Posts Tagged ‘health care’
Tuesday, April 5th, 2016
As 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.
Tuesday, September 1st, 2015
UNITE 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 firstname.lastname@example.org.
Sunday, January 11th, 2015
Some 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.
Thursday, November 14th, 2013
Jerry 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.
Monday, May 20th, 2013
If 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.
Friday, July 27th, 2012
LOS 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.
Friday, September 16th, 2011
To wax a bit conservative for a moment, while this Felix Salmon / Pedro da Costa thought experiment is fun, it’s simply not the case that “With $2 billion, you could employ 40,000 people for a full year at $50,000 each.” You’d have to pay Social Security tax, Unemployment Insurance, etc. Plus you’d probably have to carry all kinds of liability coverage. Depending on where you’re located there’s be other state/local stuff to deal with.
Then to wax back progressive again comes the big whopper: Health care. There’s a huge health insurance shaped wedge between what you think you make and what your employer thinks he’s paying you. To provide health insurance coverage to 40,000 people costs a lot more than $0. Ironically, if you were talking about paying your employees, less this wouldn’t necessarily be a problem as they’d be eligible for Medicaid. You’d be creating quintessential low-wage “bad jobs,” but you’d at least be creating a lot of them. But once you have the kind of workforce needs where you want to offer a decent wage, you’re either going to be restricting your pool to people who can get insurance through their spouse or else you have to tack a large extra employment cost onto the bill. What’s more, you’re bearing a weird kind of risk since if over time the cost of the insurance plan increases faster than your firm’s revenue and that causes you to make the plan less generous to your employees they’re going to view that as a mean cut in benefits that you initiated.
America got derailed from a long-term growth conversation by a financial crisis and a recession. Then we got derailed from a short-term jobs conversation by a ginned-up budget crisis. People in the know recognize that the health costs piece is critical to the budget issue, but the reality is that health care is critical to the long-term fate of the federal budget primarily because it’s critical to the long-term fate of the economy as a whole.
This post originally appeared on Think Progress on September 15, 2011. Reprinted with permission.
About the Author: Matthew Yglesias is a Fellow at the Center for American Progress Action Fund. He holds a BA in Philosophy from Harvard University. His first book, Heads in the Sand, was published in May 2008 by Wiley. Matt has previously worked as an Associate Editor at The Atlantic, a Staff Writer at The American Prospect, and an Associate Editor at Talking Points Memo. His writing has appeared in The New York Times, the Guardian, Slate, The Washington Monthly, and other publications. Matthew has appeared on Fox News and MSNBC, and been a guest on many radio shows.
Tuesday, August 2nd, 2011
Summer is a sleepy time at the Supreme Court as most of the justices exit the scorching Washington heat. Justice Stevens was known to keep busy on the tennis court while Justice Thomas often heads around the country in his RV. As for Justice Kennedy, he regularly teaches abroad and others hit the speaking circuit.
So the quiet period between late June and the first Monday in October, when the annual case argument schedule begins, presents vacation opportunities for those who cover the Court as well. But while little attention is paid to the Court during its annual “siesta,” appeals can and do get filed during this lull.
Amidst the hoopla over the debt-ceiling crisis, one of those appeals not surprisingly went almost unnoticed. In fact, it rated no better than a minor story on page A-18 buried in a recent edition of The New York Times. This appeal, though, will be front-page news if the justices choose to accept the case. That’s because it marks the first legitimate challenge to the new health care law, the Patient Protection and Affordable Care Act.
On July 27th, a petition was filed challenging a recent Sixth Circuit decision which upheld the constitutionality of the law. The 2-1 decision was notable because the Cincinnati-based appellate court tends to be conservative, and one of the judges in the majority was Jeffrey Sutton, a one-time law clerk with Justice Scalia.
While there have been a number of federal district court rulings on the health care law in the past year, the Sixth Circuit stands by itself as the lone appellate court to have addressed the issue. The Supreme Court typically agrees to hear a case only after there has been a circuit split among the appellate courts. But that does not mean the health care law’s supporters should take comfort that the justices will necessarily sidestep this appeal.
Cases such as Citizens United and the more recent Wal-Mart opinion are clear examples of the Court reaching out to decide hot-button disputes in the absence of a circuit split. And Chief Justice Roberts’ famed line about “wanting to decide cases on the narrowest grounds possible,” has not always matched his record or that of his colleagues. That’s a fact of which the appellants are well aware.
So there is reason to believe the Supreme Court could wade into the health-care controversy, and sooner rather than later. In fact, if the justices decided to grant this challenge, a ruling could come down late next spring as the 2012 presidential campaign season approaches its apex.
If there is one thing I learned from covering the Court for more than a decade, it is that predicting outcomes there is sometimes only slightly easier than taking your chances in Las Vegas or Atlantic City. Few people are privy to what the justices really feel, and journalists are hardly among them.
But if the justices upon their return to Washington take up the appeal of this Sixth Circuit ruling in the absence of a conflict, chances are they are not doing so to affirm the outcome. No matter what the result, however, it will have obvious ramifications for what health plans employers offer to their employees going forward.
Supreme Court review of some sort on the health care law eventually seems inevitable. But if it happens at this still relatively early juncture, another partisan battle is a near certainty. And things at the nation’s highest court will be quiet no longer.
About the Author: David Weisenfeld served as U.S. Supreme Court correspondent for LAWCAST from 1998 through June 2011. During that time, he covered every employment law case heard by the Court, and also wrote and co-anchored the company’s employment law newscasts. In addition, his work has appeared in the American Bar Association’s Supreme Court Preview magazine.
Tuesday, July 5th, 2011
Rite Aid workers from seven states last week rallied against management’s plan to make employees pay more for their healthcare and to show support for a 15-week “unfair labor practice” strike by Rite Aid employees at seven stores in Cleveland, Ohio. With strong support by the Pennsylvania AFL-CIO, United Students Against Sweatshops and the Harrisburg-area labor movement, the spirited rally took place immediately before the company’s annual shareholder meeting on June 23, 2011.
After the rally (video below), about 15 Rite Aid workers and union reps attended the shareholder meeting to voice their concerns directly to Rite Aid’s Board of Directors and top executives. Inside the meeting, I presented a shareholder proposal opposing management’s policy of paying the tax liabilities on its golden parachute deals with senior executives.
Christina Frymier, a striking Rite Aid worker from Cleveland, was the first to address CEO John Standley and the board of directors during the question and answer period. “I’m on strike because Rite Aid is trying to make our healthcare so expensive that nobody will be able to afford it. Rite Aid does most of its business with customers who are very much like me.” She continued:
When I talk to customers and tell them what Rite Aid is doing, they are angry, upset. They take their prescriptions and their business to CVS and other pharmacies. If the people who shop at Rite Aid’s 4,700 stores learn that management is trying to deny health care to its employees, Rite Aid’s reputation will be harmed. Do you really want to allow your management to continue on a path that will hurt Rite Aid’s business nationwide?
Frymier was followed by UFCW Local 1776 member Donna Weber, a 16-year veteran at Rite Aid’s Tobyhanna, Pa., store. Weber, a pharmacy technician, described how the company has cut staffing to dangerously low levels.
Weber compared the executive’s huge salaries and benefits – including free use of the corporation’s jet for their personal use – to the reality she faces in the store. “Many days I’m working on the phone with insurance companies to resolve a customer’s prescription problem while other customers are waiting to be checked out,” Weber said. “These jobs take a lot of concentration. It seems that if we can afford these high executive salaries and a free jet plane we should be able to adequately staff our stores.”
Referring to ongoing negotiations for a new contract, Weber said, “We shouldn’t have to choose between health care or food for our families.”
Weber was followed by Local 1776 President Wendell W. Young, IV, who described how 3,000 Local 1776 Rite Aid members in Pennsylvania have worked for nearly three years under the terms of an extended contract because the company is insisting that workers assume an impossibly high portion of the cost of their health care benefits.
“We are calling on Rite Aid to bargain in good faith to reach agreements on new contracts,” said Young, who called the company’s behavior, “wrong at a time when the loyal men and women of Rite Aid have worked so hard to help the company weather this economic down turn and contributed to its growth throughout the past four decades.”
“The solidarity rally and action at the shareholders meeting in Harrisburg sent a message to the Board of Directors and top managers that shifting the burden of healthcare benefits to Rite Aid workers—and taxpayers—won’t solve their financial problems or make the company profitable,” said UFCW Local 880’s director of collective bargaining Carl Ivka, who is leading the strike at seven Rite Aid stores in Ohio.
Rite Aid workers from the International Longshore & Warehouse Union, SEIU 1199, Teamsters and UFCW have attended three previous shareholder meetings.
Rite Aid workers’ union summit
The day before the annual meeting, Rite Aid union leaders met for a national summit to share information and develop common strategies for dealing with the company’s plan to shift health insurance costs to workers and taxpayers.
The meeting was attended by Rite Aid leaders from the 1199 SEIU, International Longshore & Warehouse Union (ILWU), RWDSU, UFCW Local 21, UFCW Local 880, UFCW Local 1360, UFCW Local 1776, and the UFCW International. Also on hand were supporters from United Students Against Sweatshops, Jobs with Justice, Change to Win and the AFL-CIO’s Center for Strategic Research.
In conjunction with the summit meeting, two leading workers’ rights groups released an “Investor Alert” on the mismanagement and corporate greed that has led to Rite Aid’s poor performance. The report is available from Jobs with Justice at and United Students Against Sweatshops.
Summit participants also celebrated the first contract victory by Rite Aid workers, who formed their union with ILWU Local 26 at the Lancaster, California Distribution Center more than five years ago. ILWU Organizing Director Peter Olney reported on the struggle by the workers to win their collective bargaining rights and a first contract.
“Winning our first union contract required a comprehensive campaign with customers and the community on the outside and strong leadership and rank and file action on the inside. Working together, we overcame vicious anti-union attacks and more than a year of surface bargaining by Rite Aid management. It took an incredible amount of perseverance, determination and creativity to win, but thanks to the support from everyone in this room and many more locals that couldn’t be here, we did it.”
Pictures from the summit meeting and the march and rally at the shareholders meeting are viewable on Flickr here.
This article originally appeared on the Working In These Times blog on June 30, 2011. Reprinted with permission.
About the Author: Rand Wilson is communications coordinator at the AFL-CIO Organizing Dept.’s Center for Strategic Research. He has worked as a union organizer and labor communicator in the United States since the 1980s. For more information about Wilson, visit http://en.wikipedia.org/wiki/Rand_Wilson
Thursday, January 13th, 2011
This morning, the Institute of Medicine began its second day of deliberations into defining what would constitute “essential health benefits” under the Affordable Care Act. Even though the law identifies general categories that insurers will have to cover beginning in 2014 — emergency services, mental health care, outpatient and inpatient care — these meetings are designed to help HHS reach more specificity on the issue. The agency is also required to ensure that the scope of essential health benefits “is equal to the scope of benefits provided under a typical employer plan.”
During the second session, John Kingsdale — the former director of the Massachusetts Connector Authority — predicted that defining “essential health benefits” will be “one of the more challenging parts in implementing the ACA” and warned the agency against “overreaching” in detailing which benefits insurers will have to provide:
KINGSDALE: The nation is highly divided by this and so whatever is put into the essential health benefits package that can be portrayed by those who tend to oppose ACA as unfairly burdening those employers or individuals, who want a different benefit package will be used as political fodder to tear down the ACA and I strongly believe that overreaching…could doom implementation. […]
There is a tendency to think about benefits in the context of negotiation for something more someone else would pay for and I think it continually surprises people to understand, ‘oh there are real people who cannot afford what we consider to be an ideal benefit package and they actually have to pay for it in premiums. ….This was very much about giving people decent coverage as opposed to primarily a policy of it just being about raising the standards of coverage and it seems to me when you have to make close calls about benefits, it’s important to return to that principle. Secondly, obviously, most benefits cost dollars no matter what you will hear about how they will save money and that the ACA will live or die on affordability. And thirdly, that there is a fair degree of consensus about minimum benefit steps and so that you will find most states don’t even mention most of the things that are covered typically by commercial insurance and there are additionally very few benefits that significantly improve [inaudible] or save dollars. So, I think it’s not difficult to find that essential minimum benefits package and then, as you can tell from my other principles, I would advise you to be very conservative about adding on to it. […]
My experience suggests revisiting and learning from cases and some flexibility and even phasing in would all be very helpful as you go down the path of defining a minimum benefit that will be extremely controversial.
Indeed, as CQ Healthbeat reported, it’s still unclear “if officials will seek a specific list of treatments or ask insurers to mirror benefits in particular plans, such as the Federal Employee Health Benefits Program.” Either way, they will have to balance Kingsdale’s suggestions with the concern that too loose of a definition would allow insurers to design plans differently — possibly even in such a way that would lead to adverse selection.
IOM will publish recommendations for HHS “by September, and HHS will issue its proposed rules by the end of the year, giving insurance companies time to adjust plans before the provisions take effect.”
This article was originally published on Wonk Room.
About The Author: Igor Volsky is Health Care Editor for ThinkProgress.org and The Progress Report at the Center for American Progress Action Fund. He also writes on LGBT Equality issues. Igor is co-author of Howard Dean’s Prescription for Real Healthcare Reform. Prior to joining the Center, Igor blogged at BodyPolitik.org and interned with ThinkProgress, Fairness and Accuracy in Reporting (FAIR), and the Hudson River Valley Institute at Marist College. Igor grew up in Russia, Israel, and New Jersey. Igor has appeared on MSNBC, CNN, Fox Business, and CNBC television, and has been a guest on many radio shows.