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Posts Tagged ‘health care’

Veto the Cold-Hearted Health Bill

Monday, June 26th, 2017

Donald Trump is right. The House health insurance bill is “mean, mean, mean,” as he put it last week. He correctly called the measure that would strip health insurance from 23 million Americans “a son of a bitch.”

The proposal is not at all what Donald Trump promised Americans. He said that under his administration, no one would lose coverage. He said everybody would be insured. And the insurance he provided would be a “lot less expensive.”

Senate Democrats spent every day this week pointing this out and demanding that Senate Republicans end their furtive, star-chamber scheming and expose their health insurance proposal to public scrutiny. That unveiling is supposed to happen today.

Republicans have kept their plan under wraps because, like the House measure, it is a son of a bitch. Among other serious problems, it would restore caps on coverage so that if a young couple’s baby is born with serious heart problems, as comedian Jimmy Kimmel’s was, they’d be bankrupted and future treatment for the infant jeopardized.

Donald Trump has warned Senate Republicans, though. Even if the GOP thinks it was fun to rebuff Democrats’ pleas for a public process, they really should pay attention to the President. He’s got veto power.

Republicans have spent the past six years condemning the Affordable Care Act (ACA), which passed in 2010 after Senate Democrats accepted 160 Republican amendments, held 110 bipartisan public hearings and conducted 25 consecutive days of public floor debate. Despite all of that, Republicans contend the ACA is the worst thing since Hitler.

That is what they assert about a law that increased the number of insured Americans by 20 million, prohibited discrimination against people with pre-existing conditions and eliminated the annual and lifetime caps that insurers used to cut off coverage for sick infants and people with cancer.

The entire cavalry of Republican candidates for the GOP nomination for President promised to repeal the ACA, but Donald Trump went further. He pledged to replace it with a big league better bill.

In May 2015, he announced on Twitter: “I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid.”

In September 2015, he said of his health insurance plans on CBS News’ 60 Minutes, “I am going to take care of everybody. I don’t care if it costs me votes or not. Everybody’s going to be taken care of much better than they’re taken care of now.”

In another 60 Minutes interview, this one with Lesley Stahl last November, he said, “And it’ll be great health care for much less money. So it’ll be better health care, much better, for less money. Not a bad combination.”

In January, he told the Washington Post, “We’re going to have insurance for everybody.” He explained, “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

But then, the House Republicans betrayed him. The nonpartisan Congressional Budget Office said the measure they passed, called the American Health Care Act (AHCA), would cut more than $800 billion from Medicaid. It said people with pre-existing conditions and some older Americans would face “extremely high premiums.”

Extremely high is an understatement. Here is an example from the CBO report: A 64-year-old with a $26,500 income pays $1,700 for coverage under the Affordable Care Act (ACA), but would be forced to cough up more than half of his or her income – $16,000 – for insurance under the House Republican plan. Overall, premiums would increase 20 percent in the first year. And insurers could charge older people five times the rate they bill younger Americans.

House Republicans said states could permit insurers to squirm out of federal minimum coverage requirements, and in states where that occurred, the CBO said some consumers would be hit with thousands of dollars in increased costs for maternity care, mental health treatment and substance abuse services.

In the first year, the House GOP plan would rob insurance from 14 million Americans.

So much for covering everyone with “great health care at much less money.”

It’s true that President Trump held a party for House Republicans in the Rose Garden after they narrowly passed their bill. But it seems like he did not become aware until later just how horrific the measure is, how signing it into law would make him look like a rank politician, a swamp dweller who spouts promises he has no intention of keeping.

By last week when President Trump met with 15 Senate Republicans about their efforts to pass a health insurance bill, he no longer was reveling in the House measure. He called it “cold-hearted.” He asked the senators to be more “generous,” to put “additional money” into their version.

Senators told reporters that President Trump wanted them to pass a bill that is not viewed as an attack on low-income Americans and provides larger tax credits to enable people to buy insurance.

Now that sounds a little more like the Donald Trump who repeatedly promised his health insurance replacement bill would cover everyone at a lower cost. Still, those goals remain amorphous.

The House bill is stunningly unpopular, almost as detested as Congress itself. President Trump seems to grasp the enormity of that problem. But even his calling it a “son of a bitch” doesn’t seem to have been enough to persuade senators that he’s serious about getting legislation that achieves his promises to leave Medicaid intact, cover everyone and lower costs.

Republican senators deciding the fate of millions of Americans must hear from Donald Trump that passing a health insurance bill that doesn’t fulfill his campaign promises is, shall we say, a cancer on the Presidency.

A veto threat would get their attention.

This blog originally appeared at OurFuture.org on June 21, 2017. Reprinted with permission. 

About the Author: Leo Gerard is president of the United Steelworkers.

A Winning Week for Corporations and Wall Street—Paid for by Your Health and Retirement

Friday, May 12th, 2017

Corporations and Wall Street won big last week, and working people will pay a high price for it. Here are three things Congress did for Big Business that will harm working people’s health care and retirement:

1. 7 million fewer people will get workplace health benefits. Last Thursday, the U.S. House of Representatives passed the so-called American Health Care Act by a vote of 217-213. This is the bill that President Donald Trump and House Speaker Paul Ryan (R-Wis.) are using to repeal much of the Affordable Care Act and that will cut health coverage for some 24 million people. The U.S. Senate now has to vote.

Professional lobbying groups that represent employers, like the U.S. Chamber of Commerce, are behind this bill because it guts the Affordable Care Act’s requirement that large and mid-size employers offer their full-time employees adequate, affordable health benefits or risk paying a penalty. According to Congress’s budget experts, within 10 years, this bill will result in 7 million fewer Americans getting employer-provided health insurance. Corporate interests also like the huge tax cuts in the House bill, especially the $28 billion for prescription drug corporations and $145 billion for insurance companies.

Big company CEOs—the people who now earn 347 times more what front-line workers earn—are probably salivating over the huge personal tax cuts they will get from the Republican bill. One estimate is that those with million-dollar incomes will receive an average yearly tax cut of more than $50,000. The 400 highest-income households in the United States get an average tax cut of $7 million.

2. As many as 38 million workers will be blocked from saving for retirement at work. The Senate voted 50-49 last Wednesday to stop states from creating retirement savings programs for the 38 million working people whose employers do not offer any kind of retirement plan. The House already had voted to do this, and Trump is expected to sign off on it.

In the absence of meaningful action by the federal government, states have stepped in to address the growing retirement security crisis. But groups that carry water for Wall Street companies, like the Securities Industry and Financial Markets Association, have been actively lobbying Congress and Trump to stop states from helping these workers.

3. More than 100 million retirement investors may lose protections against conflicted investment advice. The House Financial Services Committee approved the so-called Financial CHOICE Act on a party-line vote last Thursday. It now goes to the full House of Representatives, and then to the Senate. In addition to gutting the Consumer Financial Protection Bureau that protects working people from abusive banking practices and ripping out many of the other financial reforms adopted after the 2008 financial crisis, this bill overturns key investor protections for people who have IRAs and 401(k)s. A massive coalition of Wall Street firms and their lobbying groups has been fighting to undo these retirement protections by any means possible.

About the Author: Shaun O’Brien is the Assistant Director for Health and Retirement in the AFL-CIO’s Policy Department, where he oversees development of the Federation’s policies related to Medicare, Medicaid, Social Security, and work-based health and retirement plans. Immediately prior to joining the AFL- CIO, he held several positions at AARP, including the Vice President for the My Money Portfolio and Senior Vice President for Economic Security. O’Brien holds a Bachelor of Arts degree from American University and a law degree from Cornell Law School.

Congress’ Cuts in Health Care Will Hit Women Harder

Tuesday, March 7th, 2017

Republican leaders in Congress are working on plans to cut health benefits for tens of millions of people. The harms from these cuts are likely to have the biggest impact on women, both for their own health benefits and as they try to manage health care for their families.

Every major source of health coverage is now at risk under the Republican health plans. This includes individual coverage bought through the Affordable Care Act, workplace health plans, Medicaid benefits for people struggling to make ends meet, and Medicare for seniors and people with disabilities.

The ACA included important changes in the law requiring women to be treated fairly. Repealing the ACA outright, as Republican leaders say they want to do, could mean going back to the days when insurance companies could legally discriminate against women by charging them higher monthly premiums for individual coverage than men.

Repeal also could mean getting rid of protections requiring individual policies to cover pregnancy and pay for preventive services, like women’s well visits and birth control.

Republican leaders also are intent on slashing Medicaid by more than a half trillion dollars over 10 years, which will take health coverage away from millions of people and cut benefits for many others. This government health program for people struggling to make ends meet pays for one-half of all childbirths in the United States. It also covers the bill for more than three-in-five nursing home residents—a group made up disproportionately of older women who otherwise might have nowhere to go.

The fallout for women does not stop there. Women already are much more likely than men to be the ones navigating our complicated health care system for their families and dealing directly with its high costs. Women make about 80% of their family health care decisions, like deciding on the right care and how to pay for it. They also are far more likely than men to be caregivers, including for older adults, such as parents or spouses.

When the Republican health care cuts come, women are likely to have to deal with the consequences in their daily lives.

When they can no longer afford a private insurance policy or they get dropped from Medicaid, women likely will be the ones struggling to figure out how to get and pay for the care needed by a small child with an ear infection.

When Medicaid support is cut for seniors who need help so they can stay in their homes or who need to go to a nursing home, women are likely to be the family members who are figuring out how to care for an elderly parent with dementia.

When family paychecks are smaller or health benefits are cut back because Republicans have taxed workplace health plans, women are likely to be the ones at the doctor’s office figuring out how to pay the family health care bill.

Yes, women will be hit harder by the Republican health care cuts.

This blog originally appeared in aflcio.org on March 6, 2017.  Reprinted with permission.

Shaun O’Brien works for AFL-CIO.  His interests include retirement security and health care. Follow him on twitter @ShaunOBrien30.

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.

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