By Michael Scaturro, KFF Health News (TNS)

When Lyft driver Tramaine Carr transports seniors and sick patients to Atlanta hospitals, she looks like each a friend and a social employee.

“If the drive is an hour or an hour and a half and it's mostly on the highway, people tend to tell you what they're going through,” she said.

Drivers like Carr have develop into a crucial a part of the medical transportation system in and around Georgia Washington, D.C, Mississippi, Arizonaand elsewhere. While some patients use transportation corporations that specialize exclusively in medical or non-emergency ambulance rides to get to their appointments, San Francisco-based ride-hailing corporations Uber and Lyft also transport people to emergency rooms, kidney dialysis, cancer treatment, physical therapy, and others Doctor visits.

But Georgia ride-hailing drivers don't just serve patients who live in Atlanta or the sprawling suburbs. When rural Georgia residents are too sick to drive, Uber or Lyft are sometimes certainly one of the one ways to achieve medical care within the state capital.

Closure of rural hospitals in Georgia have resulted in people battling cancer and other serious illnesses now having to commute two or more hours to treatment facilities in Atlanta, said Bryan Miller, director of mental health support services at Atlanta Cancer Care Foundationan offshoot of a medical practice geared toward reducing the financial burden on cancer patients and their families.

From April 2022 to April 2024, Lyft drivers accomplished hundreds of trips longer than 50 miles each way that began or ended at Atlanta-area medical treatment centers, including Emory University's Winship Cancer Institute and Emory University Hospital Midtown Lyft .

While 75% of those trips were lower than 100 miles, the corporate said 21% were between 100 and 200 miles and 4% were greater than 200 miles, showing that even Georgians who live just a couple of hours from metro Atlanta , depend on the ride-hail platform to access medical care.

Uber Health global head Zachary Clark declined to supply comparable ridership data. Uber Health is a division of Uber that arranges medical transportation for some Medicaid and Medicare recipients, medical personnel, prescription drug delivery, and others who seek reimbursement for medical-related Uber rides. in accordance with Uber's website.

Lyft also has a healthcare division that provides programs akin to Lyft Assisted and Lyft Concierge to coordinate rides for patients.

Nationwide, some insurance firms and cancer treatment centers, in addition to Medicare Advantage and state Medicaid plans, pay for such ride-sharing services, often with the goal of reducing missed appointments, they are saying Krisda Chaiyachatiadjunct assistant professor on the University of Pennsylvania School of Medicine.

In 2024, 36% of individual Medicare Advantage plans and 88% of special needs plans offered transportation services, it said Jeannie Fuglesten Biniekdeputy director for Medicare policy at KFF, the health policy research, survey and news organization that features KFF Health News. A special needs plan provides additional advantages to Medicare recipients who’ve serious and chronic illnesses, certain other health needs, or who even have Medicaid.

And Medicaid — the state government's safety net insurance plan for individuals with low incomes or disabilities — paid as much as 4 million beneficiaries Non-emergency medical transportation services are expected for use annually from 2018 to 2021, in accordance with a Department of Health and Human Services report. Patients living in rural areas were the most probably to make use of ride-hailing and other non-emergency transportation providers, in accordance with the report.

The estimated total federal and state investment in non-emergency medical transportation was roughly $5 billion in 2019. in accordance with a study from the Texas A&M University Transportation Institute.

Even when some insurance firms cover rides or charities offer ride credits, social staff say many sick patients are still left with no ride. In 2022, 21% of adults nationwide without access to a vehicle or public transportation went without needed medical care. in accordance with a study from the Robert Wood Johnson Foundation. People who didn’t have access to a vehicle but had access to public transportation were less prone to miss needed care.

The data evaluation company Geotab classified Atlanta as a draw When it involves public transport accessibility, it’s the second worst country within the country.

“The ability to get to a doctor's appointment can be a barrier to care,” said Rochelle Schube, leader of a cancer support group in Atlanta. “If I give a patient $250 in Uber cards and they live far away, the money is spent quickly.”

The indisputable fact that Uber and Lyft are harder to get in rural America compounds the dearth of medical access in these areas. “When you move to rural areas – which you could argue have a higher need – you see fewer services,” Chaiyachati said.

Finding drivers capable and willing to supply medical transport might be difficult. The Atlanta-based start-up MedTrans Go connects patients and healthcare providers with verified drivers, lots of whom provide wheelchair or stretcher rides in Georgia and 16 other states. Many of its drivers have medical training, accompany patients to and from medical facilities or their homes and may handle complex situations for at-risk patients, said Dana Weeks, the corporate's co-founder and CEO.

The company's app also can route patients who don't need specialized assistance on to Uber or Lyft, she said.

Uber and Lyft rides can save patients and insurers money and value a fraction of the standard fee for an ambulance ride, he said David Sluskyan economics professor on the University of Kansas who has studied the impact of transportation services on medicine.

But as a substitute there was an argument Timothy Crimminsa Georgia State University history professor emeritus and former director of the college's Neighborhood Research Center, could be the perfect fit Georgia is expanding Medicaidin order that more rural hospitals could remain open and Georgians could receive health care closer to home.

Georgia lawmakers' decision not to simply accept a state-funded expansion of Medicaid has left greater than 1.4 million Georgians without medical insurance. in accordance with KFF – and that hurts rural hospitals when these patients use the medical facilities and may't pay their bills. In Georgia, 10 rural hospitals have either closed or ceased inpatient care operations since 2010, in accordance with a Report 2024 by health advisor Chartis, and 18 others are vulnerable to closure.

Until more patients are insured, Crimmins said, the state should subsidize Uber and Lyft rides for less affluent Georgians who need assistance attending to medical care in Atlanta. “Maybe we’re talking about $100 to $150 round trip,” he said. “You can subsidize that.”

However, transporting patients will not be for everybody. Damian Durand said his Chevrolet Equinox SUV is large enough to accommodate a medical passenger who needs a wheelchair, but he doesn't get charged extra to move individuals with medical needs. He said a few of his recent passengers in Atlanta were Medicaid recipients with mental illnesses or disabilities.

“It can be stressful,” he said. “I feel like Uber and Lyft are trying to surprise me. If I see the trip is going to the hospital, I try to avoid or cancel the trip.”

While Durand's experiences with medical transport have been mostly negative, Carr loves the work and appreciates with the ability to help older Georgians, who she said often give good suggestions. For them, ridesharing stays a superb option, even when it involves doctor visits.

“It’s not stressful for me,” she said. “I worked in customer service for a good 20 years. For me, human connection is important. I tried working from home but I really didn't like it. I prefer this because I can connect with people.”

politics

BOSTON (AP) — Ride-share drivers in Massachusetts are pushing a ballot query that, if passed, could give them union rights.

The move comes despite a pioneering settlement Last month, Uber and Lyft drivers in Massachusetts were guaranteed to earn a minimum wage of $32.50 an hour.

Supporters of the measure last week submitted the ultimate batch of signatures needed to put it on the November ballot.

April Verritt, president of the Service Employees International Union, said the tens of hundreds of Uber and Lyft drivers who work in Massachusetts are entitled to the collective bargaining advantages of unions.

“This would be the first union formation of its kind in the country,” she said. The group is working on an analogous project in California.

Attorney General Andrea Campbell, who secured the settlement – ​​which included an “unprecedented package of minimum wage, benefits and protections” – also supports the ballot query.

“It is a strong foundation on which we can and should build,” said Democrat Campbell of the agreement.

Verritt said the country's labor laws are usually not designed to accommodate gig staff. In Massachusetts, the ballot query would bring about some change if voters support the problem – and drivers ultimately form a union.

“We fundamentally believe that workers are workers,” she said. “All workers have a right to a union, an opportunity to join with their colleagues and have a say in their livelihood.”

Yolanda Rodriguez has been a driver for Lyft for about six years and believes that union rights would profit her and other drivers.

The 33-year-old mother of three who lives in Malden, just outside Boston, said she leaves around 3 a.m. most days and lots of of her trips involve driving people to Logan International Airport.

Rodriguez said her account was canceled a couple of 12 months ago when she was pregnant. She said it took five months to get it restored and for her to have the ability to generate income again.

“I don't want this to happen to other women or men, because often children are behind the rejections,” she said through an interpreter. “If I had a union, I could turn to them and work with them.”

As a part of a policy Lyft announced earlier this 12 months, the corporate said its goal is to make drivers feel supported and revered when their account is temporarily suspended during an investigation, including a streamlined button within the app that permits drivers to appeal deactivation decisions.

But not everyone thinks this query goes far enough – in the event that they support it in any respect.

Henry De Groot, 28, of Boston, worked part-time as a driver for each firms for five years, but said the voting issue was not a good deal.

“I am one hundred percent for the unions and one hundred percent against the ballot question,” he said.

De Groot said the problem doesn’t result in a democratic system during which all drivers have rights. He said the initiative doesn’t contain any rights beyond basic collective bargaining, including details on how contributions are used.

“You can't have a regular union and not give workers voting rights,” he said. “The drivers have no control over the leadership. It's about the basic democratic rights that other unions have. It's a top-down organization.”

Kelly Cobb-Lemire, an organizer with Massachusetts Drivers United, a corporation she describes as a grassroots campaign led by drivers, said other app-based staff, including delivery drivers, were unnoticed of the vote.

“We are fighting for both drivers and delivery workers to have the right to form a union and be classified as employees,” she said. “We support democratic collective bargaining where every driver has a voice.”

She said her group is as a substitute pushing for lawmakers to pass a bill that might give all app employees full labor rights and open up the chance for all to unionize. She said the bill would also require drivers and delivery staff to be paid a minimum of Massachusetts' minimum wage for all hours worked.

The ballot query, if passed, would define “active drivers” as those that have accomplished greater than the common variety of trips within the previous six months.

Once a union contracts 5% of the lively drivers in a bargaining unit, it receives an inventory of all eligible employees and might prevent recognition of every other union without an election.

If a union then receives 25% of the eligible voters in a bargaining unit, it becomes the certified bargaining representative unless one other union or a “non-union” group comes forward inside the following seven days with the signatures of a minimum of 25% of the eligible voters, at which point an election might be held.

Proponents of the problem had prepared to oppose a possible series of industry-backed ballot questions geared toward classifying drivers as independent contractors.

But that threat evaporated after the agreement was reached. The firms were prohibited from supporting all five proposed versions of their ballot query – meaning they might not be put to a vote.

In a press release after the settlement was announced, Lyft said the settlement resolved a legal dispute that had recently been litigated in court and eliminated the necessity for the referendum campaign in November of this 12 months.

Uber also released a press release on the time calling the agreement “an example of what independent, flexible and dignified work should look like in the 21st century.”

Under the agreement, drivers are entitled to 1 hour of sick pay for each 30 hours worked, as much as a maximum of 40 hours per 12 months.

The two firms must also pay a complete of $175 million to the state to resolve allegations that they violated Massachusetts wage and hour laws. Much of that cash might be paid out to current and former drivers.

Local News

The state auditor is wading into an ongoing debate involving drivers' ride-sharing with firms like Uber and Lyft. Some drivers need to unionize to create a greater work environment, while firms need to keep drivers as independent contractors.

Union members, rideshare drivers and representatives from the favored ridesharing and food delivery apps all spoke before a joint select committee in March about two proposed ballot questions.

It would allow rideshare drivers to unionize to guard their rights, and another person wants Ensure that drivers can’t be classified as employees.

The union is 32BJ SEIU behind the move Allow drivers to unionize. Roxana Rivera, assistant to the union's president, told lawmakers it was unprecedented that rideshare drivers needed to pay for their very own equipment, suffered from “outrageously low wages” that proceed to say no and feared an impersonal deactivation process from their firms.

“I have never seen such a large number of workers demanding change so urgently,” Rivera said. “The solution that the drivers are looking for is to have a way to address these problems themselves through the collective power of a union.”

A latest report supported by the union found that the common wage for a driver is just $12.82 per hour, below minimum wage. Drivers can also fear for his or her safety after incidents of sexual assault and harassment, some told who withheld their names because they feared the businesses would deactivate or freeze their accounts.

State auditor says state is missing out on thousands and thousands

Drivers aren't the one individuals who may gain advantage from worker status. State Auditor Diana DiZoglio released a report this week showing that transportation network firms — also generally known as ride-sharing apps like Uber and Lyft — could contribute thousands and thousands of dollars to state employee protection programs.

DiZoglio referred to the thousands and thousands as “lost payments” that Uber and Lyft are usually not obligated to pay because their employees are considered independent contractors. If drivers were considered employees and due to this fact entitled to minimum wage and other advantages, rideshare firms could be required to contribute to staff' compensation, unemployment insurance, and paid family and medical leave.

Over the past decade, the businesses could have contributed at the very least $266.4 million to those programs, the state auditor said.

“We encourage the state legislature and administration to take action to ensure full transparency of driver earnings, hours worked and other key employment statistics,” DiZoglio said in a press release.

Lyft and Uber need to proceed classifying staff as independent contractors

The major app firms — Uber, Lyft, Doordash and Instacart — have told lawmakers they need drivers to be independent contractors. They have repeatedly emphasized that drivers, a few of whom work lower than 20 hours per week, value flexibility.

“The reality is that traditional employees can’t find flexibility that compares to driving with Lyft,” said Brendan Joyce, public policy manager at Lyft, in March.

The ballot query would specifically prevent rideshare and delivery drivers from being classified as employees in the event that they work through an app, are usually not required to work certain days or accept certain requests, and are usually not prevented from working with multiple firms.

Flexibility and advantages for the Massachusetts Drivers Election Committee, an industry-backed group supporting the ballot measure, received greater than $7 million from the key firms reported.

Lyft referred comments on the state auditor's report back to the Board of Elections. A spokesman said DiZoglio's findings, based on the union-backed report, were “completely flawed” and that ride-hailing and delivery platforms bring billions of dollars to the Massachusetts economy.

“A serious, professional auditor would consider all relevant data sets before reaching conclusions, rather than starting with a predetermined, politically motivated conclusion and developing an analysis to reach it,” the spokesman said.