Describe the state of health care for the factory girls.

The working conditions for girls at the factory are appalling. As well as the long hours and abysmal pay, they are forced to risk their health each time they show up for work. There are no proper safety standards at the mill, and so there's nothing to protect Lyddie and the other girls from getting their fingers crushed by the machines or breathing in the fibers that can cause long-term damage to their lungs.
The company couldn't care less about the health and welfare of its workforce. What's more, there's no incentive to provide decent health care. At that time, the provision of employee health care wasn't a legal requirement, and so most companies made no effort to provide it—as it was generally thought too costly.
We see this attitude prominently displayed in Lyddie. If a girl got sick, then the company felt no obligation to provide support. Either she had to work through her illness—as Lyddie had to, despite sustaining a serious injury after being knocked on the head by a shuttle—or she had to leave, like Betsy. There's was no alternative.