PEP, June 2010: Health care reform. How we won real change.

By DIANE S. WILLIAMS

On March 23, President Obama signed into law a historic and sweeping health care reform plan that guarantees every American the right to health insurance and ends many abuses by medical insurance companies.

For more than a year, District Council 37 and AFSCME, its 1.6-million-member national union, stood strong in the struggle for the greatest social advancement in the United States in a half-century.

“We are grateful to President Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi for their leadership and commitment throughout this entire process,” said Gerald W. McEntee, president of the American Federation of State, County and Municipal Employees. “Health care reform is a remarkable achievement that protects and improves good union health care benefits.”

Years of struggle

“I am thrilled that after a long and tough battle, we have taken this giant step,” said DC 37 Executive Director Lillian Roberts. “We are a strong and wealthy country, and it’s about time for us to use our resources so all our people can be healthy.”

The Patient Protection and Affordable Care Act will give states over $900 billion for health care and provide health coverage for about 32 million uninsured people. Those who lose or change jobs will be able to purchase quality, affordable coverage in a new competitive health insurance market. (See box for summary of reforms.)

Unions backed health care reform 100 percent. AFL-CIO and AFSCME activists reached hundreds of thousands of working families and made more than 4 million calls to lawmakers pressing for the reform, and AFSCME spent $10 million in its largest mobilization ever.

In the struggle for reform, DC 37 members and leaders rallied with AFSCME on Capitol Hill and addressed the media at City Hall with a coalition of local health care advocates. In March, as the crucial vote approached, AFSCME activists came to Washington and made a “mass citizens’ arrest” of health insurance executives who tried to defeat the plan. Labor phoned, texted, marched and lobbied until the people’s voice prevailed.

Unions hope the new law will ultimately keep escalating health costs from consuming funds that could support wage increases, strengthening labor’s bargaining leverage. By penalizing big employers who don’t offer health coverage, the reform plan should cut the cost advantage of some nonunion firms and reduce the threat of contracting out.

“In the long drive to pass the law, President Obama showed tenacity and toughness.” Roberts said. “In the end, he put his presidency on the line to improve the lives of all Americans. We should be proud that we helped win the fight to make health care a right and not a privilege.”

What we won in the new law

Major provisions of the Patient Protection and Affordable Care Act that will take effect immediately:

Workers and dependents with health care get to keep their plans and doctors.
Closing “donut hole” in Medicare drug plan starts with $250 rebate for seniors in 2010 and 50 percent discount in 2011.
Health insurance plans can no longer deny coverage to children with pre-existing conditions.
Through a temporary program, insurers must cover patients with pre-existing conditions (becomes permanent in 2014) and cannot discriminate based on health status or gender.
Small businesses get tax credits of up to 50 percent of health insurance premium costs.

Beginning in September:

Children can remain on their parents’ health insurance until age 26.
Insurance providers can no longer drop people who get sick (rescissions) or impose annual or lifetime coverage limits.

In 2011:

Free annual Medicare preventive care visit to primary care physician; no co-pays for preventive services (January).
Insurance plans must spend 80 or 85 percent of premiums on medical care, rather than administrative, overhead, profits, CEO salaries, etc.
States will get $11 billion in federal funding for community health centers. States can expand Medicaid coverage and draw additional federal funds.
Employers, including state and local governments, can apply to a temporary $5 billion re-insurance fund to maintain health benefits for early, pre-Medicare retirees until June 2014.

Starting in 2013: Flex Spending Accounts will be limited to $2,500 pre-tax.

Beginning in 2014:

Insurers cannot deny coverage or charge higher premiums to people with pre-existing health problems, or charge higher premiums to individuals as they age.
Health exchanges for small businesses to buy coverage will open.
Annual limits on benefits will end, and insurers’ waiting periods will be limited to 90 days.
Medicaid expands to cover all individuals under age 65 whose income is up to 133 percent of the poverty level. States can create a Basic Health Plan for uninsured individuals with incomes between 133 and 200 percent of poverty. AFSCME members without employer coverage can utilize these services.

For more information visit: www.aflcio.org/healthcare.

Sources: healthreform.gov, AFSCME.org and AFLCIO.org