Originally Published in The Register Guard
Co-written by Bob Fischer and Samuel Metz
It’s not too early to begin the autopsy. President Obama’s Affordable Care Act swallowed its own poison pill, and the diagnosis was delivered by three of the most influential union leaders in America in a letter published July 12 in The Wall Street Journal, and entered into the Congressional Record on July 18.
The letter, addressed to Senate Majority Leader Harry Reid and House Minority Leader Nancy Pelosi, was written by the presidents of the Teamsters, the United Food and Commercial Workers Union, and UNITE-HERE, the first union to endorse Barack Obama for president.
The letter makes it clear that the ACA contains provisions hostile to union interests. It points out three deal-breaking issues.
The first is that the ACA will destroy the foundation of the 40-hour workweek, the economic backbone of the middle class. The ACA perversely motivates employers to cut workers’ hours below 30 hours a week and make that the new standard workweek.
The ACA exempts employers from providing coverage for part-time employees (those working less than 30 hours per week), so employers can rid themselves of onerous health care expenses by merely rearranging the employee schedules. This has two big impacts on employees: fewer hours means less pay, and those currently insured through their employers, union or not, lose their health benefits.
The second concern of these union leaders is that the ACA will destroy nonprofit health plans. President Obama pledged to working people that if they like the health plans they have now, they can keep them. But the ACA undermines nonprofit health plans that are negotiated between employers and unions under the provisions of the Taft-Hartley Act (the Labor-Management Relations Act of 1947).
Under the ACA, employees covered by nonprofit health care plans will not be eligible to receive subsidies accessible to other citizens to help buy insurance on state insurance exchanges.
To make matters worse, the ACA makes nonprofit plans more expensive by taxing them to pay subsidies offered to for-profit insurance plans.
Together, these restrictions make non-profit plans unsustainable, and deprive the health care market of viable alternatives to big health insurance companies.
The third issue is most ominous. It appears unions are locked out of the Obama administration. The union leaders’ letter says the White House disregarded union concerns about application of the ACA, leaving other stakeholders (notably employers) to enjoy successful interpretations for their respective grievances.
An example is the huge accommodation for the employer community — extending the Dec. 31, 2013 deadline, required by statute, for the employer mandate and penalties.
What are the implications for Oregon workers? More of them will find themselves without employer-sponsored insurance and therefore reliant on the ACA mandated health care exchange. Oregon’s exchange is Cover Oregon, and its launch date is rapidly approaching: Open enrollment begins Oct. 1; coverage begins Jan. 1.
But all is not well with Cover Oregon. The union leaders’ letter lists only three of the major problems to overcome, and there are more. There will be healthy young adults who won’t consider insurance until they get sick. There is the lack of any control of premium prices. No one should be overly optimistic about the ability of Cover Oregon to make health care more accessible or less expensive.
The very real problems presented by the letter illustrate a larger problem. The ACA does exactly what America has being doing wrong for the last 50 years, only more intensely and with greater complexity. Fewer employers will offer health insurance to employees, fewer employees will have full-time jobs, and more workers will pay higher prices for individual health insurance policies, if they can afford any insurance at all.
However good its intentions, the ACA will not increase access or reduce health care costs. It will make more Americans desperately dependent upon employer-sponsored private insurance. It allows private insurance companies to charge as much as they like, and if sick people can’t afford to buy a policy with good benefits, so much the better for the insurance industry.
There are no examples anywhere of competition among American private insurance companies improving access or reducing costs. The ACA changes nothing.
In contrast, single payer health care systems around the world and right here in the United States provide, for comparable patients, better care to more people for less money. President Obama acknowledges that. But if he won’t provide us with a national single payer system, we in Oregon need to create one ourselves.
Every Oregonian, employed or not, deserves health care. Publicly funded single payer health care is the way to make it happen.
Bob Fischer of Bandon is a retired professor of sociology at California State University and a member of Health Care for All Oregon. Samuel Metz, a Portland physician, is a member of Mad As Hell Doctors.
