Tag Archives: Affordable Care Act

Obamacare is Complicated, but It’s Coming: Get Ready!

img_health_care_govLittle Rock  I spent no small amount of time over the recent three-day weekend trying to figure out the Affordable Care Act on a number of different levels, as an organizer of course, but also as an employer, and even as a family guy with folks I care about making the best decisions for their health needs and pocketbooks.   My short summary is simple:  it’s complicated!  And, no matter how complicated, it’s right on us, there’s a short window for study and decision, and it’s ready or not  and down to the wire right now!

            Starting in less than a month on October 1st everyone can – and should – enroll.  To get signed up for next year, 2014, so that you have coverage January 1st, you have to get through the full application process, start to finish, and have paid your premium to somebody on whatever plan you select by December 15th.   Look at the calendar.  That’s only 10 weeks

            And, before you buy, you have to shop, and from my studying that’s not going to be a walk in the park, especially because it’s all news and you’re pretty much scuffling to find some help figuring it all out, or you’re on your own and all alone.  The shopping includes what company and whether or not you want an HMO, PPO, POS, or anything else in the alphabet soup.   Then you have to decide whether you can afford the Bronze, Silver, Gold, or Platinum plans, which determine whether your premium is paying for 60%, 70%, 80%, or 90% of the costs being borne by your company. 

            That’s the easy part, because that’s just figuring out what you want, so it’s like healthcare Christmas.   The harder part is what you can afford and puzzling out whether there’s help from the government for you to foot the bill.  Depending on you and your family’s income, you could qualify for various levels of tax credits ranging from 250% to 400% of the federal poverty level, and don’t pull my leg that you have any idea how much or how little that might be, but when you see the charts and it’s $99000 for a family of almost eight or so, trust me this is something you are going to want to memorize.  There’s also something they call “cost sharing” which means you can get reduced payments on deductibles, copayments and the like, but once again, don’t’ pretend you know all about any of this either.

            Run a business of some kind?  Good for you!  You read the paper and saw the Republicans were crowing about a postponement of some kind for businesses with over 50 employees on the mandatory policies and fines, well don’t think that means that you don’t have to do something now, friends.  There’s a special marketplace called SHOP and you need to jump on this now and figure out if it works for you.

            Ok, your head is hurting, huh, poor baby?  Want to pull the shutters down and forget about it don’t you?

            Well, then there are fines if you don’t sign up ASAP.  It’s a hand slap of $95 or 1% of your gross income if you are a scofflaw the first year in 2014, but in 2015 it’s almost $400 or 2% and almost $700 in 2016 and 2.5% of annual income for you then.   Oh, that’s based on whichever is higher, player!   Furthermore, it’s not some liberal-diberals at Health and Human Services that are going to sort that out for you, it’s the I-R-freaking-S, and they don’t mess!

            Do I have your attention yet?  I bet you’re wishing you spent some of your weekend with me?  We have to get right with this.   I’ll be talking a lot more about this in coming weeks as I get my arms around the whole mess more tightly, but for now, people get ready!



Reading the Tea Leaves on Huge SEIU-NUHW Decert in California

New Orleans  First come the disclaimers.   I have no stomach for this 5 year saga in California that has created a huge rift in the labor movement as folks picked sides between the Service Employees International Union (SEIU) and the National Union of Healthcare Workers’  (NUHW).  Depending on how you line up, NUHW is either a principled group of dissidents trying to reform SEIU and the whole labor movement and bring it back to its roots or a band of renegades who broke when they didn’t get everything on their Christmas list from SEIU. 

Regardless the ballots are now out to the workers of the huge 45,000 member bargaining unit at Kaiser Hospitals on the question of whether or not to decertify the existing bargaining unit, SEIU, or to certify NUHW.  Starting May 1st the ballots are due and the counting will begin, perhaps to put an end to all of this or maybe to simply open another chapter in his horrible mess.  This is a re-run election.  SEIU won the first round by a large margin, but the election was overturned by the NLRB based on findings of unfair labor practices in the way that Kaiser favored SEIU before the vote.

Stomach or no, I finally manned up and spent some time looking at how the campaign was going to see if there were reasons to handicap the election differently than I have done in the past.  Over recent years were I to have been asked, and believe me I was not asked, I would have advised NUHW to find a stronger path for its organizing future and let this Kaiser thing go, even knowing that if lightning might strike, it would be a whole different world for them.  I just saw the odds as too long and the strengths of SEIU’s incumbency as the bargaining agent, resources, and commitment to the fight as too strong to be overcome.   Regardless, I thought I should look to see if I should revise my prediction or reassess the odds and the outcome.

The folks at NUHW are no fools that’s for sure.  They did their best to even the odds and hooked up with the California Nurses’ Association part of the national nurses’ union affiliated with the AFL-CIO.  The union severed its no-raiding agreement with SEIU which could rekindle organizing wars in hospitals around the country.  Nurses pay big time union dues, so this tie-up gave NUHW a partner with deep pockets assuring that they wouldn’t get blown out of the water during the election.   Reading the reports of folks a little closer to the ground like NUHW supporter, former CWA representative, and labor journalist (and Social Policy contributing editor) Steve Early, these resources have allowed them to try and match the SEIU ground campaign of several years ago so that currently they have 125 organizers, mass mailings, and a contracted canvass crew to help with voter turnout. 

Nonetheless, reading the back-and-forth on the websites, it all looked “same ol’ same ol’” and that’s not enough to change the final outcome.  SEIU is making a big deal of the failure of NUHW units to get a contract with Kaiser and using the classic argument to workers that the “devil you know is better than the devil you don’t know.”  SEIU isn’t silent either on the lost court appeal of the NUHW officers on the multi-million dollar claim against them for diverting members’ dues in order to finance their schism and split.  SEIU is calling CNA and its leadership strike happy.   Theirs is a conservative, hold-the-line incumbent’s campaign.  NUHW is also still fighting the last war and arguing that SEIU is too close to management and that the labor/management partnership, now 16 years old, is hurting the workers.   On either side there didn’t seem like any real breakthrough, new issues.    If this is all there is, my guess is that it’s not enough.  My bet would still be that for NUHW to win there would need to be something more.   Something bigger.  Something much better.

Hospital workers facing the brave new world of the Affordable Care Act and the depressing recent world of the worst economy since the Great Depression are not going to be wide eyed radicals looking for a new future.  The status quo for better or worse might not look great, but will look good enough, returning SEIU as the bargaining agent with perhaps a smaller plurality than they had last time.

There can no longer be any winners in California, and at this point I would bet money that the workers are all sighing and saying under their breath, “a pox on both of their houses.”  

I could be way wrong from thousands of miles away, but as an organizer, I would be surprised if the 2nd verse of this song was any different than the first.

SEIU-NUHW Decert Audio Blog