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Surprise battle in the war for healthcare for all

By Mike Andrew 

All the drama surrounding Obamacare – the Affordable Care Act (ACA) – is centered on futile Republican attempts to defund it.

But the real battle may be to prevent employers from using the ACA as an excuse to change the basic relationship between employers and employees defined in collective bargaining agreements.

AFL-CIO President Richard Trumka said implementing the ACA raises the question whether “low- and moderate-income union members and their collectively bargained health care plans will be able to benefit from the same premium support that big insurance companies will receive and if they will have to pay fees to subsidize big insurance companies…

“There also are concerns that smaller employers will be able to get away with taking health care away from workers while paying no penalty.”

The concern is that the ACA will increase costs for health plans that are co-administered by unions and groups of smaller employers. Such plans are typical in the construction, retail, and transportation industries.

These multiemployer insurance plans are good for workers because they provide consumer choice, portability, stability, and flexibility.

They’re also good for employers because they provide predictable, consistent, and cost-effective long-term health coverage for workers.

But if the cost of these plans goes up, employers might hire fewer union workers or abandon the health plans altogether, forcing workers to buy more expensive individual insurance policies from exchanges.

The fix is simple. A resolution passed in September by the AFL-CIO convention in Los Angeles said that “multiemployer plans should have access to the ACA’s premium tax credits and cost-sharing reductions on behalf of working families, just as for-profit insurance companies will…”

A second problem with the ACA is that empoyer penalties for not providing insurance to full-time workers encourages employers to limit their employees’ hours to less than 30 per week.

We’ve already seen that the big three grocery chains – Albertson’s, Safeway, and Kroger, which owns Fred Meyer and QFC – are cutting back employee hours to avoid paying insurance premiums, potentially leading to a “Walmartization” of the grocery industry.

Erosion of the 40-hour work week and the benefits plans predicated on full-time work is not good for working families, either as employees or as taxpayers, since uninsured part-time workers will have to participate in taxpayer-subsidized healthcare plans.

Again, the fix is simple. The AFL-CIO resolution on the ACA called for “applying a full employer penalty for failing to provide affordable comprehensive coverage to workers who average 20 or more hours per week and adding an employer penalty on a pro rata basis for employees who work fewer than 20 hours per week.”

While the ACA has been a “clear gain for working families” as the AFL-CIO resolution states, it still falls short of the ideal, and that’s why the resolution reaffirmed the labor movement’s “commitment to pursue health care for all ultimately through a single-payer system…”

In the meantime, the ACA needs to be revised to protect the health and prosperity of working families.

“It needs to be changed and fixed now,” LIUNA General President Terry O’Sullivan told the AFL-CIO convention.

“We will work with the president to do everything we can to fix the Affordable Care Act … We want it fixed, fixed, fixed.”

AFL-CIO Resolution 54: “On the Affordable Care Act” can be read online

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