the forms to qualify.

Tran estimates 95 percent of patients at the ICHS’s Chinatown International District location are Southeast Asian. Others are from the Philippines, China and Taiwan.

For two years, Asari and Salima Mohamath ran Salima Restaurant on Martin Luther King Way South. Despite positive reviews, they closed the business due to the demands of operating a restaurant and raising a family at the same time. Now they own Salima Catering serving Malaysian, Vietnamese and Cham cuisine.

When Salima Restaurant was in operation, they provided insurance for their cooks, but found it difficult overall to get health coverage for a small business. There were many part time employees and the turnover rates were high.

“It was very basic insurance, but we needed to have groups of three or more,” said Asari.

“I like my staff to have insurance, but I don’t want to force them to,” Asari said.

According to the United Healthcare Alliance (UHC) website, one of every two or three restaurant workers are without health insurance. UHC said Census Bureau data estimates overall there are 50.7 million people with no insurance. There was a 16.9 percent increase in 2009 as workers lost jobs and companies cut benefits. There are four to six million restaurant employees among the nation’s uninsured.

Asari says health insurance requirements for restaurants are a good thing. However, because of the expense, it could “wipe out a lot of ‘mom and pop’ restaurants.”

“It’s a very good incentive to offer staff, if you have a good business plan,” said Asari.

As businesses become more profitable, they may be able to afford health insurance. Small restaurants may be unable to do that.

“We incur the costs as business owners,” said Asari. Instead of being required to offer health benefits, businesses should make their decisions based on their growth.

“Every year insurance goes up. We cannot keep up with [insurance companies],” said Tai Tung’s Chan.

Eng says new immigrants are learning about the importance of having insurance. “Asian people pay attention to the insurance issue,” said Eng.

The ICHS Medical and Dental Clinic is located at 720 8th Avenue. Call (206) 788-3700 for medical and (206) 788-3757 for dental. The ICHS Holly Park location is located at 3815 S. Othello St. Call (206) 788-3500 for medical and (206) 788-3502 for dental. Visit for more information. CHP customer service can be reached at 1 (800) 440-1561 or [email protected].

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