Outten & Golden: Empowering Employees in the Workplace

Posts Tagged ‘health care’

BREAKING: Iowa Lawmakers Pass Sweeping Anti-Union Bill

Friday, February 17th, 2017

DES MOINES, Iowa – Lawmakers in Iowa have voted to dismantle the state’s 40-year-old collective bargaining law, dramatically weakening the power of public sector labor unions and leaving some 185,000 public workers unable to bargain over benefits, healthcare, vacations, retirement, and nearly all workplace issues outside of wages.

Iowa is a right-to-work state, and the new law would prevent voluntary union dues from being deducted from a public employee’s paycheck. It would also require regular recertification votes. Police officers, firefighters and transit workers are exempt from most of the bill’s provisions.

Republican lawmakers introduced their union-busting bill on February 7 and fast-tracked it through the legislative process. Both the House and Senate, which are controlled by the GOP, approved the bill Thursday, passing the most sweeping and impactful changes to Iowa law in decades. Gov. Terry Branstad is expected to sign the bill soon.

During the 10-day stretch before lawmakers voted, Iowa saw its largest labor mobilization in years, with thousands of union members standing up, speaking out and taking action. The weekend before Valentine’s Day, workers and their families packed legislative forums and town hall meetings in districts across the state. Teachers and their allies rallied and marched at the state Capitol.

A union rally and public hearing Monday drew scores of demonstrators so dense that the Iowa Capitol was packed shoulder-to-shoulder on every floor. Firefighters wore their iconic helmets. Nurses showed up after their shifts in scrubs. Workers continued to pour into the Capitol for hours after the event started, with lines of people spilling out of the statehouse entrances. More than 4,600 people went through the Capitol security checkpoints, Radio Iowa reported. Thousands more Iowans flooded statehouse switchboards and lawmakers’ emails.

Minority Democrats in both chambers managed to briefly slow down the bill’s passage, extending debate over three days of marathon sessions and raising important questions about outside influence by corporate interests like the Koch Brothers, ALEC and Americans for Prosperity.

“We’re talking about people’s lives, their kids, and their homes,” said Candace Acord, an AFSCME member and community-based corrections officer from Iowa City. “I don’t understand what the problem is here when we just want health insurance for our families.”

“My main concern is insurance may now become so unattainable due to the cost that I may not be able to afford healthcare for me and my family,” said Lynette Halsted, an SEIU member and emergency room nurse at the University of Iowa Hospitals and Clinics. “Staffing ratios are no longer permissible subjects of bargaining, but evidence-based practice shows that the more patients a nurse has the worse the outcome can be for patients.”

The nonpartisan Iowa Policy Project weighed in with a report on the impacts of the new law, stating it will:

“exacerbate existing trends—low and stagnating wages, growing uncertainty about access to affordable health care, and increasing income inequality—that are already accelerating downward mobility for many Iowa households. And these effects are likely to disproportionately harm rural communities, low-income workers, and to threaten the quality of the health care, public safety, and public education systems upon which all Iowans depend.”

Thousands of people also submitted written comments opposing the union-busting bill.

Carrie Dodd, a junior high English teacher from rural Madrid, wrote: “My husband and I both work in school districts and we will be financially devastated if we lose our insurance, receive lower pay, and have to work more for less.”

T.J. Foley, a senior at Valley High School in Des Moines, wrote: “Union power is key to effective teachers, and effective teachers mean Iowa’s students are successful and our future as a state is secure.”

The recent demonstrations highlighted the power, however diminished, that labor still has to educate, organize, and mobilize workers and their families, and the critical role unions play in bringing every day, regular people into social justice movements.

But the future of organized labor is now more uncertain than ever, and the path forward is unclear. Many workers at the demonstrations said they believe the next step is to re-elect Democrats into the majority in 2018. That task will be even more difficult now that Iowa’s public sector unions have been severely weakened, arguably the real purpose of the new law.

There is also no guarantee a Democratic majority would restore collective bargaining rights. Democrats controlled the Iowa Senate in 2013, and collaborated with a Republican governor and House Republicans to pass the largest corporate property tax cuts in state history, cuts which caused a budget shortfall that Republicans are now using to justify their attacks on labor. Unions were unable to expand their collective bargaining rights even when Democrats held a trifecta of political power in 2008.

But workers aren’t giving up.

“We will resist and persist in the face of these neoliberal attacks,” said Naoki Izvmo, a teaching assistant and UE-COGS member at the University of Iowa. “Workers are the true source of power in society, not the law.”

This blog originally appeared at Inthesetimes.com on February 16, 2017. Reprinted with permission.

David Goodner is a writer, organizer and Catholic Worker from Iowa City. Follow him on twitter @davidgoodner.

Social Media is a Danger Zone for the Healthcare Industry

Thursday, February 2nd, 2017

Social media can cause big problems for healthcare workers and their employers. Because of HIPAA rules and other concerns, posting something as seemingly harmless as a selfie with a patient could ruin careers, or worse. Healthcare professionals do form bonds and friendships with some of their patients and because social media has become a place where people share details of their lives and their friends’ lives, it is understandable that a healthcare worker might slip up and post something that he or she shouldn’t. Understandable, but not excusable.

Blurred Lines

Healthcare workers are advised of HIPAA rules and know that information about their patients is confidential, but that hasn’t stopped some healthcare workers from getting into trouble for their social media posts. For example, when a police officer was brought into an emergency room and the staff was unable to save him, some posted their condolences on Facebook, complete with the name of the deceased officer. To make matters worse, the officer’s family had yet to be notified.

Certainly, the ER staffers were reacting to the heartbreak of losing a patient and doing what felt natural in the moment—sharing thoughts and feelings on social media. They were acting out of kindness.

Intent Doesn’t Matter

A post that is meant to be kind is still not OK. The bottom line is this: sharing any information about a patient is a HIPAA violation even if the social media account has the highest possible privacy settings (which are never 100% reliable), and even if the post is mourning the loss of a patient.

As Ed Bennett, director of Web strategy at University of Maryland Medical System points out, “We already have guidelines; social media is simply another form of communication. It’s no different from e-mail or talking to someone in an elevator. The safe advice is to assume anything you put out on a social media site has the potential to be public.”

What About Free Speech?

A recent social media conduct survey found that 41.2% of Americans believe that getting fired because of a social media post is an infringement of their First Amendment rights. In the private sector, it’s usually not.

The First Amendment affords Americans the right to free speech, which means they can express themselves without interference or constraint by the government. The First Amendment does not protect employees from private sector disciplinary action.

Healthcare professionals can get fired for a post, even one that does not violate HIPAA laws, as a Philadelphia hospital employee learned when she posted a racially-charged rant on social media. Word spread (because social media is not private!), someone started a change.org petition to demand that the hospital fire the employee (for a post that had nothing to do with her job) and the worker was fired.

Headaches All Around

An inappropriate social media post can become a major headache for everyone involved. According to the AMA:

Criminal penalties for a violation of HIPAA are directly applicable to covered entities—including health plans, health care clearinghouses, health care providers who transmit claims in electronic form, and Medicare prescription drug card sponsors. Individuals such as directors, employees, or officers of the covered entity, where the covered entity is not an individual, may also be directly criminally liable under HIPAA in accordance with principles of “corporate criminal liability.”

HIPAA was enacted in 1996 and social media didn’t begin to hit its stride until Facebook opened to the public in 2006. Since employers are liable, and HIPAA doesn’t explicitly address social media, many deem it prudent to have a very clear social media policy. As a healthcare employee, you should be aware of your employer’s policies, which may go above and beyond HIPAA.

Conclusion

The healthcare provider/client relationship is like no other. Healthcare professionals know the most personal details about their patients, and they care about their patients, yet they’re expected to maintain a professional relationship.

According to the US Department of Labor, “Employment of healthcare occupations is projected to grow 19 percent from 2014 to 2024, much faster than the average for all occupations, adding about 2.3 million new jobs. Healthcare occupations will add more jobs than any other group of occupations.” Workers of the future who have grown up with social media and habitually post random moments of their days on Snapchat or Instagram will have to learn to curb that behavior if they intend to get a job in the healthcare field—and keep it.

 

Ellen Gipko is a marketing analyst for white label SEO firm HubShout, and a writer specializing in the topics of social media and digital marketing. She has contributed content to Social Media Today, Search Engine Watch, Search Engine Journal and other industry websites.

AFL-CIO Tells Congress No Repeal Without Replacement of ACA

Thursday, January 12th, 2017

Today, as Congress debates the future of the Affordable Care Act, the AFL-CIO sent a letter to Senate Majority Leader Mitch McConnell (R-Ky.), Speaker of the House Paul Ryan (R-Wis.) and all members of the U.S. Senate and House of Representatives.

Signed by AFL-CIO President Richard Trumka, the letter urges Republican leaders to abandon plans to roll back coverage protections and declares it “reckless to repeal the ACA without providing an immediate replacement.” The letter also details how the core components of the Republican health care plan pose serious threats to working people in America.

Some key passages in the letter:

You are now poised to repeal the Affordable Care Act (ACA) with breathtaking speed at the beginning of the new Congress, without providing replacement coverage to the 30 million Americans who will become uninsured as a result. This action appears to mark just the first stage of a massive Republican plan to cut federal support for health coverage….

It is reckless to repeal the ACA without providing an immediate replacement. This approach will cause the individual insurance market to collapse, destroying coverage for millions of Americans, even if Congress provides itself with a “transition period” to try to enact an alternative to the ACA….

Workplace insurance is the leading source of health coverage for Americans, covering 178 million people. The major Republican plans levy destructive new taxes on this coverage; and their sponsors endorse the belief of most economists that these new taxes will drive employers to cut back on the health benefits they provide by increasing the out-of-pocket expenses working people and retirees are required to pay….

Medicare beneficiaries will be forced to pay a greater and greater share of the cost of coverage as excessive health care cost growth outpaces the new Republican limits on federal support for Americans’ earned health benefits. As with the other major rollbacks, the federal government would retreat, leaving beneficiaries to fend for themselves in the hopes that “market forces” will temper the growth of costs….

The major Republican plans also make substantial cuts to Medicaid, even though it currently pays for most nursing home and community-based long-term care for America’s seniors and, in conjunction with the Children’s Health Insurance Program, ensures that more than a third of America’s children can get the medical care they need….

Read the full letter.

This blog originally appeared in aflcio.org on January 9, 2017.  Reprinted with permission.

Kenneth Quinnell: I am a long-time blogger, campaign staffer and political activist.  Before joining the AFL-CIO in 2012, I worked as labor reporter for the blog Crooks and Liars.  Previous experience includes Communications Director for the Darcy Burner for Congress Campaign and New Media Director for the Kendrick Meek for Senate Campaign, founding and serving as the primary author for the influential state blog Florida Progressive Coalition and more than 10 years as a college instructor teaching political science and American History.  My writings have also appeared on Daily Kos, Alternet, the Guardian Online, Media Matters for America, Think Progress, Campaign for America’s Future and elsewhere.  I am the proud father of three future progressive activists, an accomplished rapper and karaoke enthusiast.

Transit Workers Reach Agreement to End Weeklong Strike in Philadelphia

Wednesday, November 9th, 2016

On Monday, transit workers in TWU Local 234 reached a tentative agreement with the Southeastern Pennsylvania Transportation Authority and ended a weeklong transit strike in Philadelphia. Nearly 5,000 employees are returning to work, and the deal now goes to the local’s membership for a vote, which is set for Nov. 18.

Willie Brown, president of Transport Workers (TWU) Local 234, lauded the agreement:

“This is a contract with many important gains, especially on pension benefits and a host of non-economic issues effecting the working conditions and job security of our members. As everyone with experience in collective bargaining knows, we didn’t get everything we wanted—but we came a long way from where we were prior to the strike. We made gains in pensions and wages and minimized out-of-pocket health care expenses at a time when health care costs are soaring, while maintaining excellent medical coverage for our members and their families.

“We worked day and night at the bargaining table in an attempt to finalize a new contract over the past week. We settled just hours before facing the possibility of a back-to-work court-ordered injunction. We ultimately prevailed because our members were determined and united from beginning to end. We also benefited from the assistance of city leaders such as Congressman Bob Brady and Democratic congressional candidate Dwight Evans, who worked to help us settle this dispute with a SEPTA Board controlled by Republicans.

“Our members will keep Philadelphia moving, and we will continue to fight for our members’ economic well-being and their rights on the job.”

Said TWU President Harry Lombardo:

“TWU’s members in Philadelphia are some of the hardest working people on the job. We’re pleased they’ll have a contract that recognizes that.”

Details of the agreement will be made public after the vote.

This blog originally appeared in aflcio.org on November 7, 2016.  Reprinted with permission.

Kenneth Quinnell: I am a long-time blogger, campaign staffer and political activist.  Before joining the AFL-CIO in 2012, I worked as labor reporter for the blog Crooks and Liars.  Previous experience includes Communications Director for the Darcy Burner for Congress Campaign and New Media Director for the Kendrick Meek for Senate Campaign, founding and serving as the primary author for the influential state blog Florida Progressive Coalition and more than 10 years as a college instructor teaching political science and American History.  My writings have also appeared on Daily Kos, Alternet, the Guardian Online, Media Matters for America, Think Progress, Campaign for America’s Future and elsewhere.  I am the proud father of three future progressive activists, an accomplished rapper and karaoke enthusiast.

Is Your Workplace Wellness Plan Worth the Risk?

Tuesday, April 5th, 2016

Tina Bio picAs healthcare costs continue to soar, many employers are using wellness programs as a way to help curb their costs. In addition, employees who enroll in wellness programs also enjoy the program’s great health incentives and rewards, however, unbeknownst to them, the personal information collected may also be used for other undisclosed financial or discriminatory purposes.

This is important as the Americans with Disabilities Act (ADA) generally protects employees from discrimination based on health status or disability. The ADA specifically prohibits employers from generally requiring mandatory health examinations and also prohibits the disclosure of an employee’s protected health information. However, these exams are allowed if they are part of a voluntary employee health program or if classified as a “business necessity.”

The U.S. Equal Employment Opportunity Commission (EEOC), or the federal agency that enforces these federal laws also recently raised concern about wellness programs

and published a Notice of Proposed Rulemaking (NPRM) explaining how ADA applies to employer wellness programs that are also apart of group health plans. The NPRM explicitly prohibits employers from requiring employees to participate in a wellness program and also prevents the employer from disciplining or denying health coverage based on refusal. Although other federal laws prevent discrimination, the existing laws only apply to certain wellness programs under certain circumstances and as a result, some employers allow wellness program companies to share and use an employee’s information. Therefore, the proposed rule would not only help align federal laws to cover most wellness plans but would also require confidentiality and provide employees notice on how information is used and collected.

In a recent example, Houston city employees who participated in a wellness program were required to disclose their disease history, blood pressure, weight, drug and seat belt use to a wellness company. However, unknown to the employees, the contracted wellness company was also permitted to share the data with “third party vendors acting on [their] behalf.” Although the employees were permitted to refuse or opt out of the screening, they were subject to a $300 a year penalty for medical coverage. Therefore, the employees who “voluntarily” participated in the program in order to avoid the penalty, also unknowingly waived their privacy rights as the information shared could lead to discrimination by employers, lending institutions or even life insurance companies.

In another example, an employer required an employee to submit to medical testing and assessment in connection with a wellness program or “face dire consequences.” When the employee refused to comply with the mandatory program, the employer shifted responsibility for the payment of her entire health insurance premium and ultimately fired the employee shortly thereafter. This initiative unfortunately has many unintended consequences and as the Regional Attorney for the EEOC in Chicago noted, “having to choose between responding to medical exams and inquiries — which are not job-related — in a wellness program, on the one hand, or being fired, on the other hand, is no choice at all.”

While wellness programs have positive effects on employees and the workplace in general, these programs should not provide barriers to healthcare benefits or force penalties on those who cannot participate. Instead, these programs should also provide alternatives for employees who have disabilities and should not be implemented as a new way to determine insurance premium rates.

Another closely connected issue relates to privacy and the disclosure of employee data. Data companies such as Castlight Health, praised for their ability to help inform smarter decisions, are being hired by employers or wellness program companies to handle and process employees’ data. Whether it is being used, correctly or incorrectly, to identify which employees are likely to get sick, have surgery or get pregnant, these companies are using personal data and third party healthcare apps to monitor an employee’s personal information. However, even more concerning is how unregulated access to big data is.

Although some may think that the Health Insurance Portability and Accountability Act (HIPAA) applies, the privacy rule in HIPAA only applies or protects an individual’s identifiable health information held by either a covered entity or business associate. Therefore, depending on how the wellness program is administratively structured and whether the wellness program is offered as part of a group health plan, the identifiable health information may or may not be protected under HIPAA rules.

While some employers have structured wellness program incentives to comply with some federal laws, the exceptions in others have made achieving privacy while protecting civil rights difficult. Despite the EEOC’s best efforts to strike a balance between encouraging workplace wellness plans and compliance with federal laws, the “results appear to please no one, as the EEOC’s efforts to ensure only voluntary disclosure of private health information…drew sharp criticism from agency stakeholders.” In addition, despite legislation such as the “Preserving Employee Wellness Programs Act” introduced by Representative John Kline to offer clarity on incentives consistent with the ACA final rule not violating the ADA, the effect of these promulgated rules remains unknown as poorly designed wellness programs continue to have unintended consequences.

Although wellness programs offer attractive health and wellness benefits, until the various issues with discrimination, data privacy, and uniformity with all federal laws are addressed, employees may still be at risk of discrimination.

Tina Jadhav is an attorney barred in Maryland. Tina is actively involved in health law as a member of the American Health Lawyers Association as well as the American Bar Association-Health Law section. Tina recently earned her Law and Government LL.M. degree from American University Washington College of Law in 2014 and her Juris Doctor degree from Florida Coastal School of Law. Tina also served as a Health Policy Fellow for U.S. Senator John D. Rockefeller IV, Legal Intern at Inova Health System Office of General Counsel and the Office of the Attorney General for Commonwealth of Virginia.

Workers at Trump Taj Mahal Begin Preparations for Strike

Tuesday, September 1st, 2015
Mario VasquezUNITE HERE Local 54 members speak to the press outside of their “strike pod.”

While Donald Trump’s push for the Republican nomination for president is showing no signs of slowing, worker unrest at a hotel and casino that bear his name appears near the boiling point. Strike preparations have begun for over 1,100 non-gaming casino employees at the Trump Taj Mahal in Atlantic City, New Jersey. The workers, represented by UNITE HERE Local 54, gathered near their local headquarters last Tuesday to load strike materials like bullhorns, signs and drums into a storage container in a public attempt to prove to management that they are ready and willing to strike over large compensation package cuts that occurred last year.

The Trump Taj Mahal has been at the mercy of billionaire investor Carl Icahn since 2009, when bankruptcy led Donald Trump to cut ties with the casino and resort’s operator, Trump Entertainment Resorts. After months of courtroom drama, Trump exchanged the rights to his name and likeness over to Icahn (who Trump has mentioned in recent months as a possible cabinet member if he were elected president) in exchange for a 10 percent stake in the restructured company.

While Trump has run into his own problems in Las Vegas, where workers at his current gaming jewel, the Trump Casino, have started a union drive (though Trump is adamant that his workers love him), conditions at his namesake in Atlantic City have deteriorated into escalated conflict between new management and the organized hotel housekeepers, bartenders, servers, cooks, and sanitation workers at the Trump Taj Mahal.

Since Icahn began his attempt to gain control of Trump’s Atlantic City gaming empire, the unionized workers at the Trump Taj Mahal have consistently derided Icahn’s alleged role in driving the casino-hotel toward bankruptcy, with workers and UNITE HERE arguing that Icahn, as Trump’s main debt holder, pushed higher interest rates onto the company as a way to reach personal profit of hundreds of millions of dollars and ultimately maneuver into ownership position.

In October 2014, Icahn successfully gained permission from a bankruptcy judge to end company contributions to health care and pension benefits as a way of cost-cutting, saying it would help keep the casino-resort open. “Workers were stripped of their health and retirement benefits; they even cut paid lunch breaks. Our calculation was that the average full-time worker would lose approximately $12,000 over the course of the year as a result of these cuts,” says UNITE HERE spokesperson Ben Begleiter.

UNITE HERE Local 54 contends that the bankruptcy court was out of its jurisdiction with the decision, and because Icahn has declined to renew the union’s contract since its expiration in September, the matter is a labor dispute fit for the NLRB, who has since agreed in a January statement. The union’s case against the cuts is currently pending in the U.S. Court of Appeals for the Third Circuit.

A survey of workers conducted by UNITE HERE in March found that 44 percent of responding workers, who had previously been covered under a health care plan since their first day of employment, no longer had health insurance. This was a much-valued health care package that had led workers over the past decade to accept near-stagnant wages in order to maintain their health benefits.

“I’ve been part of the negotiating committee for the past 11 years, and I voted to have my pay frozen numerous times in order to preserve our health insurance. I got one 25-cents-an-hour raise in the past decade,” says Paul Smith, a surveyed cook, who has been at the site for 21 years. “In 2005, I had a massive heart attack. The bill was over $1 million. If I hadn’t had the union health insurance, I would have been destroyed financially. Right now, my health is out of whack. I need three surgeries, which is difficult because I have no insurance since Icahn took it away.”

The survey also claimed to shed light on the mental toll of out-of-reach health care, finding that at least 70 percent of participating workers suffered from symptoms of depression at least every other day.

Dr. Alan Glaseroff, Co-Director of Stanford Coordinated Care and Clinical Professor of Medicine at the Stanford School of Medicine, reviewed the results and commented: “Strictly from a financial perspective, depression as an ‘add-on’ condition combined with diabetes, heart disease and other chronic conditions more than doubles the cost of treating those illnesses, making the lack of coverage an even greater problem for patients and those paying for and providing their care.”

When the October cuts were announced, 24 people were arrested staging a sit-in and shutting down traffic in front of the Trump Taj Mahal. In June, 68 more were arrested for participating in a similar action. Workers authorized the union’s contract negotiating committee to a call a strike if necessary on July 16, a decision that was followed up by reports that the Trump Taj Mahal was preparing to take on several hundred replacement workers.

Casino-hotel employees in Atlantic City last went on strike in 2004 when 10,000 UNITE HERE Local 54 members walked out for over a month at seven different locations; Trump’s casino-hotels workers did not participate in this strike. The Trump Taj Mahal and the Tropicana Entertainment, Icahn’s other bankruptcy capture in Atlantic City, are currently the only casino-hotels in the city working with an expired contract. The possibility remains open for Local 54 members at Tropicana to go on strike as well.

Workers like Hannah Taleb, a casino-hotel employee in Pittsburgh, allege that Icahn’s hardball tactics are an effort to lower workers’ standards throughout the industry. “If the standards are lowered in Atlantic City, how can I expect to fight for high standards in my city? All casino workers are linked in that way,” Taleb told the Press of Atlantic City before being arrested in June’s intersection-shut-down.

Icahn has a history of eliminating worker benefits at various companies he’s acquired over his years, building a reputation of as a corporate raider. “Mr. Icahn is worth more than $20 billion, but two months before the contract for PSC’s union workers was scheduled to expire in late 2013, management told them that it was dropping their health insurance benefits and that they would have to buy their own insurance through the new exchanges set up under the Affordable Care Act,” the New York Times reported last December. Unsurprisingly, Icahn was the one of the inspirations for the Gordon Gecko character made famous by Michael Douglas in Oliver Stone’s Wall Street.

“Jobs that provided benefits, that were middle-class jobs where a worker could support a family on [are] part of the promise of casino gaming,” Begleiter says. “Casino gaming in Atlantic City is unlike any other industry in the state, because it’s an industry that came into existence by a vote of the people of New Jersey to change the constitution—specifically to rebuild Atlantic City. That means in part, making sure that it provided for workers,” Begleiter says.

As the protests expand and the so-called “strike pod” storage container is filled up with the essentials, the workers at Trump Taj Mahal say they are ready to defend their share of that promise.

This blog was originally posted on In These Times on August 31, 2015. Reprinted with permission.

About the Author: The author’s name is Mario Vasquez. Mario Vasquez is a writer from Santa Barbara, California. You can reach him at mario.vasquez.espinoza@gmail.com.

Republican House Bill Cuts Workers' Health Care Coverage

Sunday, January 11th, 2015

Image: Mike HallSome 1 million workers could lose their employer-provided health insurance under a Republican bill (H.R. 30) passed by the House (252-172, with 12 Democrats crossing the aisle) today. On top of stripping health care coverage from those workers, the bill also would add some $53.2 billion to the federal deficit over the next decade, according to the Congressional Budget Office.

The attack on the Affordable Care Act (ACA) comes just two days after Republicans approved legislation that could lead to cuts in Social Security disability and retirement benefits.

Under the ACA, large employers must provide health care coverage to employees who work 30 or more hours a week or they face a penalty. H.R. 30 kicks up the 30-hour threshold to 40 hours a week.

That increase, say health care experts, provides an incentive for employers to drop their 40-hour a week employees down to just 39 hours without a penalty and avoid any responsibility to offer health benefits.

A UC Berkeley Labor Center study estimates there are 6.5 million people at risk of having their hours cut back under the Republican bill. That’s nearly three times the number (2.3 million) that are vulnerable to losing their hours under the current 30-hour threshold.

But even with the current 30-hour a week definition, some employers are cutting back the hours of workers—many of whom worked 30–36 hours a week—to duck providing health coverage and avoid paying the ACA’s penalty. The AFL-CIO and other groups support strengthening employer responsibility rules in the ACA.  Delegates to the AFL-CIO Convention 2013 approved a resolution on the ACA that includes a call for:

Applying a full employer penalty for failing to provide affordable comprehensive coverage to workers who average 20 or more hours per week and adding an employer penalty on a pro rata basis for employees who work fewer than 20 hours per week.

Since the ACA became law, the number of Americans with health insurance has increased by more than 10 million, with the majority of those receiving employer-provided health care. Since the law’s requirement for Americans to have health insurance went into effect a year ago, the percentage of uninsured has dropped from 17.1% to 12.9%.

H.R. 30 and a companion Senate bill that Senate Majority Leader Mitch McConnell (R-Ky.) says he will have on the floor before the end of January will wipe out those gains. We’ll keep you posted on the Senate bill and how you can take action.

This blog originally appeared in AFLCIO.org on January 8, 2015. Reprinted with permission.

About the Author: Mike Hall is a former West Virginia newspaper reporter, staff writer for the United Mine Workers Journaland managing editor of the Seafarers Log.  He came to the AFL- CIO in 1989 and has written for several federation publications, focusing on legislation and politics, especially grassroots mobilization and workplace safety.

"It's good to know that at the end of the day you'll have the help if you need it."

Thursday, November 14th, 2013

seiu-org-logoJerry Depeine is a single father of two and works as a dietary aide at a West Palm Beach, Fla., nursing home. Despite working in a healthcare setting, Depeine doesn’t have insurance since he cannot afford the plans his employer offers.

For Depeine, getting sick often meant he’d have to miss more time from work than normal because he couldn’t always afford the treatment that would speed his recovery. “Not long ago, I had a throat infection and the prescription was too much for me to pay. I couldn’t afford it, so I just walked away. I just had to bear the pain and not go to work,” he explained.

Now Depeine is in the process of enrolling in one of the insurance plans created by the federal marketplaces–one that will cost less than his employer’s plan and will fit into his monthly budget.

Depeine looks forward to some of the preventive care that is a hallmark of the new law. He feels that regular checkups, which he’s never been able to afford, are a key to staying healthy. “Now that I’m turning 30, I want to get routine checkups so I can find out what going on with my body and stay informed about the status of my health,” he says.

Depeine is also looking forward to the protections he’ll have in case of an accident or a medical emergency. “It’ll make me feel safe and protected knowing that if something happens it’s not going to break me with all the medical bills,” he says. “It’s good to know at the end of the day you’ll have the help if you need it.”

Now that he is on his way to getting affordable insurance, Depeine shifted his focus to educating his fellow UHW-East members and folks in his community about the new healthcare law. “Everyone should know about their options, and everyone should be able to feel safe and secure in terms of their health,” he added.

This article was originally printed on SEIU on November 13, 2013.  Reprinted with permission.

Author: SEIU Communications.

The “New” Discrimination: Retaliation Based on Health Care Rights

Monday, May 20th, 2013

Ryan PriceIf you don’t already know, the Affordable Care Act (“ACA”), a/k/a Obama Care, does not take effect all at once. (I say “if you don’t already know,” because a recent poll shows that 42% of Americans are unaware that Obama Care is currently the law of the land).

Title I of the Act, which is considered one of the most controversial parts of the Act, does not take effect until next year. Once it takes effect, employers may not make employment decisions based on an employee’s health care decisions. Employers will, of course, make decisions that impact employees negatively, because the ACA will increase employers’ costs and responsibilities associated with health care. This is why employees need to be aware of their new rights.

You have probably heard about the many employers who have started cutting employee hours to evade having to comply with Obama Care. If you’re one of them, you’re out of luck. The law doesn’t protect you yet.

Starting on January 1, 2014, an employer may not retaliate against you based upon your health care selections. Specifically, an employer cannot terminate, demote, discipline, intimidate, threaten, deny benefits or promotion, reduce pay or hours, blacklist, or fail to hire an employee based on the fact that the employee:

  • Provided information relating to any violation of Title I of the ACA, or any act that he or she reasonably believed to be a violation of Title I of the ACA to the employer, the Federal Government, or the attorney general of a state;
  • Testified, assisted, or participated in a proceeding concerning a violation of Title I of the ACA, or is about to do so;
  • Objected to or refused to participate in any activity that he or she reasonably believed to be in violation of Title I of the ACA; or
  • Received a credit under section 36B of the Internal Revenue Code of 1986 or a cost sharing reduction under section 1402 of the ACA.

If an employer retaliates against you for engaging in any of these activities after January 1, 2014, you may file a complaint with the Occupational Health and Safety Administration(“OSHA”). OSHA has a broad range of powers to help employees combat the “evildoer” employers, including the powers of investigation, enforcement, negotiation, settlement, and the ability to award damages. The employee’s first, and critical step, is to file a claim with OSHA within 180 days from the date of retaliation.

Unlike most employment discrimination cases, the standard for proving retaliation in these cases is much more employee-friendly. You only need to demonstrate you had a reasonable belief that the employer was retaliating against you. Further, you will only need to provide evidence that your health care decision was a factor in the retaliation, not the only factor in retaliation. Hopefully, employers will have a much more difficult time defending against these types of discrimination cases. With any luck, this will deter them from violating the ACA in the first place.

This article was originally printed on Screw You Guys, I’m Going Home on May 10, 2013.  Reprinted with permission.

About the Author: Ryan Price is an Associate Attorney at Donna M. Ballman, P.A., Employment Advocacy Attorneys.

Making Health Care Reform Work: A Perspective from California Doctors

Friday, July 27th, 2012

kari-lydersenLOS ANGELES—At a conference convened by the organization Reporting on Health at the University of Southern California this week, doctors and health care experts shed light on labor-related aspects of the health care field as the sweeping health care reform legislation is set to take effect after being upheld by the U.S. Supreme Court.

They provided a window into the workplace stresses and challenges doctors themselves have faced in our tumultuous and trouble-plagued health care system, and also the health care needs and challenges of low-income workers.

Marcia Sablan, a doctor in the tiny northern California town of Firebaugh, embodies both of these narratives. Marcia is one of many doctors who depended on a federal program that helps people afford medical school in exchange for working in under-served rural districts. After her residency at the University of Hawaii, she was assigned to Firebaugh, in the agricultural valley of Fresno County, with a population then of just over 3,000. She was accompanied by her husband, also a doctor and the first native of Saipan to graduate from a U.S. medical school.

Panelists at the conference noted that such programs will be increasingly important if the government wants to encourage more doctors to go into general primary care rather than becoming specialists. Specialists make an estimated $3.5 million more over their lifetimes, yet there will be an estimated shortage of 30,000 primary care doctors in coming years especially as more people become insured under the new health care law.

Sablan arrived in Firebaugh in 1981 and eventually founded her own private practice there, where she primarily serves low-income Latino farmworkers, about half of them immigrants, including many uninsured people who may or may not end up insured under the health care bill reforms. Doctors and experts at the USC conference echoed the widespread concern that due to the way the health care reform bill and Supreme Court decision played out, people living under the poverty line may not get insurance under the new law. That’s because the insurance exchanges and subsidies the law mandates are designated for people who make more than the poverty line, while people making below the poverty line (including childless adults —a change from the past) are all supposed to be covered by Medicaid.

States are ordered to expand their Medicaid programs to cover people making up to 133 percent of the poverty line, but the mandate doesn’t have strong teeth since it is unclear if or how the federal government can punish states that don’t expand their Medicaid programs to cover the newly eligible people. Many states say they cannot afford their share of the expansion plus the extra costs expected when currently eligible but un-enrolled people “come out of the woodwork” thanks to the publicity around the reform law.

Sablan notes that she never asks her patients about immigration status—she is not required to under California’s Medicaid law—and she typically charges a $50 fee which most patients pay out of pocket.

“Undocumented workers know not to leave a trail, not to leave bills,” she said.

But when her patients need specialty care, the seasonal nature of farm work can cause serious problems. Many of them do have insurance during the months they are employed, but not during the off-months, she said. In her early years in Firebaugh, many of the locals were migrant workers living in labor camps who returned to Mexico or otherwise left Firebaugh for half the year. But the labor camps have been demolished and now many farmworkers have bought homes and live year-round in the town with their families, even as they continue to depend on seasonal agricultural wages. Hence an illness or injury that keeps them away from work for days or weeks during the crucial seasonal employment period is especially devastating financially.

“What does an agricultural-based seasonal economy mean to a doctor practicing there?” Sablan asked, noting that Firebaugh’s population now numbers 6,741: 88 percent Latino, 22 percent living below the poverty line, more than a third unemployed and almost two-thirds without a high school diploma. “It means people have insurance and Medi-Cal (California’s version of Medicaid) at certain seasons of the year. But we know diseases don’t work like that. So this is a huge problem for us—seasonal workers have a very difficult time keeping up with chronic diseases.”

From a health perspective, Sablan is glad to see the valley’s once-thriving cotton industry decline, she said, since it involves heavy pesticide use that raised serious health problems for workers and other residents. Once she treated victims of what was known as the worst pesticide-poisoning case in state history—28 workers critically poisoned after being ordered to return to a field too soon after it had been sprayed with phosphates. Now almonds and pistachios are the main crops in the area, grown mostly by huge industrial farms. (Meanwhile a sustainable cotton project has been in the works.)

Sablan hopes the health care reform law will indeed result in better preventative care for low-income and currently uninsured people. She cites the case of one patient, a 54-year-old farmworker who had a heart attack and was prescribed medication which, at $400 a week, he could never afford. Also suffering from diabetes and lacking medication, he eventually had another heart attack and ending up needing permanent dialysis by age 60.

“When you think about the Obama plan, think about [the farmworker] – do we want to be upstream or downstream?” in health care spending, she asked. “Someone paid for him to be in the hospital two times and on dialysis, which costs about a million dollars a year. He’s totally disabled now, unable to work, from what should have been a preventable situation.”

Despite such challenges, Sablan and her husband feel lucky to work in an environment where they have treated three generations of patients —it gives them a sense of personal connection and continuity that other doctors say they lack when forced to see up to 30 patients a day, in the common “fee for service” health care model.

Dr. Ken Kim described the challenges of working in a typical profit-driven, urban system. He and other internists were disgusted to see how badly many of their patients were faring under the standard health care model. He described multiple diabetic patients with legs amputated because they were shuffled between specialists, waiting for months for appointments, while a “pin-sized” wound became infected and festered. And he described elderly patients unable to comply with a doctor’s orders because they lacked a ride to the clinic or couldn’t open medicine bottles with arthritic hands or ate high-sodium meals as shut-ins. Doctors and nurses want to help such patients with personalized care, he indicated, but the fee-for-service model and other aspects of the traditional insurance system create so much time pressure that patients fall through the cracks.

So Kim and other doctors formed an “accountable care organization” (ACO) wherein insurance companies like Blue Cross pay the organization a flat fee to provide care for a certain group of the insurance companies’ enrollees. Kim said that after floundering at first, the company, CareMore, where he now serves as chief medical officer, was able to provide holistic, preventative care to a patient base of mostly ailing senior citizens by subverting the fee for service model, focusing on prevention and making sure the various nurses and doctors working with a given patient communicate and develop a cohesive plan. He said that under their organization rates of hospital readmissions, amputations, mortality and other indicators have decreased drastically. Many hope this type of accountable care organization will become more common under the health reform law.

While the general public is obviously confused about the implications of the health care reform bill, doctors and health care experts are also uncertain about how the law will play out and what it will mean for their own work lives and those of their patients.

This blog originally appeared in Working In These Times on July 26, 2012. Reprinted with permission.

About the author: Kari Lydersen, an In These Times contributing editor, is a Chicago-based journalist writing for publications including The Washington Post, the Chicago Reader and The Progressive. Her most recent book is Revolt on Goose Island.

Your Rights Job Survival The Issues Features Resources About This Blog