Every day millions of women work for a nonprofit organization or receive vital services from one.  Women depend on nonprofits to deliver a steady paycheck, child care, affordable food, housing, medical care, domestic violence assistance and many other services that provide an important social safety net for our communities.

Nonprofits are predominantly small employers and are facing serious challenges in providing and affording health care coverage for their employees.  Unfortunately, regardless of the role nonprofits play in our nation’s economy and the welfare of our citizens, the sector has been lost in the overall health care dialogue.  As a result, they are at risk of not receiving adequate support in the final health care legislation.

Nonprofits have suffered from the economic crisis like every sector.  Over the past year, organizations have faced escalating operating costs, decreased revenues from all types of funders and increased demand for more services.  As a result, nonprofits have had to re-evaluate their operations and lay off employees.  Ironically, at a time when nonprofits need to provide more services to our most vulnerable citizens, they cannot with the potent combination of decreased revenue and sky rocketing health care premiums.

Unaffordable health care puts an even greater pressure on the nonprofit sector, which is why it’s vital that nonprofits receive the relief they deserve from Congress.

Nonprofits bring value to all of our communities every day.  The economic viability of nonprofit organizations is critical to sustaining a healthy, vibrant citizenry in strong communities. Nonprofit organizations provide a wide spectrum of services that touch every person’s life in one way or the other.  They provide support to our most vulnerable populations, and many of those clients are women and children who depend on various programs to survive.  If nonprofits suffer and have to downsize services because they do not receive equivalent relief as other sectors, thousands of women will be impacted nationwide.

For decades, nonprofits have struggled to attract a talented pool of employees.  Part of this is their inability to provide competitive wages and benefit packages that can attract capable applicants who will grow within the sector.  Nonprofits want to pay their employees a living wage and decent benefits, but with the increasing costs of health care it has gotten much harder. A critical component of any benefits package is health care so if policymakers fail to recognize and address the needs of nonprofits the damage to the sector and its female employees could be long lasting.

Together, nonprofits employ nearly 13 million individuals–almost 10 percent of the U.S. workforce–who are integral to the vital services these organizations provide to communities throughout the nation.  Nonprofit employees are predominantly female and depend on their employers to provide adequate, affordable health care coverage.  However without appropriate health insurance subsidies from Congress, nonprofits will have to either cut benefits to their employees, stall wages in order to afford benefits, or cut back on needed services.

In the end, nonprofit employees suffer financially, organizations lose capable staff and nonprofit clients get denied the services they need.  Nonprofits feel the health care cost squeeze much like small business and need equivalent support.  Among the 30 million uninsured people, many of them are working for small nonprofit employers that cannot afford insurance.  According to the Urban Institute of the 984,386 registered nonprofits nationwide, 82.3% (810,149) have budgets of $500,000k or less. Therefore most nonprofits have small budgets and according to the Johns Hopkins University Listening Post Project, only 46 percent of small nonprofits offer health benefits to their employees.

Nonprofits are a significant piece of our nation’s small businesses.  Yet with all of the attention small business has garnered throughout the health care reform debate, nonprofits have been completely left out of the dialogue. Policymakers and the media have failed to acknowledge this important sector of the workforce.  Because nonprofits are predominately small employers, they suffer from the same challenges as small business even with a different tax status.

Fortunately through the hard work of nonprofit advocates, some headway has been made in getting nonprofits included into reform legislation.  The Senate Finance Committee included in their completed bill a tax credit amendment that would allow charitable organizations with 25 or fewer employees to be eligible to apply the tax credit against the organization’s payroll taxes withheld from its employees.  Nonprofits would be eligible for a 25% credit from 2011-2013 and a 35% credit in 2013 to help provide quality, affordable health insurance to their workers.

The Senate Finance Committee amendment is a viable way for Congress to support the sector.  At the very least, it recognizes the role nonprofits play in our nation’s economy and their need for health care relief.  Unfortunately the proposed comprehensive House health care bill does not include a nonprofit amendment and leaves the sector out.  As a result, nonprofit advocates will be monitoring whether this amendment gets included into the final Senate bill and not lost during the final Conference Committee process.

Nonprofits must be innovative and diversify their funding to stay financially solvent, but at the same time the federal government must be a supportive partner.  Nonprofits should not be dismissed by policymakers, but instead embraced for their immeasurable value.  And the health care debate is a prime opportunity for federal policymakers to recognize the unique and important role nonprofits play in our society.

Nonprofits are naturally resilient and nimble because they have to be in order to survive.  However their tenacity can be pushed only so far.  They can be crippled by health care costs like any other sector and now is the time to send a clear warning signal to Congress.  As the debate continues to rage on, nonprofits want to see the federal government showcase their support of the sector by explicitly including them into the final health care reform bill.

This post is a part of the National Women’s Law Center “Women Blog for Health Care 2009“

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