Breastfeeding, Grandfathering, and the World to Come in New Health Care Act

Citizen Wealth Financial Justice Health Care

hospital_signPortland Talking shop with a couple of unions about the future and prospects for new organizing was interesting, but it was truly educational to listen to three of the labor lawyers (Gregory Hartman, Henry Kaplan, and Thomas Doyle) pulled together by the Association of Western Pulp and Paper Workers to update us about some of the impacts of coming health care act and what it will mean for workers and unions.  Not surprisingly in a 2000 page bill that ended up being a compromise coat of many colors, there are a lot of patches still coming into focus, so I’m betting this is first blush gives evidence of a lot more to come.

  • Cadillac Plans:            For all of the uproar from unions and big corporations no one is thinking or worrying about this at all.  Since it doesn’t hit until 2018, this is another lifetime in politics and has no meaning now.
  • Breastfeeding:             Oregon had stood out among other states by mandating that women who were breastfeeding would have regular, mandated paid breaks on the job for the purpose of pumping and storing.  Thanks to an Oregon Senator, these provisions and guarantees of additional 15-minute breaks are part of national policy and protection for women in the new Affordable Care Act (ACA).  I’m hoping we snuck some other “wins” into this thing!
  • Grandfathering:          A huge bargaining issue for unions with collective agreements that had decent health coverage in the contract falls on provisions that allow grandfathering these plans during the life of the agreements if there are no substantial changes.  Given the current uncertainty about the future plans, rating boards and panels, unions are beating back employer demanded concessions in many negotiations on the old argument of “the devil you know is better than the devil you don’t.”
  • Retiree Reinsurance:   Most folks around the room thing that retiree insurance as part of union contracts is a dinosaur walking its last steps.  It seems that a sweetener for the death match is a current provision requiring employers (those who are on top of their jobs) to apply now to a direct subsidy to reinsure self-insured retiree plans (like in auto etc) for a actual cost for retiree medical of 80% of the cost between $15 and $90K, reducing claims exposure.  The dream stays alive a little longer for the last of these retirees.

It was clear a lot of this was tactical in the transition rather than long term strategic.  The lawyers and reps were convinced that once the new ratings are done and the various plans on offer are shaped up that the initial impact will be better and cheaper plans when grandfathering fades away as a real concern and the rush of new workers being covered and the competition for the plan.  That sounds exciting at bargaining tables everywhere.  There will be a lot of 2014 re-openers as most of the ACA provisions come on line.

One point made over and over that might actually have some real weight, is that workers are going to see this maze with skepticism (as they should!), and are going to be looking for good unions and good representation to make sure that their interests and not just the cheapest price and the thinnest coverage prevail when all this comes on line.  Worth doing a lot of homework now and making sure that workers understand the enormous stakes and the union advantage here.