New Orleans   I can’t tell if we have a widening gap in the way big employers see health insurance or a huge opportunity to finally get coverage for lower waged workers.  

A week or so ago, I talked about a potential bargaining opportunity for lower waged workers for 2014 before penalties apply to larger companies under the Affordable Care Act who have more than 50 fulltime employees, where we should try to get the companies to subsidize premium payments for their lower waged workers in the Marketplace health exchanges.  I was hedging some of my bets in case there were some legal or other obstacles that might be in the way.

Further research indicates there are none and actual meetings with employers demonstrates that even on the eve of Obamacare enrollment on October 1^st, bosses both local and national are still clueless about how to respond.  The front page of the Wall Street Journal blared that Walgreen’s, the mega-drugstore chain, was immediately moving all 160,000 of its workers onto the exchange and offering, much as I had proposed, to pay various levels of subsidies for coverage.   Walgreen’s workers in the main are not high paid, and talking to them across the counter, you’ll find that no matter what the company had on offer, the take-up rate was low, fitting the profile, I had argued could benefit workers getting fuller coverage when coupling subsidies from the government and the company.

The Journal is not sure whether this is good or bad, but notes that the trend may be to move away from company determined, paternalistic plans, towards direct cash transfers to their workers and letting them make their own decisions about coverage with the money.  They compare the potential development to the way pension funds moved from companies to 401k plans with joint contributions and investment decisions driven by the employees.  I’m not sure about all of that.   401k plans are a long way from mandatory for workers as we all know in the way that Social Security is, and Social Security is the apples-to-apples comparable here with mandatory health insurance coverage.  

So, yes, there might be a gap between the best plans offered by some companies and what the rest of us will find on the exchanges, and, yes, the few unions with Cadillac plans within the 11% of the workforce that is unionized clearly have a beef, especially since they traded wage increases for these benefits, and are unlikely to be able to get the benefit losses returned in higher wage rates paid to them now, but for the masses of uninsured workers, getting on ACA and the potential of getting help from their employers in paying their part of the premiums could allow them huge benefits.  

There’s a lot of difference between a “bronze” plan at the bottom which only pays 60% of your major healthcare needs and Silver, Gold, or Platinum paying up to 90%.   Knowing that you are eligible for premium tax credits and cost sharing on deductibles, plus getting some help from your job in paying both of those costs, would allow lower waged workers to purchase significantly better coverage for themselves and their households and do so by the millions.   That’s a good thing!

Meanwhile, back at the ranch, even bargaining contracts with top flight, sharp as nails, corporate labor relations guys and management-side lawyers, I can tell you they are not ready for primetime in bargaining on the mandatory subject of health insurance and ACA and the new law triggers bargaining in almost any contract I can imagine. If they are still groping for a plan, we need to be going hard right now as enrollment opens between October 1^st and December 15^th so that workers and our members end up with good, affordable insurance right now, rather than taking the risk and dragging our feet until companies figure out what’s best for them.  The answer is clear for us that healthcare insurance right now is best for us.  We just need to make sure it happens.  Lives literally may depend on it.