On top of all the obscure extra fees that get heaped onto your already overpriced plane ticket, you might be getting an unexpected discount—a single nickel saved on every airfare. That’s how much extra it would theoretically cost to provide a decent healthcare plan to thousands of airline catering workers. An extra five cents a ticket, according to their union, could ensure that the person who prepares your reheated pasta tray doesn’t sneeze on your butter pats because she can’t afford to see a doctor.

Hundreds of catering workers represented by UNITE HERE marched in Washington, DC yesterday to demand access to decent health insurance that will help them stay healthy, do their job safely, and avoid falling further into poverty. Representing some 12,000 airline catering workers with major contractors like Gate Gourmet and Sky Chefs, the union is calling on the big airlines to build into their supply chain the cost of decent healthcare, which they calculate as roughly five cents per ticket, to be passed down to workers to offset insurance costs.

According to a national survey of airline catering workers, over 40 percent of catering service workers—who handle meal preparation, processing and logistics at airports across the country—earn less than $10.10 per hour. That’s well below a living wage in many of the cities where major airports are located (and less than the minimum wage repeatedly proposed by the Obama administration to bring the base wage closer to 1960s levels). According to UNITE HERE, extremely low wages leave workers “unable to pay the premiums of so-called ‘minimum value plans,’ [those complying with federal mandates] but ineligible to purchase more affordable options from health care exchanges.”

Despite the introduction of Obamacare, precarious airline catering workers have fallen into an insurance black hole. Though they are unionized, many earn just above the threshold to qualify for a federal subsidy, so they may end up getting penalized for being unable to afford the prohibitive cost of a $120-a-month plan with a deductible that effectively prices them out of needed services.

Los Angeles-based food service worker Manuel Valdovinos earns just enough to afford care this year, but says he now owes a $300 federal fine because he couldn’t afford to buy insurance last year. “I had to get a second job just to cover the basic expenses,” he tells The Nation. “And the IRS feels that I owe them money, for not being able to afford it [last year]….What my second job is giving me, I’m basically giving it away in healthcare.”

The workers’ dilemma reflects an ongoing controversy over companies seeking to circumvent Obamacare’s mandate for employer-sponsored health coverage, by pushing workers onto the exchanges. Despite regulatory checks against “dumping” sick workers onto exchanges, many low-income workers may get stuck with inadequate coverage and unaffordable premiums.

UNITE HERE workers complain that the healthcare crisis reflects the broader decline of pay and benefits since economic turmoil has rocked the aviation industry in recent years. But now that business has been improving, workers say their paychecks continue to lag behind rising profits. As airlines outsource jobs to service companies, the outsourcing system creates structural pressure on vendors to drive down the cost of wages and benefits. So the union is targeting aviation giants like American Airlines, which they say are hoarding profits and in turn suppressing pay scales for workers down the production chain.

The economic insecurity workers experience is aggravated by a relentless drive toward more “efficient” production. According to the union’s surveys, under a so-called “lean production” system, the majority of workers surveyed reported being squeezed to produce more with fewer staff, driven to work faster and take on extra hours, and often being subjected to strict time monitoring. Many experience health impacts like mental stress and repetitive motion injury, and “Sixty percent of the workers currently take pain medication…due to muscular aches and back pains.”

Cruz Peña of Miami, who has worked for Sky Chefs for 25 years, tells The Nation that the company used to take better care of workers, “but after 9/11, all that changed. They started to lower our wages, now they’re always pushing basically one person to do the job of two or three people.”

Now she is paying hundreds of dollars a month for a health plan that doesn’t cover the services she needs, and the combination of inadequate care and unlivable wages is exacerbated by the physical toll her job takes. “From all the years I have been working at this job, I have a bad back, I have a lot of pain,” she says, but “it’s not easy for me to get that treated.”

The healthcare campaign is part of UNITE HERE’s push to mobilize airport operations workers. Along with SEIU, UNITE is reaching into this historically marginalized industry with various campaigns to mobilize airport operations workers in low-wage sectors like baggage, custodial and concession services. In cities like New York and Chicago, these workers, disproportionately people of color, are reportedly extremely vulnerable to wage theft and workplace safety hazards.

In response to the healthcare campaign, Sky Chefs says in an e-mailed statement that since many budget factors determine vendors’ meal costs, “There is no way that we can evaluate the claim that a five cent increase in ticket costs would equal a specific amount of revenue or that additional revenue would flow through to our company or others in our field.” Still, the company says it supports “negotiating in good faith to reach a fair and equitable contract.”

Regardless of the exact numbers, the UNITE HERE campaign works like the penny-per-pound campaign for tomato harvesters of the Coalition of Immokalee Workers. The nickel-per-ticket concept is a strategic demand to force passengers, contractors and airlines to recognize the role major carriers play in determining labor conditions across the supply chain.

With all the fees tacked onto your airfare for your carry-on and every inch of leg room, just think: spending an extra few pennies to keep the person who made your lunch out of the emergency room today just might be the best deal in the business.