As the Affordable Care Act (ACA) continues to roll-out over the next few years, its expected effect on nursing professionals and Allied Health workers may be significant. Most notably, the ACA should cause a dramatic spike in demand for these skilled providers, creating staffing shortages at many healthcare facilities around the country.

One of the areas that figures to be the hardest hit by this trend is home care – the domain of Certified Nursing Assistants (CNAs) and Home Health Aides (HHA). With the percentage of the U.S. population made-up by senior citizens already at record levels and rising, there is a rapidly growing number of Americans who will rely on home care as their primary means of receiving treatment.

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What Does This Mean for Nursing Assistants?

As is reflected on our list of the Top 15 Healthcare Careers for High School Graduates, both Home Health Aides and Nursing Assistants are projected to see more than a 20% increase in demand for new positions through 2022. Overall, the number of new direct-care positions created is

expected to exceed 1.6 million according to projections from the U.S. Department of Labor, making home care one of the fastest-growing fields in the labor force over the remainder of the decade.

Who is Hiring?

The majority of home care services are provided by home health care agencies. According to the Bureau of Labor Statistics’ Occupational Outlook Handbook, approximately 37% of all HHAs were employed by such agencies in 2012. By comparison only 4% of nursing assistants worked for these types of agencies (42% work in skilled nursing facilities, or SNFs), although that number is expected to increase significantly. provides an excellent national database of home health agencies. You can search for employers in your area by clicking here.

What are the Work Requirements?

Because most of the new home care jobs being created must meet government guidelines under the ACA and Medicare, employers are now required to only hire workers who have completed formal training. This means that, in addition to meeting the minimum requirements for work in your state, you will now most-likely be required to also hold either an HHA or CNA certification.

Other typical requirements for hire through most agencies include:

  • Be at least 18 years of age

  • Have proof of recently passing a tuberculosis test

  • Be able to pass a criminal background check

  • Have a high school diploma or GED equivalent

What is the Pay?

Pay for home care providers will vary considerably according to a number of factors, but will generally fall within the range reported by the U.S. Bureau of Labor Statistics in 2013.

The median U.S. salary for Home Health Aides was $10.10 per hour, or roughly $21,000 per year. Nursing assistants, on the other hand, earned a median wage of $11.97 per hour, or $24,900 annually.

Summary of the ACA’s Effect on Home Care

Despite the reports of the negative effect that the Affordable Care Act may have on certain employers and their ability to retain their workers, home care stands as one example of an industry that will clearly benefit from the law. Therefore, if you’re looking for a first job or are interested in changing careers and getting into healthcare, the home care field is an ideal place to start and figures to remain a major source of opportunity for years to come.