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AEA Healthcare Update Archives



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The Patient Protection and Affordable Care Act

By Rachel Laforest
Public Policy Director

The April health care article painted a broad-stroked picture of what Equity members can expect from our new health care system. This issue contains an in-depth analysis of one component of the new act that will affect them, the individual mandate and subsidies. (Note: The Equity/League trustees are monitoring the possible impacts that the new health care act could have on our plan.)

Individual Mandate and Subsidies
(All information gathered from www.Healthcare.gov and http://voices.washingtonpost.com/ezra-klein/2010/03/how_does_the_individual_mandat.html)

The new health care reform legislation will require most individuals who can afford it to obtain basic health insurance coverage or pay a fee to help offset the costs of caring for uninsured Americans. Subsidies will be offered to assist with compliance and if affordable coverage is not available to an individual, he or she will be eligible for an exemption.

The individual mandate will require most Americans to have a minimum level of health insurance or else pay a penalty.

  • In 2014 the penalty will be $95 a year or 1 percent of the household income, whichever is greater.

  • In 2015, at least $325 or 2% of the household income, whichever is greater.

  • In 2016, at least $695 or 2.5% of the household income, whichever is greater (with a maximum penalty of $2,085 per family).

After 2016, dollar amounts will increase by the annual cost of living adjustment.

Exemptions
The following people are exempt from the individual mandate requirements:

  • people with low incomes who are not required to file taxes;

  • members of certain religions who are exempt for religious reasons;

  • people who are incarcerated;

  • people who are not legal residents;

  • members of an American Indian or Alaskan Native tribe;

  • people who go without coverage for less than 3 months;

  • people who do not have an affordable offer of coverage, either through the exchange or through their employer (coverage is considered "affordable" if the monthly premium does not consume more than 8% of a family's gross income in 2014. This will be indexed in later years to account for both premium and wage increases).

In addition, anyone who would face hardship if they purchased coverage may file for an exemption from the individual mandate requirements. There will be no criminal penalties for failing to meeting the individual mandate requirements.

Individual Subsidies
The federal government will provide tax credits to low and middle-income people, those earning between 133% and 400% of the poverty level, to help them buy health insurance from marketplaces called "exchanges", where they can compare prices and benefits.

Premium Limits and Cost Sharing Assistance

Average Income

Premium Spending Limit

Cost Sharing Assistance

133 – 150% of poverty level

($29, 327 - $33,075) Family of 4

($24,352 - $27,465) Family of 3

($19,378 -  $21,855) Family of 2

($14,404 - $16,245) 1 person

3-4% of income

Subsidized plan will cover 94% of costs.

150 – 200% of poverty level

($33,075 - $44,100) Family of 4

($27,465 - $36,620) Family of 3

($21,855 - $29,140) Family of 2

($16,245 – 21,660) 1 person

4 – 6.3% of income

Subsidized plan will cover 87% of costs.

200 – 250% of poverty level

($44,100 - $55, 125) Family of 4

($36,620 – $45,775) Family of 3

($29,140 - $36,425) Family of 2

($21,660 - $27,075) 1 person

6.3 – 8.05% of income

Subsidized plan will cover 73% of costs.

250 – 300% of poverty level

($55,125 - $66,150) Family of 4

($45,775 - $54,930) Family of 3

($36,425 - $43,710) Family of 2

($21660 - $32,490) 1 person

8.05 – 9.5% of income

Subsidized plan will cover 70% of costs.

300 – 400% of poverty level

($66,150 - $88,200) Family of 4

($54,930 – $73,200) Family of 3

($43,710 - $58,2800) Family of 2

($32,490 - $43,310) 1 person

9.5% of income

Subsidized plan will cover 70% of costs.


Role of AEA
Equity staff and members of the Health Care Committee have attended several forums, seminars and teach-ins on the new health care legislation. These sessions have increased our understanding of how things are rolling out. While the rules and regulations for each component of the bill continue to be forged, we will continue to monitor the process, weigh-in when necessary and report that details to the membership.




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Healthcare Update - June 2010

The new Consumer Information Website, HealthCare.gov, has been launched!

The comprehensive web portal required by The Affordable Care Act went up July 1. It replaces existing websites that provided information on the law and its interpretation.

Its primary purpose is to help individuals and families navigate health care, e.g., unemployed workers looking for coverage to replace employer coverage that they lost. It contains information on all applicable federal laws, links to state government resources, and a huge amount of information on private health plans (currently 5,100 plans) with pricing information scheduled to be added in October.

In addition, the Nationwide Network of High-Risk Pools is up and running.

As an interim step towards covering people with pre-existing conditions who have been turned down by insurers, new high-risk pools opened for business in all fifty states on July 1. The pools are run either by the states or federally by Health and Human Services (HHS) and are in addition to existing pools that have been available on a limited basis in some states.

For complete information on benefits, eligibility and application processes, go to www.healthcare.gov/law/about/provisions/pcip/index.html. The pools will be a significant new source of health coverage for unemployed workers with pre-existing conditions who have been without coverage for six months.

Actors' Equity Association will continue to provide the latest information on our website and in Equity News.




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America's New Health Care System

The new health care reform legislation passed by Congress will have immediate and long term impacts on Equity members and their families.

It will create stronger accountability mechanisms for insurance companies, make it law for most Americans to carry health insurance, try to keep premium costs down and subsidize many who cannot afford coverage. It is far from a perfect solution but it represents a significant step towards affordable health insurance for the thousands of Equity members and all Americans who cannot presently afford it.

What kicks in this year?

  • Insurance companies will no longer be able to put a life-time cap on their costs. Annual caps will be severely reduced and totally eliminated in 2014.

  • Insurance companies will not be allowed to deny coverage to children because of a preexisting condition. A special program will help adults with preexisting conditions find coverage, until 2014 when insurers will be required to cover everyone, regardless of preexisting conditions.

  • Rescission - the technical term for canceling coverage on grounds that the insurance company was "misled", will end. Rescission has been found to be practiced when plan holders find themselves sick with something they had not mentioned on their insurance application. Most times it is an ailment that developed over time or was unknown to the plan holder and their doctor.

  • Insurers with unusually high administrative costs have to offer rebates to their customers, and every insurance company will have to reveal how much it spends on overhead. Insurers will be required to spend between 80 to 85 cents of every dollar of their premium revenues on medical claims. The largest for-profit insurance companies currently spend about 74 cents out of every dollar on medical care.

  • Those insurers who raise prices excessively could be barred from the exchanges and premiums for older people cannot be more than three times the premium for young adults.

  • Children will be considered "dependent" until the age of age of 26 and therefore eligible for coverage on a parent's health plan. Within six months, all health plans, including employer-sponsored plans, must cover children of policyholders.

  • Over 3 million Medicare recipients will get a one-time rebate of $250 towards closing the Medicare D "donut hole" in their prescription drug coverage. Next year, 50% of the doughnut hole will be covered and the entire gap will be eliminated by 2020.

  • Medicare will now provide a free visit to primary care physicians every year to plan out prevention services.

  • Small businesses will get tax credits - up to 50 percent of premium costs - for offering health insurance to their workers.

  • Employer plans that cover early retirees ages 55 to 64 will receive a subsidy.

  • Beginning in 2011 a voluntary federal program will be established to provide long-term care insurance and cash benefits to people with severe disabilities. The amount of benefits will vary, depending on the degree of a person's disability, but could not average less than $50 a day.

Starting in 2014, the bill will:

Insurance Exchanges
These on-line insurance marketplaces will help individuals and employers to shop for insurance and compare prices and benefits.

Government Contracted Insurance
While there is no Public option, like a "Medicare for All" plan in the new legislation, the Federal government will be entering the insurance market indirectly. There will be at least two national health plans to individuals, families and small businesses. At least one of the plans will have to operate on a nonprofit basis.

Individual Mandate
Will require most Americans to have a minimum level of health insurance or else pay a penalty.

Individual Subsidies
Low and middle-income people will receive tax credits to off-set premium costs, co-payments and deductibles.

Employer Mandate
Most employers having more than 100 workers will either have to offer coverage or pay a penalty of $2,000 for each full time worker forced to receive federal subsidies to buy insurance on their own.

Employer Subsidies
Employers with less than 25 workers and annual average payroll of less than $50,000 could qualify for tax credits. Employers with less than 10 workers and average payroll of less than $25,000 will automatically get the tax credits.

Medicaid
Expanded Medicaid will cover an estimated additional 16 million low income and impaired people, including parents and childless adults who are not eligible under current rules.

Benefit Requirements
Insurance plans will be required to offer a federally-defined minimum package of health insurance benefits.

Paying for the bill
In order to cover the cost of the legislation new fees and taxes will be imposed and Medicare payments to hospitals and many other health care providers will be curbed.

Starting in 2014 a 40% "excise tax" will be leveraged on employer-sponsored group health plans with premiums over $10,200 for individual coverage and $27,500 for family coverage. Beginning in 2020, the tax thresholds will rise by the inflation rate.

Starting in 2013 the Medicare payroll tax rate will increase by just under 1% for individuals earning more than $200,000 a year and families earning more than $250,000. In addition, a 3.8% tax on capital gains, dividends, interest and other "unearned income" will also be applied.

There are obviously many more details of the new system that are not covered in this article. Future issues of Equity News will provide in-depth coverage of all that is mentioned here as well as any new developments in the law.

The Equity-League Pension, Health and 401(k) Trust Funds are administered by a Board of Trustees made up of an equal number of representatives from Actors' Equity Association, and the Producers. The Funds are legal entities separate from the Union and from any Producer. If you are currently a plan participant, please direct your questions to the Funds office at 212-869-9380 in New York City; if you are outside of New York, please call 1-800-344-5220.


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Actors' Equity Weekly Health Care Up-date 3/23/10 – 3/24/10

No Public Plan and an Individual Mandate
But Bad News for the Insurance Industry Too

On Sunday, March 21, 2010, the U.S. House of Representatives voted 219 - 212 to overhaul the nations health care system and expand coverage to an estimated 32 million more Americans. Among many other benefits, the bill also promises to prevent insurance companies from dropping coverage of the sick, barring those with pre-existing conditions and raising premiums without just cause. While it does not include a Public Option and mandates that everyone purchase insurance, it is a step in the right direction.

After approving the bill, the House adopted a package of changes to it (know as the budget reconciliation proposal) by a vote of 220 to 211. This package will be reviewed and voted on by the Senate this week. It includes key compromises that will keep costs down and benefit union members and multi-employer insurance plans.

President Obama signs historic legislation

On Tuesday, March 23rd President Obama signed the bill into law. Now the real work begins. The more detailed components of reform will be worked out after both bills are signed. Some components will be implemented immediately and others will be modified, and hopefully improved, leading up to the full enactment of the bills in 2013. Equity will monitor and provide information on anything that may impact our insurance plan and the membership.

Please visit Equity’s website www.actorsequity.org later this week for a more in-depth analysis of the current bills and how we will be moving forward.


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Actors Equity Health Care Alert!

The Time to Act is Now!

The House may vote on the Senate-passed bill as early as this weekend! While there are some substantive reforms in the Senate bill, Equity also has several concerns:

  • The Senate bill does not include a Public Option!

  • The Senate bill puts a 40% tax on health benefits!

  • The Senate bill mandates coverage without guaranteeing affordability!

Poll after poll has shown that Americans are overwhelmingly in favor of an affordable Public Option which will help hold down costs. Similar polls show that Americans also oppose the proposed tax on benefits.

When we've been heard, we've made progress! Equity members along with many other constituents contacted their elected representatives in DC and the President responded.

Proposed thresholds for the tax on benefits were raised substantially. As a result, the Equity health plan will not be affected by the tax when it begins in 2018.

Time is running out! Equity encourages all members to contact their elected representatives before it is too late.

Visit www.Senate.gov and www.House.gov. Input your full Zip Code + 4 to be directed to your Representative's mailbox.

Cut and paste the sign-on letter below or say it in your own words:

We need serious health care reform that includes a Public Option, does not tax health benefits and provides the uninsured with affordable insurance choices. As your constituent I am asking that you stand strong in the final vote.

  • Without a Public Option there can be no meaningful reform.

  • With a tax on health benefits there can be no meaningful reform.

  • Without guaranteed affordable insurance option there can be no meaningful reform.

Thank you for your public service.

A note from the Actors' Equity Association Health Care Committee Chair

"I know how frustrating it can be to wait on a phone line or compose a letter to your representative, but this is truly democracy in action. I urge you to take part and take five minutes to contact your representatives. Use our sample letter or just 'hang in there' and speak directly to their office. Many thanks for all your efforts.

- Arne Gundersen, Committee Chair




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Actors Equity Weekly Health Care Up-date 3/3/10 - 3/10/10

"So, no matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform. We have debated this issue thoroughly, not just for a year, but for decades. Reform has already passed the House with a majority. It has already passed the Senate with a supermajority of sixty votes. And now it deserves the same kind of up-or-down vote that was cast on welfare reform, the Children's Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts - all of which had to pass Congress with nothing more than a simple majority. I have therefore asked leaders in both Houses of Congress to finish their work and schedule a vote in the next few weeks. From now until then, I will do everything in my power to make the case for reform. And I urge every American who wants this reform to make their voice heard as well - every family, every business owner, every patient, every doctor, every nurse."

The above quote is from President Obama's speech on March 3rd in regard to moving forward on health care reform. Essentially what he has said is the reconciliation process will be used to finalize a health care bill. In order to proceed, the House would have to first pass the Senate-passed health bill. Then both chambers would use reconciliation to pass a package of changes that would bridge gaps between the initial House and Senate versions. The final bill language would then be sent to the Congressional Budget Office for evaluation and scoring.

While the leadership is supposedly hoping to wrap up healthcare reform by March 18, when the President departs for Indonesia and Australia, the more likely target date is by March 29, when the week-long Easter recess begins.

The issue for most Americans is still less about process and more about the content of a final bill. As mentioned in last week's up-date, the President's plan does include some of the better proposals from the Senate and House bills, such as expanded Medicaid, subsidies for low and moderate income people to buy insurance, closing the Medicare drug benefit "donut hole," and insurance regulations. It also includes a federal commission with the authority to prohibit excessive premium increases.

That said, President Obama's proposal still does not do enough to create affordable health care and lower costs. Equity would continue to be concerned with the following:

  • Equity members and all Americans could see an individual mandate to purchase insurance without any sturdy mechanism to ensure its affordability or the quality of coverage.

  • Multi-employer health plans such as ours may be taxed resulting in reductions in benefits and/or eligibility.

  • In the absence of any public option, the "open market" state-by-state approach could mean that insurers would be able to sell their plans across state lines, putting consumer protections in jeopardy. Insurers could gravitate to states with the most lax regulations and coverage requirements, craft insurance policies there and sell them to people across the country.

In his speech, the president urged every American to make their voice heard; once again, Equity encourages the same. All Equity members concerned with the effects that any reform will have on themselves and our health plan need to reach out to members of the House, Senate and White House.

Let them know:

1. A public option must be a part of any final bill

2. No tax on health benefits is acceptable

3. Any individual mandate must be affordable

4. Multi-employer plans such as ours need special consideration

www.senate.gov

www.house.gov

www.whitehouse.gov or 202-456-1111

To help you better understand the differences in each proposal and to assist with your emails and calls to elected officials, below is a comparison of the key elements in each of the 3 proposals:

COMPARISON OF OBAMA HEALTH CARE PROPOSAL WITH HOUSE & SENATE PROPOSALS

Key:
FPL = Federal Poverty Level
CBA = Cost Benefit Analysis

 

House

Senate

Obama

Public Option

National public option with negotiated provider rates between Medicare and average private plan rates

No Public Option

No Public Option

Benefits Tax

No tax on health benefits

40% tax on health plan cost in excess of $8,500 (individual) or $23,000 (family) beginning in  2013

 

 

40% tax on health plan cost in excess of $10,200 (individual) or $27,500 (family) in 2018

 

Adjustments for age and gender mix.

Tax on Wealthy

5.4% surtax on individuals earning more than $500,000 and families earning more than $1 million

Increase Medicare payroll tax rate by 0.9% for individuals earning more than  $200,000 and families earning more than $250,000

Increase in Medicare payroll tax same as Senate PLUS

 

2.9% assessment  (total of Medicare payroll tax paid by employees and employers) on unearned income for individuals earning more than $200,000 and families earning more than $250,000

National Exchange

National exchange overseen by federal government to negotiate and enforce agreements with insurers

State exchanges

 

Federal government sets up exchange if state fails to do so by 2013

Same as Senate

Affordability

Exchange subsidies limit premium contribution from 1.5% to 12% of income based on FPL percentage

 

 

Plan coverage of anticipated costs range from 97% for lowest income brackets to 70% for 350% FPL and above

 

Out-of-pocket limits in exchange from $500/$1,000 to $5,000/$10,000. 

 

Employees offered coverage at work are eligible for exchange if premium contribution exceeds 12% of income (subject to CBA rule)

Exchange subsidies limit premium contribution from 2% to 9.8% of income based on FPL percentage

 

Plan coverage of anticipated costs range from 90% for lowest income brackets to 70% for 200% FPL and above

 

Out-of-pocket limits in exchange from $1,980/$3,960 to $3,960/$7,920. 

 

Employees offered coverage at work eligible for exchange if premium contribution exceeds 9.8% of income

Exchange subsidies limit premium contribution from 2% to 9.5% of income based on FPL percentage

 

Plan coverage of anticipated costs range from 94% for lowest income brackets to 70% for 250% FPL and above

 

Out-of-pocket limits same as Senate

 

 

 

Same as Senate

Rate Review

State-based review of insurance rates that requires insurers to document and justify reasons for rate increases

Similar to House

Similar to House and Senate, plus

new Federal Insurance Rate Authority to oversee and assist states

 

Require insurance companies to lower premiums or pay rebates if rate increases unreasonable and unjustified




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Actors Equity Weekly Health care Up-date 2/22/10 - 3/1/10

On Monday, President Obama outlined a legislative plan to overhaul health care. In preparation for his health care summit scheduled for Thursday, February 25th he has crafted a plan to offer as a compromise between the proposals made by the House and Senate. His hope is to receive bipartisan support and push this plan through Congress with the budget reconciliation process, which needs only 51 votes.

What's painfully obvious in reviewing the President's proposal is the absence of a public option, an included tax on health care plans, no device for protecting multi-employer plans and a questionable formula for maintaining affordability.

The public option would provide real competition to the health insurance industry and would function as an umbrella mechanism for monitoring insurance rates. President Obama's proposal to exclude it coupled with open state exchanges almost ensures an impossible task of regulating rates and keeping insurance affordable.

It appears that this process will soon be coming to a close; the outcome of the health summit on the 25th should make the direction and timeline clearer.

  • Equity members and all Americans could see an individual mandate to purchase insurance without any sturdy mechanism to ensure its affordability or the quality of coverage.

  • Multi-employer plans such as ours may have to grapple with a tax leveraged on the health plans we provide resulting in a watering-down of the coverage or a reduction in the number of members covered.

  • In the absence of any public option, the "open market" state-by-state approach could mean that insurers would be able to sell their plans across state lines, putting consumer protections in jeopardy. Insurers could gravitate to states with the most lax regulations and coverage requirements, craft insurance policies there and sell them to people across the country. Selling insurance across state lines disrupts the very concept of insurance: to pool the sick and healthy together to spread risk and cost.

The President's plan does include some of the better proposals from the Senate and House bills, such as expanded Medicaid, subsidies for low and moderate income people to buy insurance, closing the Medicare drug benefit "donut hole," and insurance regulations. It also includes a federal commission with the authority to prohibit excessive premium increases.

With all that the President's plan would achieve, it still does not do enough to create affordable health care and lower costs. Without enough public pressure it will likely close with reforms that do not come close to meeting any real standards for comprehensive, affordable health coverage. Americans need to make themselves heard now more than ever.

The Equity health plan will be affected by the reforms that get passed. Equity encourages all members to reach out to members of the House, Senate and White House and let them know:

1. A public option must be a part of any final bill

2. No tax on health benefits is acceptable

3. Any individual mandate issued must be affordable

4. Multi-employer plans such as ours need special consideration

www.senate.gov

www.house.gov

www.whitehouse.gov or 202-456-1111

To help you better understand the differences in each proposal and to assist with your emails and calls to elected officials, below is a comparison of the key elements in each of the 3 proposals:




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Equity Health Care Up-date 2/22 - 2/29

Council resolution, September 10, 1991:

"RESOLVED UNANIMOUSLY to accept the recommendation from the National Health Plan Committee Co-Chairs that AEA support and participate in the formation of a national coalition of labor organizations, health care suppliers and public interest groups, the goal of which is the adoption and implementation of a single-payer, universal, comprehensive national health care plan."

If you are interested in learning more or participating in local meetings, forums, or conferences regarding a single-payer healthcare plan, please consult the list below and stay tuned for our weekly national Health Care up-dates.

For more information, contact Rachel LaForest, AEA National Public Policy Director, at 212.869.8530 x 554.

Single-Payer Events in February 2010

February 18, 2010 - St. Louis, MO
The Future of Single Payer in the Health Care Debate
Dr. Pamella Gronemeyer, a pathologist and progressive political activist who lives in Glen Carbon, IL will talk on "The Future of Single Payer in the Health Care Debate."
When: 6:30 p.m., Thursday, Feb. 18
Where: Hanke Room of the Ethical Society of St. Louis, 9001 Clayton Rd.
The program is sponsored by Missourians for Single Payer and is free and open to the public.

February 19, 2010 - Rochester, NY

Non-violent civil disobedience demonstration
WHY: to bring public awareness of the need for improved Medicare for All
WHEN: 2/19. 12:PM
WHERE: OFFICES OF BLUE/CROSS/BLUE SHIELD
165 STATE STREET
CONTACT: JACK KASHINSKY, jackann410@aol.com
585-442-7898, (cell) 585-314-5336

February, 20, 2010 - Columbia, MD

Maryland Single Payer Leadership Training
Join us for a full day of interactive workshops with nationally known single payer advocates! Network with other single payer advocates in Maryland! Get the tools you need to be an advocate in your area!
When: 9am to 3pm
Where: 7246 Cradlerock Way, Columbia 21045
For more information or to RSVP (if you want materials) contact Margaret Flowers. There is no registration fee (donations accepted).
Sponsored by Maryland chapter Physicians for a National Health Program and Healthcare-Now of Maryland.

February 21, 2010 - Teaneck, NJ

The Sorry State of Health Care What You Don't Know Can Hurt You
A Panel Discussion Moderated by State Senator Loretta Weinberg, Chair, Senate Health, Human Services and Senior Citizens Committee
Panel Members:
-Congressman Steven Rothman
-Martha Livingston, Ph.D., Associate Professor of Health and Society SUNY College at Old Westbury
-Dr. David Hodges, Practicing physician, internist, and cardiologist
When: February 21, 2010, 3:00-5:30 PM
Where: Rodda Center - 2nd Floor, 250 Colonial Court, Teaneck, NJ, (enter from Palisade Ave.)
More Info: www.teaneckdmc.com

February 22, 2010 - Detroit, MI

Retirees for Single-Payer Healthcare Meeting
When: Monday 02/22/10 1 pm
Where: UAW Local 22, 4300 Michigan Ave, Detroit, MI 48210

February 24, 2010 - Syracuse, NY

Public Screening of PBS FRONTLINE Documentary: Sick Around the World
What could health care reform look like? Learn from the successes and failures of five modern industrialized democracies - UK, Germany, Japan, Taiwan, Switzerland - that provide health care for their citizens which costs less and keeps people healthier than in the US.
When: Wednesday, February 24, 2010, 7 PM to 9 PM
Location: Art Rage Gallery, 505 Hawley Avenue, Syracuse, NY 13203
More Info: Karl Newton, MD knewton@pol.net or 315-475-1053
Sponsored by PNHP Syracuse.

February 23, 2010 - New York, NY

On the Road to Single Payer: Adventures of PNHP's National President
Dr. Oliver Fein will share highlights and anecdotes of his year of travels across the country organizing for PNHP.
Time: Tues., February 23, 7:30 PM
Where: Beth Israel Medical Center
Phillips Ambulatory Care Center
10 Union Square East
(between 14th and 15th Streets)
Second Floor - Lecture Hall
More info: info@pnhpmetro.org org org www.pnhpnymetro.org
Admission is free.

February 25, 2010 - Washington, DC

Sidewalk Summit for Improved Medicare for All
Meet us at 9 AM at the White House. Specific meet up details here.
Sidewalk summits hare happening in a dozen other cities. Check here for updates on when and where.
For more information, email info@healthcare-now.org

February 25, 2010 - Birmingham, AL

Health Care Reform 2010: Where do we go from here?
Dr. Fein will present on the current legislation being debated in Washington and why it will not solve our health care crisis. Dr. Fein will then outline the need for the expansion and improvement of Medicare for all. Audience Q&A will follow the presentation.
When: Thursday, Feb. 25 7:30-9:00 p.m.
Where: Sixteenth Street Baptist Church, 1530 Sixth Ave South, Birmingham
For more information, call (256) 489-3884, e-mail lahaynes@knology.net or online www.NorthAlabamaHealthcareForAll.org.

February 26, 2010 - Huntsville, AL

Healthcare Reform 2010: Where Do We Go From Here?
Physicians understand the urgent need for healthcare reform - for the good of patients, the profession and the U.S. economy. However, according to Dr. Fein, the present legislation in Congress is not going far enough AND is headed in the wrong direction. This talk, by a leading advocate of an expanded and improved Medicare for All (single payer) program, will describe what's really happening with our healthcare system and where we need to go from here to reach universal, high quality coverage at an affordable cost for all. Audience Q&A will follow.
When: Friday, Feb. 26, 6:00 PM
Where: Shelby Center for Science and Technology, UA Huntsville Campus. Room 107 Auditorium. (near intersection of Sparkman Drive and Lakeside

February 27, 2010 - Huntsville, AL

Healthcare Justice: The Moral Imperative for Universal Healthcare from a Christian Perspective
This event offers an overview of problems with the healthcare system, the status of reform legislation, and an affordable solution aimed at just and equitable healthcare for all. We begin by laying out an ethical framework for the discussion. Speakers then address various aspects of healthcare justice and the moral imperative they see as central to the Christian perspective. Audience Q&A will follow.
When: Saturday, Feb. 27, 10 - 11:30 AM
Where: Faith Presbyterian Church, 5003 Whitesburg Drive, Huntsville. Fellowship Hall. (at intersection of Airport and Whitesburg)

February 27, 2010 - Huntsville, AL Point / Counterpoint: Fixing the American Health System
Physicians from opposite ends of the policy spectrum will present their solutions to our health care crisis. Dr. Oliver Fein, president of PNHP, will present the case for expanding and improving Medicare to all. Dr. Allan Goldstein, Alabama delegate to the American Medical Association, will focus on quality of healthcare as a way to reduce costs, and the reforms necessary to reach that goal. Audience Q&A will follow.
When: Saturday, Feb. 27, 1 - 3 p.m.
Where: Crestwood Medical Center, One Hospital Drive, Huntsville. First floor auditorium. (near intersection of Airport and Whitesburg)

Single-Payer Events in March 2010

March 1, 2010 - Detroit, MI

Demonstration for Single-Payer Healthcare
When: Monday 03/01/10, 10 am
Where: Solidarity House, 8000 E. Jefferson, Detroit, MI 48214

March 5th, 6th, 7th, 2010 - Washington, DC

National Labor for Single-Payer Conference
In one year, LCS-P's growth and impact have been significant. All labor organizations that want to continue to build the campaign for a universal, comprehensive, affordable single-payer system in this country are invited to attend and help shape the strategy to take the fight for healthcare justice to the next level for the enduring benefit of our members and all workers in America. The nation's lawmakers are taking a wrong turn with today's health care "reform" legislation. Collective bargaining will be further compromised and the need for single-payer will become more acute. The AFL-CIO Resolution to pursue health care as Social Insurance in the form of Single-Payer Legislation directs us to redouble our efforts to secure true social justice through universal, single-payer health care for all in America. For more information on the March Conference, go to: www.laborforsinglepayer.org.

March 8, 2010 - Detroit, MI

Retirees for Single-Payer Healthcare Meeting
National Health Care Speakers Program - Maureen Taylor, State Chairperson for the Michigan Welfare Rights Organization.
When: Monday 03/08/10, 1 pm
Where: UAW Local 22, 4300 Michigan Ave, Detroit, MI 48210

March 9, 2010 - Champaign, IL

Who Controls Your Health Care: a Debate on Free Markets vs. Government Control
Featuring:
Michael Tanner, Senior Fellow at the Cato Institute
Steffie Woolhandler, Professor of Medicine at Harvard and co-founder of Physicians for a National Health Program
When: Tuesday, March 9, 2010 - 4:00-5:30 pm
Where: Deliotte Auditorium, Business Instructional Facility, 515 E. Gregory St., Champaign, IL
Sponsored by the Center for Business and Public Policy in the College of Business

March 15, 2010 - Detroit, MI

Retirees for Single-Payer Healthcare Meeting
National Health Care Speakers Program - Olivia Boykins, Congressman Conyers subject matter expert in Michigan for the United States National Health Care Act HR 676.
When: Monday 03/15/10, 1 pm
Where: UAW Local 22, 4300 Michigan Ave, Detroit, MI 48210

Ongoing

ChiSPAN Meetings-Chicago, IL

Meetings every other week. Visit www.chispan.org for more information.


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Actors Equity Weekly Health care Up-date 2/8/10 – 2/12/10

By Rachel LaForest
Public Policy Director

There is unlikely to be much progress on health care this week, as the Senate focuses on passing a bill aimed at reducing unemployment and Democrats look forward to regrouping during the weeklong Presidents Day recess. Yet many in the House and Senate remain optimistic that they will somehow complete the legislation.

The bill made no evident progress last week, in spite of assurances by some senior elected officials that they would move quickly to decide how to move forward. Perhaps the only viable plan—a two-step strategy that requires budget reconciliation to avoid a Senate filibuster and amend the Senate-passed health bill (HR 3590) - is being met with resistance. Leaders in the House and Senate believe that this may be the only way to move forward and hold on to some of the “fixes” made during the negotiations in December, however, the process is being viewed with increasing skepticism.

The alternative would be to identify core elements of the bill and pass them piecemeal but President Obama is still advocating passage of complete, comprehensive legislation. He has even extended invitations to congressional leaders of both parties to attend a Feb. 25 Health Summit with the intent to hold “substantive discussion about how best to achieve the health care goals previously laid out."

Another major component of the delay was waiting for newly elected Senator, Scott P. Brown, R – Massachusetts to take his seat. Now that Brown has been sworn in, elected leaders can move forward, once they resolve a procedural question giving rise to much of the skepticism: can the Senate pass a reconciliation bill that amends legislation that is not yet law?

The answer to this question is vital. Those who wish to fix the ills of the bill would prefer the Senate pass a reconciliation bill that addresses those ills before the House passes the Senate bill in its entirety. House members view the Senate's health bill as inferior to (HR 3962) the bill they passed in November and want assurances the Senate bill would be changed before they vote.

Whatever the final decision, they need to move quickly as the national health expenditures are projected to have risen to $2.5 trillion in 2009, or 17.3 percent of the Gross Domestic Product. This is a 1.1 percentage-point increase compared to 16.2 percent in 2008 and has been cited as the largest single-year increase since the government began tracking health spending in 1960. Americans cannot afford this kind of cost increase in health care.


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Actors Equity Weekly Health care Up-date 2/1/10 – 2/7/10

By Rachel LaForest
Public Policy Director

National Health Care Reform Debate Not Over Yet

With no clear path forward on major health care legislation, leaders in Congress have significantly slowed the process but have not “slammed the brakes” as many major dailies have been reporting. For lawmakers the situation seems to be less dire than it was a few weeks ago. Representatives on both sides of Capitol Hill, as well as in the administration, insist negotiations will continue, just as they have for the last week.

After surveying all the options, including drafting a smaller health care bill or passing the most popular parts piecemeal, many Democratic leaders in the House and Senate are realizing that there may be only one way to move forward and hold on to some of the “fixes” made during the negotiations. If the House passes the Senate bill as is, they could make revisions though a “reconciliation” process that would only require a simple majority, rather than the 60-votes required by Senate rules. The reconciliation process would only handle budgetary matters but that would include the proposed tax on health care which has become a major point of contention.

Although Speaker Nancy Pelosi announced last week that she would not be able to find the votes needed to pass the Senate bill as is, her members might if they knew that there could be some fixes. Many House members do not want the Senate bill's tax on benefits, they would like a national health insurance exchange, rather than individual state exchanges proposed in the Senate bill, and they are concerned about affordability.

It is still unclear that this is the conduit that will get us a final bill as several key Senators have expressed no confidence in the reconciliation process. Is also unclear whether or not the final bill will include a public option, though progressives in the House appear to be gathering support around reinserting such a proposal in a reconciliation process.

Meanwhile, the state of California is contending with its own health care legislation. SB810, a bill that would provide health coverage to every resident of California was passed last week by the state’s Senate. Actors Equity affirmed its policy of commitment toward single-payer, universal health care by joining hundreds of thousands of other single-payer advocates in submitting letters to the Senate to urge the bill’s passage. We were successful!

It now has to be reviewed and voted on by the Assembly and then will be sent to the Governor’s desk. Governor Schwarzenegger has vetoed similar legislation twice in the past but advocates are hopeful that given the national climate regarding health care he can be swayed. Equity plans to weigh-in on pushing the Governor in that direction as well.

Whatever the outcome, the passage of such a bill sends a clear signal that the people of California, just like Equity, want affordable, universal health care.

For more information on SB810 visit Equity’s own Advocacy-Public Policy page for the Western Region or go to:

www.californiaonecare.org

www.healthcareforall.org


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Actors' Equity Weekly Health care Up-date 1/18/10 - 1/22/10

By Rachel LaForest
Public Policy Director

The outcome of the special senatorial election in Massachusetts has changed the balance of power in the Senate. Now, the Obama administration no longer has a filibuster proof Senate forcing the Executive and House to reset their sights with regard to the content of a health care bill as well as the method for getting it passed.

There are a few options open to lawmakers in order to move forward:

1. They can go back to the formal reconciliation process that would have normally taken place. Rather than modifying the Senate bill alone, a small committee made up of House and Senate members would address both bills simultaneously and blend various components of each. In reconciliation it would be possible for both houses to get rid of the worst pieces of the bill and they would only need 51 votes in the Senate to pass it. Because of the reconciliation rules agreed to early in the reform process a filibuster would not be allowed. It is unclear however, whether or not there are enough favorable votes in the Senate for it to pass.

2. There can be a "fix it" bill submitted to the Senate. This bill would include all of the compromises agreed to by the conference committee that modified the Senate bill over the last 2 weeks. This bill would also be subject to the reconciliation process and not all items would meet the test for what can be done via reconciliation (items must have a budgetary impact to be considered). It will then have to be passed by both houses in addition to the House having to pass the original Senate bill.

3. The House could pass the Senate bill as is and wait to make amendments to the worst pieces of it bit by bit over time.

4. Finally, they could scrap the entire process and start over from the beginning. This is an unlikely step but a possibility nonetheless.

President Obama has announced that he does not want Congress to move forward until Scott Brown has been sworn into office but it is unclear what direction things will take once that is done. As the direction becomes clearer, Equity will pay particular attention to the bill components that were either modified (in favor of working families) over the last 2 weeks or still being negotiated prior to and during the special election in Massachusetts. Of up-most importance is:

  1. Ensuring a Nationally-regulated exchange rather than one regulated state-to-state. This helps to keep costs down and is closer to functioning like a single payer system;

  2. Maintaining the modifications made to the 40% tax on health care;

3. Ensuring that any mandate for individuals to purchase insurance is affordable; and

4. Minimizing any adverse affects the bill would have on multi-employer plans.

For more information visit:

Comparison of House and Senate reform bills - www.afl-cio.org/issues/healthcare

Health Reform Resource Center - commonwelthfund@cmwf.org (email)

Various articles and analysis - www.HealthReform.gov


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AEA Health Care Weekly Update - 1/11- 1/15

By Rachel LaForest
Public Policy Director

We're just weeks away from final health care legislation, merging the versions passed by the House and Senate. The House is in the process of modifying the Senate bill. Those modifications will have to be passed by the Senate again before the end of the month and then the final bill will go to the White House for the President's signature.

The process of creating this combined bill is a vital opportunity for real health care reform, but we must let Congress know what real reform means. We need to make sure that the final bill that goes to President Obama provides good, affordable coverage, holds insurance companies accountable, and is not financed on the backs of the working and middle class.

The House health care bill is better for working families and includes vital provisions that were dropped by the Senate. Unlike the Senate bill, it has a public option to keep insurance companies accountable. It does more to make health insurance affordable and it pays for these reforms with a modest surtax on the wealthiest Americans. The Senate bill contains no public option and includes a 40% tax on many middle class families' insurance benefits instead. This benefits tax:

  • will increase out-of-pocket costs for workers

  • is designed to increasingly impact lower cost plans over time (at the current rate AEA's health plan would meet the tax threshold by 2011!)

  • will impact many plans that have higher costs for reasons that have nothing to do with containing so-called "Cadillac" benefits

As these two bills get merged, we need our Representatives to insist that the best pieces of the House bill are included.

What You Can Do

1. Call/Email your Representatives. Visit www.House.gov. Input your full Zip Code + 4 to be directed to your Representative's webpage. Tell them that you're calling to make sure the key elements of real reform-including a public option-are in the final bill before the House and Senate vote on it.

2. Cut & paste, say in your own words, or use the talking points below:

    As your constituent I am asking that you stand strong in these final weeks. I'm calling/emailing today to urge you to vote for health care reform that:

    • DOES NOT tax our health care benefits.

    • Requires employers to pay their fair share.

    • Controls health care costs-and the best way to do that is by creating a public health care insurance plan option.
    Thank you for your public service.



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Actors Equity Weekly Health Care Update 1/5/10 – 1/8/10

By Rachel LaForest
Public Policy Director

While passage of the Senate bill late last year continues the momentum for health care reform, many feel the bill itself does not live up to the kind of reform we need. National pressure is now mounting on the U.S. House of Representatives to shape a health care bill worthy of public support.

The House intends to modify the Senate bill, pass it again before the end of the month and send it back to the Senate for a final vote. If the Senate accepts the House changes, a vote that will require the approval of 60 Senators, the bill will go to the White House for the President’s signature.

There are several issues the House must contend with, most notably the pressure to include a public option, to control costs, and omit an unfair tax on the middle class. By the end of the week, Equity will be issuing a call to the membership to “take action”. Members will be asked to contact members of the House to ensure they maintain components of the bill that will not force working and middle class Americans to have to decide between forking over money they do not have or foregoing necessary health care.

Equity encourages the membership to read beyond these weekly up-dates for more information. Below are several links to current articles that give informed and concise breakdowns of the issues highlighted in our up-dates.

“A Less Than Honest Policy”New York Times
http://www.nytimes.com/2009/12/29/opinion/29herbert.html?_r=1

“Fact Check: The Cadillac Controversy”Health Beat Blog
http://www.healthbeatblog.org/

“For Unions, A Messy Bargain”Miami Herald
http://www.miamiherald.com/opinion/inbox/story/1397696.html

“Reaction from across the political spectrum to health vote”Boston.com
http://www.boston.com/news/politics/politicalintelligence/2009/12/reaction_from_a.html

“Health Insurance Exchanges in Health Care Reform: Legal and Policy Issues”The Commonwealth Fund
commonwelthfund@cmwf.org


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Actors' Equity Weekly Health Care Up-date - 12/28/09 - 1/1/10

By Rachel LaForest
Public Policy Director

On Thursday, December 24th, Christmas Eve, the United States Senate passed their version of a health care reform bill. On January 4, a week before the official opening of the Second Session of the 111th Congress, Speaker Nancy Pelosi will call her leadership team back to Washington to begin formulating the House strategy for getting a final health care bill to the President.

Rather than convening a formal conference committee, the House intends to modify the Senate bill, pass it again before the end of the month and send it back to the Senate for a final vote. If the Senate accepts the House changes, a vote that will require the approval of 60 Senators, the bill will go to the White House for the President's signature.

Both versions of the bill have been estimated by the independent Congressional Budget Office to cost in the upper $800 billion range and that the Senate and House bills would save $132 billion and $138 billion respectively. Democrats and Republicans continue to argue what the true longer-term costs will be. Lawmakers who will negotiate the differences for the Senate and House will have to ensure that a final bill is below the $900 billion President Obama set as a maximum figure.

Republicans maintain both versions of the bills are bad. All the members of the minority party voted against the Senate measure, and only one supported the legislation passed in the House.

Both bills seek to make health-insurance coverage accessible to between 94 and 96 percent of Americans, compared to the current 83 percent, adding about 30 million people. Both would also use tax increases (a modest 5.4% surtax on millionaires in the House version and a sharp 40% tax on the middle class in the Senate version), various other taxes, and reductions in payments to medical-care providers under the government Medicare and Medicaid programs to pay the costs of expanded insurance. Getting rid of the benefits tax is a top priority for House Democrats.

The House bill would immediately (starting 2013) bar private insurance companies from denying coverage or raising insurance premiums based on age or gender or pre-existing condition, whereas the Senate would wait until 2014 for similar regulations to take effect, except for children who would be covered immediately. Both bills would also require nearly all Americans to purchase some form of insurance, while lower-income Americans would receive help from federal government subsidies.

Of course, the biggest difference between the two bills, and one likely to cause the most friction in House-Senate negotiations, involves the inclusion of a public option. House lawmakers included such a government option in their bill, with rates to be negotiated by the government. The Senate's version relies on private insurance marketplaces, or exchanges, to expand choice.

The next 4 weeks will be crucial for increasing pressure on the House to maintain the following:

  1. Ensuring that a public option remains on the table.

  2. Removing any tax on benefits that would adversely affect the middle class.

  3. Ensuring that any individual mandate issued is affordable.

  4. Ensuring the components of the final bill will not adversely affect multi-employer plans such as ours.

Given the modification and approval process outlined earlier, it will likely be a massive battle.


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Equity Health Care Cmt. Weekly up-date 12/21-12/25

By Rachel LaForest
Public Policy Director

Early last week, once again, attempting to court the votes of moderate holdouts such as Senator Joseph I. Lieberman, I-CT, and Senator Ben Nelson, D-NE, the Senate Democratic leadership discarded from their Patient Protection and Affordable Care Act all language allowing people as young as 55 to buy into Medicare. The Medicare buy-in provision had been a compromise made to assuage the afore-mentioned senators who would not pass a bill containing a public option and has effectively stripped the last vestige of a public option from the bill.

What exists now in the Senate is a bill with no public option, severe restrictions on getting coverage for an abortion, major breaks for the insurance industry and a 40% tax on health benefits.

In regard to the proposed benefits tax, a higher threshold is now being considered ($9,500 for individual coverage and $25,000 for family coverage). However, unless the annual index is inflated at the same rate as private sector health plan cost trends, the number of plans hitting the tax could grow rapidly. AEA and many other unions representing middle class workers who would incur this tax believe that a fairer way to fund health care reform is contained in the House bill, where a proposal to issue a moderate tax on millionaires would raise much more than the Senate's tax on benefits.

The Senate bill does some good things: It will provide health insurance to 30 million more Americans and provide subsidies to low income individuals and families. Benefits will have to meet minimum standards and insurance companies will no longer be able to deny coverage based on pre-existing conditions or impose lifetime or unreasonable annual limits. The bill also includes some relief for plans with early retirees as well as delivery system reforms that may lead to lower costs over the long haul. And Senate leaders have made a commitment to close the Medicare prescription drugs donut hole which is so costly to seniors. Taking all of this into account however, it is still not enough to adequately service and protect those who need it most.

The White House is pushing hard for the Senate to meet its Christmas deadline so that the House and Senate bills can be sent to committee, revised and merged. Democratic leaders have mapped out a timetable that envisions passage before Christmas but just barely. As of Monday, December 21st they had voted to end debate, putting the legislation on a course for a final vote on Christmas Eve.


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Actors' Equity Weekly
Health Care Update

By Rachel LaForest
Public Policy Director

Given the constantly changing issues and misinformation within the national debate for health care reform, and the many complicated facets of it, the Health Care Committee of Actor’s Equity Association has decided to issue a weekly up-date to the Equity website in order to keep the membership as well-informed as possible. Below is the first of these weekly up-dates, a process that will likely see us into the new year.

There are a few issues of particular importance to Actors’ Equity Association that we are tracking closely:

  1. Ensuring that a public option remains on the table.

  2. Removing any tax on benefits that would adversely affect the middle class.

  3. Ensuring that any individual mandate issued is affordable.

  4. Ensuring the components of the final bill will not adversely affect multi-employer plans such as ours.

Last Tuesday, seeking to break a deadlock between liberals and moderates over a proposed public option that would compete with private plans, Senate Majority Leader Harry Reid, D-NV and other Democrats essentially abandoned a full-blown government-run public option in favor of national health plans run by private insurance companies and supervised by the Office of Personnel Management, which currently runs the federal employees' health plan. In addition, they recommended opening Medicare to uninsured Americans beginning at age 55 rather than 65, starting in 2011. Details of the plan remain secret pending analysis by the Congressional Budget Office, which will project its cost to those who might be eligible and to the federal government. Several Republican and Independent Senators who previously agreed to the Medicare proposal are now coming out against it saying they see it as a possible inroad to a single payer system.

Congress has a clear choice to make in order to fund any reform bill that is passed. Tax millionaires a little, as proposed by the current House bill; or, tax working families a lot, as proposed by the Senate’s current Patient Protection and Affordable Care Act. The American people support the House idea in huge numbers. Unfortunately, given President Obama’s push to have a bill ready to be signed by Christmas week, there will not be time for the Senate to seriously consider amendments to the benefits tax (Senator Kristen Gillibrand’s, D-NY amendment to raise the tax threshold to a 40% charge on $25,000 for individuals and Senators Bernie Sanders’, I-VT and Al Franken’s, D-MN amendment to tax millionaires). Senate Majority Leader Reid says he feels confident that by next week, the Senate will be on their way toward final passage in the Senate, meaning the benefit tax, abortion restrictions and dismantled public option that it currently includes will likely remain the same.

Focus is now returning to the House, to maintain support for our priorities when Congress conferences to resolve differences between the Senate and House bills. Earlier in the reform process, the 82-member Congressional Progressive Caucus of the House issued a letter to Speaker Nancy Pelosi stating they would not pass a bill that did not contain a public option. Proponents of the public option are looking to shore-up that commitment and convince additional lawmakers to sign-on. Additionally, the call to defeat any tax on benefits continues to be a major priority nation-wide.


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Health Care Debate Continues

December 2, 2009

On the evening of Saturday, November 21st, a week before they would break for Thanksgiving recess, All 58 Democratic senators and two independents voted to stop a Republican filibuster against debating health care reform. The result was the introduction of "The Patient Protection and Affordable Care Act".

The trajectory moving forward begins with amendments to the senate bill and debate. Senate Majority Leader Harry Reid, D-NV would like to have the debate wrapped up by Christmas (schedule adjournment is December 18th), in order to keep close to President Obama's new year deadline, however, given the issues at hand, it appears unlikely that will happen.

While majority Democrats will need 60 votes again to finish the process, some in the party say they'll jump ship from the bill without tighter restrictions on abortion coverage. Others say they'll go unless the public option is removed. Of the many issues senators have to weigh, abortion funding and the public option promise to be the most difficult. On abortion, no compromise seems possible but on the public option plan many are hopeful there will be more willingness to make concessions.

The debate will be challenging: The last three Senators to announce support for Senator Reid's cloture motion - Senator Mary L. Landrieu, D-LA, Senator Blanche Lincoln, D-AR and Senator Ben Nelson, D-NE - all warned that they did not support the bill in its present form, and Senator Joe Lieberman, ID-CT said he would filibuster a bill with a public option. In addition, most labor unions, including Equity, are opposed to the senate's "Cadillac" excise tax on benefits (the threshold in the Senate bill was raised to a 40% charge on $8,500 for individuals and $23,000 for families) and will be mounting pressure on key senators to introduce amendments that substitute fair financing for the tax or raise the threshold significantly.

Once a Senate bill is passed, House and Senate negotiators will meet in conference to resolve differences and fashion one bill that will go back to each chamber for final votes (Senate will once again need 60 votes). Late January is the likeliest target for President Obama to sign the legislation into law.

Equity Ramps-up Its Involvement

On Tuesday, November 5th members of Actors' Equity Association participated in a nation-wide call-in to pressure House members (who had not yet finalized their bill) to wrap up the debate and pass a bill that maintained the public option. On that same day, all three national Equity offices and the satellite office in Orlando distributed "Health Care Can't Wait" stickers to members and staff. It is clear with the passage of HR3692 that Equity's joint effort with all national and international unions, allied groups, and community organizations was successful in keeping the debate alive.

Several Actors' Equity Councilors and Liaisons in various states have submitted Op-Eds to their local papers in order to state more publicly Equity's position and to enrich the national dialogue. The Health Care Committee has coordinated with the Communications Department and Regional Board Chairs to finalize those Op-Eds and they are now in the process of being shopped around to state dailies.

We'll also be tailoring a new Equity "Take Action" targeting 9 key senators who stand in opposition to a public option.

Despite the tough road ahead there are solid elements contained in the two bills before us. In a new Commonwealth Fund report, leading analysts of health system change assess the impact of 11 structural proposed changes in health care found in both the House & Senate health reform bills. They find that all but the tax on benefits in the Senate bill would make significant contributions to lowering health costs and increasing numbers of uninsured and underinsured people. Equity will continue to work toward achieving the best plan possible and monitor closely our main concerns:

  1. That the final bill contain a public option that is robust enough to control costs and guarantee quality health care;

  2. That any individual mandate be affordable; and

  3. That a final bill does NOT include a tax that will adversely affect multi-employer plans or place a burden on working and middle-class families.

Log on to www.actorsequity.org to keep abreast of this fast-paced debate and participate in our future "Take Action" activities.


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Debate on Health Care Coming Down to the Wire

By Rachel LaForest
Public Policy Director

It's clear to most of us in this country that our health care system is inefficient, businesses and families are drowning in health care costs, and health insurance companies are profiting while denying care to those that need it most. This is why there must be reform.

As Congress gets down to the final business of what has seemed to be a never-ending whirlwind of high-strung, controversial debate, lobbying and politicking, the name of the game is getting real reform through the Senate

Earlier in the legislative process, "real reform" was a chaotic picture of different options, depending on whose lens you were looking through; and if you didn't know it before, you know it now, the initial bills that get funneled into our grand and complicated legislative process won't always look the same coming out on the other end. Much of what was present at the beginning was there to engender conversation and explore possibilities.

At the end of the day, the majority of us just want lawmakers to deal with the three big problems in our current health care system: (1) the cost of care, (2) the lack of access to care; and (3) the need for better-quality care. What has been present from the beginning and still remains today is the call for a public option as an answer to those three demands, meaning the government would offer a public plan similar to Medicare as one of the choices in the health insurance exchange to compete with private insurers.

Where do we stand now?

As of late October Senate Majority Leader Harry Reid, D-Nev was attempting to blend two versions of the Senate bill, one which contained a public option and one that did not. It was unclear whether or not there would be enough votes in the Senate to stop a filibuster.

On October 29th, Speaker Pelosi unveiled the contents of the House bill at a press conference on the steps of the U.S. Capitol The House bill includes a watered down public option, after differences were resolved within the Democratic Party. The toughest of them covered the terms under which the government insurance option would function. Moderates, fearing the impact on their local hospitals, held out for negotiated rates between the government and private insurers and won. The newly revised plan will not dictate what is paid out to hospitals, doctors and other providers, a goal that many liberal Democrats had hoped for as a means to control costs.

The legislation would be financed by a combination of cuts in planned Medicare spending and an income tax surcharge of 5.4 percent on individuals making at least $500,000 annually and couples making at least $1 million.

Equity Continues the Fight

Equity has not wavered on our demand for a public option. Despite the difficulty in monitoring the daily changes to the bills in both houses, Equity has continued its outreach to elected officials and other unions and its participation in a national call for health care reform.

The insurance lobby has raised millions of dollars to defeat reform but labor and our allies have been flooding congressional offices with phones calls, letters and faxes to make sure the proponents of reform aren't drowned out by the same element who have successfully blocked reform for over 40 years.

Equity will continue to post up-dates and action alerts to our website www.actorsequity.org.


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Debate on Health Care Coming Down to the Wire

By Rachel LaForest
Public Policy Director

AEA Health Care Initiative
Congress has reached a critical point in its development of health care reform legislation. Both the Senate and the House of Representatives are working on the details of bills which could make affordable health insurance a reality.

Click here to Take Action...

We're down to the wire and it now seems nearly certain that the Senate Finance Committee will not support a public option to enter the marketplace to compel competition with private health insurers. It is unlikely that any progressive public option reforms will be written into the Senate Finance Committee's bill. Immediately after their final vote however, there is still the task of attempting to merge the Finance Committee's bill with that of the more progressive bill of the Senate Health, Labor and Pension Committee, which still includes a public option.

Given Senator Max Baucus' (D-MT) insistence that "no bill with a public option will pass on the floor of the Senate", it could leave the House bill as the last bastion for any type of progressive public option, but with such an aggressive lobby by the insurance industry and other private special interest groups what gets further stripped away could leave little to be desired. This is less of a pessimistic view than it is a realistic one. We know that reform is necessary or the health coverage we currently have will become more expensive and/or offer less in terms of the quality of coverage. What we get left with at the end of this war however, may be far less than expected.

This remains a highly politicized issue with Republicans accusing Democrats of not seeing the forest for the trees and being consumed with the possibility of "making history." On the flip side, Democrats criticize Republicans for having offered little to nothing in terms of creating reform options.

We've watched President Obama's original ideas to slow the ever-expanding costs of healthcare be watered down immensely. Within the Senate bill, only two are left: a minimal tax on the "Cadillac" private health insurance policies and a non-partisan commission that would be charged with cutting the Medicare budget. While the "Cadillac" tax is not supported by organized labor, these two ideas being the only two vestiges remaining, are demonstrative of how much pressure has been put on the administration to make concessions.

Insurers fight back

Added to the waffling of many lawmakers is a huge increase in pressure from the insurance industry. They have worked for months behind the scenes to help shape healthcare reform. They have been attracted by the promise of millions of more people getting coverage (millions of new consumers buying policies).

Their latest blow has been the release of a study commissioned by PricewaterhouseCoopers. The industry trade group, America's Health Insurance Plans, sent its member companies a new accounting firm study that projects the legislation would add $1,700 a year to the cost of family coverage in 2013, when most of the major provisions in the bill would be in effect. The study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.

A spokesman for Senate Finance Committee Chairman Max Baucus questioned the credibility of the numbers. Baucus spokesman Mulhauser said the study is "seriously flawed" because it doesn't take into account provisions in the legislation that would lower the cost of coverage, such as tax credits to help people buy private insurance, protections for current policies and administrative savings from a revamped marketplace.

"The misleading and harmful claims made by the profit-driven insurance companies are politicking for corporate gain at its worst," Senator John Rockefeller (D-WV) said in a statement. "Their recent statements only further highlight that our focus here in Congress must be on the inclusion of a public health insurance option in the marketplace to protect families and put more money back in their wallets by creating greater competition and driving down costs."

Equity Continues the Fight

Despite the difficulty in monitoring the daily changes to the bills in both houses, Equity has continued its outreach to elected officials and other unions and its support of the AFL-CIO's health care campaign. We have not wavered on our demand for a public option and hope that House Speaker Nancy Pelosi and the House representatives do not either.

Member involvement and demand for continued up-dates and information has been key in this fight. Your letters, inquiries and comments have kept us on our toes. This is exactly the way Equity's legislative work should function.

At press time, the Senate Finance Committee was scheduled to vote on its ten-year, $829 billion bill. The battlefront now becomes the Congressional floor and how heavily President Obama will weigh-in on ensuring there remains a solid public option remains to be seen. To cave in would seem to present a profound betrayal of the public good and so we must all do our part to keep their feet to the fire.

Equity will continue to post up-dates and activities to our website, www.actorsequity.org.


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Heath Care Update - September 14, 2009

by Jack Goldstein, Healthcare Consultant

The health insurance debate was greatly energized by President Obama's decisive speech to a joint session of Congress on Sept 9, 2010. The President clearly debunked some of the worst misconceptions and intentional distortions that have plagued the public discourse on the issue. Among the most egregious false charges he refuted were that health care to senior citizens would be rationed, that Medicare would be gutted, or that his insurance proposal would cover undocumented workers.

In a subtle policy shift, the President declared that a Public insurance option was necessary, not just to offer a low cost alternative to average consumers, but to regulate the private insurers through honest competition. However, he guaranteed that the Public option would be unsubsidized by tax payer dollars and therefore will have to operate according to the same economics as private insurers. He argued that the Public option's lower premiums would flow from its more economic operations as a major non-profit and that those savings would be passed along to the consumers. Far from putting private insurance out of business, the President's advisers estimate that only 5% of the available new insurance market would opt for the Public option because private insurers would rush to provide competitive plans, particularly to the young and the healthy.

The notion of an unsubsidized Public option was first floated by New York Senator Charles Schumer during early debates in the Senate and it remains to be seen if the idea is attractive enough to move the Senate Finance Committee to include the option in its long awaiting legislation due out the week of September 14, 2009. It also remains to be seen if an unsubsidized public option, even with tax credits to consumers to soften the cost of maintaining insurance, would produce low enough premiums so as not to create a hardship on low income Americans, including many Actors.

Equity has long stated that a worst case scenario of health insurance reform would be an Individual Mandate requiring every one to carry insurance - a major component of the President's proposal - but the absence of a guarantee of affordable insurance plans choices for consumers. Simply creating a huge new market of individuals for the private insurance industry is not, by any progressive standards, a definition of real reform. A calculation of how inexpensive the Public insurance option is likely to be must form a central test of the President's proposal.

In what many agree was the most effective and affecting speech of his Presidency, Mr. Obama lingered over the moral implications of Congress' responsibility to enact health insurance reform. Referring to a letter written by Senator Edward Kennedy shortly before his death, the President reminded legislators of both parties that history would judge the character of the Nation, its leadership and it deliberative bodies by their success or failure on health insurance reform.

Equity will be examining the proposal as it develops in the Senate and in debate during the weeks to come.


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AUGUST HEALTHCARE UPDATE

by Jack Goldstein, Healthcare Consultant

A deal appears to have been reached with fiscally conservative Democrats on the House Energy and Commerce Committee which may allow a Committee vote to take place before the House recesses on Aug 8. That would set up floor debate and a vote by the entire House of Representatives sometime in September. The Democratic leadership of the Senate Finance Committee is still struggling to win over Republican support for anything approaching meaningful healthcare reform - a goal many believe should be shelved at this point. Senate Finance must act soon so that the reconciliation of its measure with the bill previously released by the Senate Health Education, Labor and Pension Committee can begin.

The House Energy and Commerce action contains a compromise which has already alienated many reform progressives. It retains the President’s call for a Public health option, but removes provision which would mandate medical billing at Medicare rates in favor of private negotiations with healthcare providers. In other words, the Public option would be required to operate like any other insurance company. A more economic schedule of payments for services by the new government sponsored insurance program was seen as a way to insure low and moderate wage earners and put a necessary break on private insurance rates. Without it, the legislation’s efforts to reign in costs would be seriously weakened.

The enormous investment in private healthcare insurance and delivery, an investment which is registering as growth in the employment and real estate sectors, has always been an underlying governor of resistance to cooling down escalating health insurance premiums and cost of healthcare services. Profit expectations have fueled many of the stands taken by interest groups and, as expected, coalesced into a political bloc on Capital Hill. While this group is often called economically conservative, it is in practice tied to a belief in runaway healthcare costs which will actually cripple the economy. The resistance to positive change is neither more vociferous nor unprincipled than anticipated.

President Obama has signaled his willingness to extend his deadline for health insurance reform into the fall. Equity plans a series of outreach activities to the membership involving targeted email, letters and, perhaps, lobbying visits over the course of the next few months. The strategy will include trying to enhance the participation of Area Liaison Committees, Regional Directors and coordination with other entertainment Unions. It will executed cooperatively with the AFLCIO healthcare field and messaging campaigns.


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July Health Care Update

By Jack Goldstein, Equity Consultant

Equity took the lead in organizing entertainment labor participation in one of the largest health care reform rallies on record. Co-sponsored by the AFL-CIO and Health Care for America Now, the gathering in Capitol Hill's Upper Senate Park on June 25, 2009 drew thousands of supporters of health care reform from the Eastern seaboard and as far away as Ohio and West Virginia. Among others, featured speakers Actor Edie Falco, Senators Charles Schumer of New York and Sherrod Brown of Ohio and CWA President Larry Cohen called for sweeping changes to the Nation's health care system. The rally was meant primarily to support President's Obama's Public health option which is designed to compete with private insurance companies and to ensure the survival of existing employer-based insurance won through many negotiating cycles over the past decades.

Equity was represented in the persons of Health Care Committee Chair Arne Gundersen, Second Vice President Kim Jordan and her daughter Marin, and DC members Barbara Callander and Sandy Murphy, supported by Staff Joe Chiplock and consultants Maria Somma and Jack Goldstein. Other unions represented included, AFTRA, SAG, SDC, Local 802 AFM and the WGAEast. Responding to requests from the NY State AFL-CIO and the New York City Central Labor Council, Equity and its professional colleagues collectively visited the entire New York State Congressional delegation, some expressing support for the President's proposal and others for HR 676, the John Conyer's Single Payer legislation in the House of Representatives.

The successful lobbying day was made possible by the cooperation of the Washington DC/MD Area Liaison Chairs Jess Speaker III and Carl Randolph. As Executive Director John Connolly and Arne Gundersen wrote to the DC/ Maryland membership,

"We think this summer represents the best chance to make sure that President Obama's healthcare reform contains all the elements that working people need, not the insurance industry! But to do that we need to stand up and show up to support our ideas. Your support will also give our Council a better sense of the kind of power Equity can exercise by mobilizing nationwide in every Equity city around healthcare, funding for the arts, and professional standards and jobs for Equity Actors everywhere. This issue is the place to start."

While the rally and Congressional visits were taking place, the Senate Finance Committee was holding hearings on some of the more contentious aspects of health care reform- the Public option and the possibility of taxing existing health care benefits. The House had recently issued its comprehensive reform bill which is being referred to as the Tri-Committee bill because it is the product of cooperation by the House Ways and Means Committee, the Committee on Energy and Commerce and the Committee on Labor and Education

As reported in The Wonk Room, "the House plan establishes a 'new national health Exchange' to enroll Americans in affordable coverage, gives Americans the choice to enroll in a new public health insurance options, prohibits private insurers from excluding Americans with pre-existing conditions from coverage and offers sliding scale "affordability" credits to help middle class families afford health insurance." This is essentially the same bill introduced by the Senate Health, Education, Labor and Pension Committee several weeks ago, but it is stronger in many ways than what appears to be evolving in Senate Finance Committee.

It will be the job of the Congressional Democratic leadership, working closely with the White House, to reconcile all these versions and emerge with a consensus bill which the rank and file Democrats can support. It seems less and less likely, as time passes, that Republicans will align themselves with any meaningful health care reform. Reactions from that side of the aisle have so far been almost universally negative.

Equity will be following up with all the Congressional contacts made the day of the rally and is committed, with the help of Area Liaisons, to keeping the pressure on as legislation develops. As you may have read, the President is reaching out to Governors across the country to intercede with their political allies on the Hill. Because of the enormous lobbying pressure being aimed at Congress, regional involvement and grassroots support are being seen as essential to the success of health reform.


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June Health Care Update

By Jack Goldstein, Equity Consultant

Health care reform still seems on track although the schedule is pretty aggressive. The Congressional Democratic leadership in both Houses remain committed to having legislation written and reported out of committees in June and brought to the floors for a vote in July.

The Senate will go first- the Senate Health Committee under Sen. Ted Kennedy and Senate Finance under Sen. Max Baucus are not necessarily on the same page on key issues such as the Public plan. The House will follow with a bill that is expected to strongly reflect the President’s original proposal. The dynamic of the reconciliation process between the two Houses will then turn on trying to strengthen the weaker Senate version.

The AFLCIO has participated in Committee roundtables during the past month on health care delivery, coverage and financing. They have focused on many aspects of insurance reform such regulations limiting consideration of age and preexisting conditions when setting insurance premiums and the details of early Medicare buy-in. But their three central issues of concern have been:

1. The Public insurance option,
2. An Employer Mandate requiring employers to cover some percentage of health care or pay into a national pool,
3. Preventing the taxation of health benefits.

They report satisfaction with the direction on all three issues in the Senate Health Committee and the expected House bill, but say all three are in trouble in the Senate Finance Committee. Sen. Baucus continues to be a strong supporter of taxing benefits and there has been talk of a provision which would trigger a Public plan some time in future only if the private insurance industry failed to enact necessary reforms.

Many economists from both sides of the aisle support taxation of benefits. Those on the left and in the White House budget office think that it would largely pay for the Public plan. Conservative economists feel it is a regressive tax on those without employer insurance and should be eliminated.

At this point, the AFLCIO is trying to exert equal pressure in support of a strong Public plan and the taxation question and doing what they can to avoid it becoming a contest between the two issues. Taxation of health benefits is politically volatile and the AFLCIO is trying to convince Committee Democrats that it would simply hand the Republicans a ready made issue with which to defeat the whole reform effort. Still, they are very concerned that they are making too little progress with Senate Finance and are focusing a great deal of attention there.

A major rally is being planned for the Senate Park on Capital Hill on June 25th which is being organized by Health Care for America Now (HCAN) with the support of AFLCIO and Change to Win. Following the rally, HCAN is setting up a series of state by state “town hall “ meetings in various nearby locations and inviting key members of Congress from those states to listen to their constituent concerns. Other lobbying measures are also in the planning stages for the day.

We’re trying to determine the best use of our resources. Equity has contacted AFTRA, SAG, Local One, Local 802 and SSDC to see if we can organize a bus to attend the rally. We are also working with the Washington DC/ Baltimore Liaison Committee to involve local Equity members. Letters are also being sent to all members of the five Congressional committees with jurisdiction.

The Health Committee is fully involved in the planning. Francis Jue can’t make it this trip because of work, but Arne and Sharon Wheatley are able to participate in one–on-ones with Congressional Reps on the Hill. That option is under consideration.

June is going to be a busy month and we will try to keep everyone up to date.


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Health Care Legislation May Be Signed by September

By Jack Goldstein, Equity Consultant

The President and Democratic Congressional leadership seem to be holding to their aggressive time table for passage of major health care reform this year, projecting that the bulk of the work on legislation will be completed by the August recess and that a final bill will go to the White House for signature sometime in September. As is becoming a hallmark of his political style, President Obama has apparently reigned in his Executive staff assigned to health care reform, and expects the relevant Congressional Committees to devise a workable bill within a suitable framework set by his office.

Some observers note that policy-watchers have fewer details to read from the White House now, on the eve of real action, than they did nine months ago during the campaign and that Nancy-Ann DeParle, Director of the White House Office of Health Care Reform seems to be a conscientious observer of the edifice-in-the-making rather than its chief architect. There can be little doubt that the President is operating behind the scenes and defining the overall objectives of reform, but time will tell if his distance is meant to empower or protect him.

House Bill
Five Congressional committees have jurisdiction over the question of health care. Those in the House chaired by Representatives Rangel of NY and Waxman and Miller of CA are essentially in agreement on the basic outlines of legislation that they would like to see enacted. Its major components would include: 1. an Employer Mandate, or a requirement that businesses either provide insurance or pay into a National insurance fund; 2. an Individual Mandate, or a requirement that every adult American be required to carry some form of health insurance for themselves and their dependents, and 3. a Public Health Insurance Option, or basic, low cost insurance plan offered and subsidized by the Federal government, pegged to income and therefore affordable to those who cannot afford private insurance.

Senate Bill
Senators Kennedy of MA and Baucus of MT chair the two Committees in that Chamber where the picture seems less clear cut but where most of the action is really likely to take place. There seems to be sufficient interest in Individual and Employer Mandates to assure their inclusion in a Senate Bill, but the Public Health Insurance Option is far less secure. It is in the Senate that the private health industry is likely to put most of its resources to kill the Public Insurance option, which it sees as a threat to its short term profits and long term existence. New York Senator Charles Schumer is leading the Senate fight in support of the Public option and once again advocates are looking to the few moderate senators such as Olympia Snow and Susan Collins of ME and Arlen Specter of PA to avoid a filibuster. Iowa's Chuck Grassley will also be a major player and the hope is that he will see the necessity of the Public Health Insurance Option.

At press time, a well-orchestrated roll out of the legislation in the Senate seemed to be shaping up as follows. Hearings will revolve around three major issues with roundtable discussions planned for April 21, on medical delivery systems, for May 5 on the Public Health Insurance Option and for May 14 on finances. We can expect a mark up of a bill in June and the joint bill itself in July. This schedule is in keeping with expectations that a bill would arrive on the President's desk for signature sometime in September.

Equity Continues Outreach
Equity is continuing to track all of these developments and trying to maintain its outreach to elected officials, other unions and coalitions. Councillor Sharon Wheatley recently represented the Union at a meeting with Congressman Mike McMahon of New York's 13th Congressional District, who as Co-Chair of the Health Care Committee of the 70 member New House Democrats Caucus has a key role to play in the upcoming debate. Arne Gundersen, Eastern Regional Vice President and Chair of the Equity Health Care Committee, also recently attended a health care reform roundtable with freshman NY Senator Kirsten Gillibrand, sponsored by Heath Care for America Now. Senator Gillibrand enthusiastically supported the notion of a Public Health Insurance Option and vowed to work to avoid or neutralize the threat of a Senate filibuster.

Organized Labor is also keeping the heat up on health care issues. Single Payer forces continue to rack up important endorsements for HR676, John Conyers' Single Payer legislation, which now number more than 500 labor unions and State AFL-CIOs and Vermont Senator Bernie Sanders' recently introduced Single Payer legislation in the Senate is also likely to rack up significant support. This success is notable in the face of the realities that the President does not support a Single Payer solution at this time and it, therefore, seems to have little chance of success despite labor's close White House ties. Nor, as yet, does there appear to be any effective plan to use Single Payer advocacy on behalf of the Public Health Insurance Option.

AFL-CIO

The AFL-CIO has mounted another major on-line survey campaign to duplicate its success during the Presidential campaign of gathering 25,000 real life stories of health insurance disasters. This year's survey is designed specifically to gather information on insurance company abuses. If you wish to participate, please link to www.healthcaresurvey.aflcio.org. MoveOn.com and Howard Dean have also joined forces to secure the signatures of 250,000 Americans in support of the Public Health Insurance Option, which Dean will deliver to Congress. That address is www.pol.moveon.org/standwithdean/


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April Health Care Reform Update

By Jack Goldstein, Equity Consultant

Gov. Howard Dean is joining MoveOn.com in a major effort to secure 250,000 signatures in support of the most controversial aspect of President Obama’s health care reform plan - a new low-cost government sponsored health insurance option to compete with private insurers.

Clinking on the following link will add your name to the list which Gov. Dean hopes to deliver to Congress in person. http://pol.moveon.org/standwithdrdean/o.pl?id=15863-3260752-9Ny6pmx&t=1

The initiative is vital because, as of this writing, the first test of President Obama’s health care reform strategy is playing out on Capitol Hill as both Houses of Congress are voting on the Annual Budget Resolution.

The President’s budget calls the establishment of a $634 billion reserve fund to pay for the cost of health care reform over the next 10 years. Half of the new health care fund will come from limiting itemized deductions for the wealthiest 1.2% of taxpayers and another quarter will come from eliminating excessive payments to private plans under Medicare. The last quarter has yet to be identified. It could involve taxing the health care benefits of a small percentage of highest wage earners and organized labor is lining up in opposition to that solution.

The Budget Resolution is a prerequisite to health care reform. Serious reductions would jeopardize the White House’s and Congress’ ability to enact the sweeping revisions to the Nation’s insurance patchwork that experts generally concede are necessary. The political loss would undermine the new Administration at a time when its influence over the Legislative process is essential. The AFL-CIO has made the Budget Resolution an outreach priority and has asked its affiliates to engage the Congressional leadership.

President Zimmerman and Executive Director Connolly have therefore written to Senators Kennedy of MA and Baucus of MT and Representatives Rangel of NY, Waxman of CA and Miller of CA expressing the Union’s unequivocal support for the President’s proposal as currently structured. They chair the five Senate and House Committees with shared jurisdiction over budgetary and health care matters. Equity has also contacted New York’s Freshman Senator, Kirsten Gillibrand as a new member of the Senate Budget Committee.

As President Zimmerman and Executive Connolly wrote,

"Real health care reform must inevitably be broad and expensive. Those charged with steering a new course must be confident that proper fiscal provision will be made or the cost to the Country will be registered in their capacity to innovate and make meaningful progress. That cost, we can all agree, is too great to risk."

Once the Budget Resolution is passed the debate on the nature of health care reform can begin in earnest. It promises to be rancorous. While the Democratic Congressional leadership seems to have come to a consensus on the essentials of reform legislation, some of the rank and file Democrats and much of the Opposition object to basic elements.

As noted above, the most contentious proposal remains the establishment of a new Government run health insurance program, like Medicare, which would offer a basic, low cost insurance plan open to all. Critics see it as a thinly veiled effort to put private insurance out of business charging that the non-profit Public option would have an unfair competitive edge over commercial insurers. Proponents see it as the only way to establish cost controls and to make insurance affordable enough for universal converge to become a reality. It highlights the central question of reform-is health coverage a marketable commodity or a benefit of citizenship?

Even the White House staff are split on the Public plan with Mary-Ann DeParle, Chief of the Office of Health Care Reform and HHS Secretary-designate Sibelius for it, and Peter Orszag, Director of the Office of Budget and Management against it. The challenge to proponents will be to keep the Public plan from becoming so great a political liability that it threatens the whole reform process- hence the importance of the MoveOn.org campaign.

The political rhetoric which killed President Clinton’s health care reform plan in 1994 is already resurfacing on talk radio and in television ads. "Harry and Louise" scare tactic ads, threatening government control over daily medical decisions are expected to become part of the debate again. It remains to be seen if the Administration, organized labor and other allied interest can effectively counter that strategy this time. Certainly the still-active network of Obama for President campaign organizations will have a role to play. As for Equity, the Union will continue to use its resources effectively, reaching out to legislators when appropriate and coordinating when possible with its fellow labor unions.


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Late March 2009

Government Sponsored Health Insurance Option Comes Under Attack

By Jack Goldstein, Equity Consultant

The best of all possible worlds for the insurance industry and pharmaceutical companies would be a national health reform bill that required every American to buy health insurance, that would allow insurance companies to do business across state lines thus avoiding highly regulated states, and that left it to the private market place to compete with one another for all the new customers, preferably as individuals unable to negotiate as part of large groups.

The health care industry is apparently willing to spend millions of dollars to enact reform legislation based on these "free-market" principles, and that vision is certainly much more of a possibility today than any Obama supporter could have imagined during the Presidential campaign. While they might have to accept a requirement to cover everyone regardless of expense related factors such as age, genetic predisposition to diseases or pre-existing conditions, private insurers could be the biggest beneficiaries of the campaign to reform the nation's dysfunctional public health system and to provide universal coverage.

President May Reconsider
There are signals enough of the growing influence of the private industry on the White House thinking, most prominently the President's willingness at his health care summit on March 5, 2009, to reconsider his campaign pledge to create a new, low cost, government sponsored Public health insurance plan to compete with private insurers and keep them honest.

The Public option is seen by many reform advocates as the only way to reverse the triple threat of rising costs, shrinking coverage and diminishing quality of health care and health coverage in America today. While attacks on the Public plan from the private sector were to be expected, the President's flexibility on so defining an issue was enough to create a serious wave of doubt among public policy analysts. It was, at the very least, a quiet call to arms for organized labor which is planning a spring filled with public demonstrations and attacks on insurance industry abuses.

Commonwealth Fund Report
The Commonwealth Fund, one of the most highly respected voices in health care policy recently issued an executive report entitled, Path to a High Performance U.S. Health System: A 2020 Vision and the Policies to Pave the Way. Among a great many interlocking steps, the Fund's comprehensive plan calls for the institution of a Public insurance policy which would, according to their calculations, be able to provide "... premiums 20% lower than traditional fee-for- service insurance." This lower premium would also influence private insurers within a national insurance "exchange," that is, companies wishing to compete with the Public plan. The Fund estimates individual annual premiums under the Public plan would be $2904.

The Commonwealth Fund's Commission on a High Performance Health System, which is responsible for the study, includes representatives of the private health care industry. The report's policies were modeled into cost estimates by the Lewin Group, a nationally recognized health policy analyst with its own private industry ties. This is all to say, the study is a conservative document which eschews radical solutions and clearly says that under the new system it proposes, private insurance can still make money. Yet, the study calls for an independent Public insurance option as essential to gain control of an otherwise out of control sector of the economy.

The President and Congress should take heed.
Labor made its Agenda clear with talking points distributed to its representatives at the President's March 5th health reform summit.

  • "Change is needed across the board to reform health care:
    • Everyone must have coverage and take responsibility for maintaining good health status;

    • All employers must pay their fair share towards the cost of care;

    • Public subsidies are necessary to help low-wage individuals and small businesses pay for care;

    • Hospitals must stop competing based on bigger and supposedly 'better' facilities;

    • Insurers have to accept the discipline of competition that only a Public insurance plan can impose;

    • Drug and device manufacturers must accept cost-effectiveness as a standard measure for their products. "

Labor is gearing up to defend the Public option. Health Care for America Now (HCAN), which is taking a progressively more central role in advocacy and organizing labor on the issue, is planning a spring campaign that includes home District meetings with Congressional leadership in April. HCAN is also planning a major demonstration on the Mall and a lobby day on Capitol Hill late in June when Senator Baucus is expected to introduce the Administration's major health care reform Bill. It is vital to reform that the Bill contain a Public plan option from the beginning and that it be strongly defended by the President and his allies in Congress.


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March 2009

Obama Reaffirms Support for Healthcare Reform

by Jack Goldstein

President Obama reaffirmed his strong support for comprehensive health care reform in three important policy statements last week. At his White House summit on fiscal responsibility, the President linked controlling health care costs to the success of his economic recovery program. His address on Tuesday to a joint session of Congress reiterated his campaign pledge to sign a reform bill into law this year that will achieve his three part agenda toward universal health insurance: cost control, expanded coverage and better quality of care. Lastly, the President unveiled a sweeping new budget proposal that includes a reserve fund of $630 billion over the next 10 years dedicated to financing reforms of the health care system.

These unequivocal policy directives correct the sense of drift which followed the withdrawal of Sen. Tom Daschle from the joint appointment as Secretary of the Department of Health and Human Services and Director of the White House Office of Health Care Reform. (Gov. Kathleen Sibelius of Kansas has been nominated to serve) and sets in motion an aggressive timeframe for Congressional action. It is now expected that a Senate bill be marked up in June drafted by Sen. Max Baucus, followed by a House version based on a "outline" submitted by the White House and, if all goes well, a final bill sent to President for signature before the end of the year.

It is an aggressive schedule. But to some extent the President's confidence is based on the mood of the Country. In a new CNN poll, 72% of those asked said that Government must get more involved in health care reform. That is a high percentage tied to widespread anxiety over growing unemployment and doubt in the private sector’s ability to solve the Nation's problems. The President is now committed to a course of speedy and comprehensive reform which will test his political skills and risk considerable political capital.

Perhaps for that reason, and to prevent premature sniping, the President shared relatively few specifics. Rather, his office issued a summary of points that established a framework for reform. It began is with a summary of legislative actions already taken separately and in connection with the economic stimulus and recovery act.

  • Instituting temporary provisions to make health care more affordable for Americans who have lost their jobs.
  • Increasing health care coverage for children via the State Children's Health Insurance Program already signed into law.
  • Computerization of America's health records within five years.
  • Developing and disseminating information on effective medical interventions (i.e. Comparative treatment analysis)
  • Investing $1 billion in recovery act funds in prevention and wellness interventions, particularly among the young.

In moving forward on the actual reform legislation, the President established the following framework for Congress:

  • Guaranteed Choice-the plan should allow Americans to keep their current insurance if they choose.
  • Affordability-the plan must reduce waste and fraud, high administrative costs, unnecessary services and other inefficiencies that drive up costs.
  • Protect Families’ Financial Health- the plan must reduce the growth of premiums and other costs and protect from bankruptcies due to catastrophic illnesses.
  • Invest in Prevention and Wellness-the plan must address public health issues such as obesity, smoking etc.
  • Portability of Coverage- People should not be locked into insurance because of employment or discriminated against because of preexisting conditions.
  • Aim for Universal Coverage- the plan must put American "on the path" to full coverage.
  • Improve Patient Safety and Quality of Care.
  • Maintain Long Term Fiscal Sustainability.

The President skirted some tough issues. Most notable was the absence of any specific reference to a Public insurance alternative, at once the most divisive and essential aspect of a meaningful reform strategy. The budget alone takes on many vested interests and, while the President looks to costs savings, reductions in abuses, tougher bargaining for the costs of services and taxing the rich to pay for health care reform, even supporters questions whether those alone will do the job. There will be a high level meeting of health care interests at the White House later this week which the AFL-CIO will attend and we expect to hear more from them.

Labor is gearing up. The AFL-CIO's national grass roots mobilization schedule is going to its Executive Council for approval this week. AFL-CIO is also following up on its successful on-line survey of last year which gathered thousands of stories about the health care crises. This year the focus will be on insurance company abuses and will go live in April. (We will post the survey address in Equity News & on the Website) Health Care for America Now (HCAN) will launch a major campaign against insurance industry abuses in March. HCAN is also planning home district meetings during the spring recess. These actions will be accompanied by work site briefings, shareholder actions and culminate with a mass demonstration in Washington DC in June. We will try to involve ourselves to the fullest extend possible.


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February 2009 Update

Equity Continues Reaching Out to City, State, National Leaders on Plans for Health Care Reform

By Jack Goldstein

"Health care is a human right and providing it is in large part what government is essentially for" was Councillor Francis Jue's succinct assessment of the health care reform process, at a community roundtable discussion sponsored by Christine Quinn, Speaker of the New York City Council. The meeting on Jan 12, 2009 at City Hall brought together a broad spectrum of interest groups from the five boroughs to provide the Obama-Biden transition team with input on how to right the nation's health care system.

The discussion was moderated by Carol Reiss of the New York City Department of Education and considerable time was devoted to the need to preserve and expand wellness programs in schools. Improved preventative care for the young, both to reduce the incidence of conditions such as diabetes and heart disease and to lower costs is a central component of the Obama plan.

Projected through the prism of personal experiences and professional expertise, participants in the forum touched on essential realities of health care and cultural attitudes in America today:

  • The United States has no health care "system" to speak of, but an imperfect patchwork of very often disconnected or overlapping services;
  • Cultural biases, language barriers and fear of authority discourage many who are eligible for public assistance from taking advantage of it;
  • Disparities in the health provider network and abuses in the health insurance industry are a part of a much larger issue of growing economic injustice, and
  • The profit motive, while appropriate to so many areas of American invention and achievement, is not the way to achieve universal affordable health coverage.

Eastern Regional Vice President Arne Gundersen and Councillor Sharon Wheatley also attended the forum. Mr. Gundersen spoke of the need for greater public awareness of patients' rights and cautioned against being victimized by the system. In his experience, when dealing with an imperfect system, persistence and knowledge of how things work may be the most effective tools. Councilor Wheatley described how, as a working Actor married to a performer and with two young children, the need for affordable family coverage can dictate significant life choices, in her case the need for her husband to augment his work in the profession with an academic position and the health coverage that comes with it.

Equity's participation in the forum came about through an invitation by Speaker Quinn to First Vice President Paige Price who also sits on the City's Theatre Sub-District Council. Equity's Executive Director John Connolly has made the Union's participation on the health reform process a priority. "Every time we participate in an event like this we gain valuable experience, and add to our stature as serious players in this discussion."

Entering the National Debate

The Western and Central Regions will assume a greater importance in the health care reform as the national debate begins in earnest after the inauguration. California's two Senators and particularly Ron Widen of Oregon will be influential in the Senate and, as the House Ways and Means Health Subcommittee Chairman, Representative Pete Stark of California's 13th Congressional District in the East Bay will play major role in the House. Representative Stark has already joined with 12 House Democrats to reintroduce legislation, twice vetoed by President Bush to expand the State Children's Health Insurance Program (SCHIP) Mr. Stark stated, "With a new President, we can and should quickly enact this legislation to help millions of children maintain their health coverage, a step made all the more important by the failing economy."

Equity is reaching out to State Labor Federations and to its fellow entertainment Unions to maximize its limited resources to greatest effect. A full list of key Congressional members who will be the major proponents and opponents of health care reform will be posted on Equity's website (www.actorsequity.org) by state and district with their contact information should members wish to express their views. Equity's position will also be posted along with talking points.

Who's in Charge?

The White House has had to shift gears on health care reform with the withdrawal of former Senate Majority Leader Tom Daschle of South Dakota. Daschle had been named to the twin posts of Secretary of the Department of Health and Human Services and Director of the White House Office of Health Care Reform. As such he would have been the Administration's chief health care architect and spokesman. Daschle was one of the longest-serving Senate Democratic leaders in history and the only one to serve twice as both Majority and Minority Leader. His knowledge of the Senate and his cordial relations with Democrats and Republicans will be hard to replace.

Dr, Jeanne Lambrew, appointed the same time as the Daschle nomination will remain Deputy Director of the White House Office of Heath Care Reform. Dr. Lambrew is a nationally respected leader in Medicare, Medicaid and children's health care. From 1997 to 2001, she worked on health policy at the White House as the program associate director for health at the Office of Management and Budget and as the senior health analyst at the National Economic Council

Dr. Lambrew's philosophical approach to health care reform can best be summarized by the Abstract of an article she co-authored with John D. Podesta and Teresa L Shaw entitled, Change In Challenging Times: A Plan for Extending and Improving Health Coverage.

    "Some speculate that Americans are neither politically capable of nor morally committed to solving the health system problems. We disagree. We propose a plan that insures all and improves the value and cost-effectiveness of health care by knitting together employer-sponsored insurance and Medicaid; promoting prevention, research, and information technology; and financing its investments through a dedicated value-added tax. By prioritizing practicality, fairness, and responsibility, the plan aims to avoid ideological battles and prevent fear of major change. By emphasizing the moral imperative for change, especially relative to other options on the policy agenda, it aims to create momentum for expanding and improving health coverage for all."

President Obama, therefore, has assembled a professionally and politically fit team to implement his vision for health care reform and provide the nation with affordable universal health coverage for the first time in its history. But, if advocates for sweeping government intervention and supporters of a free market solution can agree on anything, it is the size of the problem and the depth of the ideologies that divide opinion.

Differing Approaches

Ideally, private insurers would like to see a national individual mandate requiring everyone to buy health insurance tied to the ability of insurance companies to do business across state lines and avoid headquartering in states which have strong consumer protection regulations. Single payer advocates would like to see private health insurance legislated out of existence and replaced by a uniform national health insurance policy paid for out of tax revenues.

President Obama's plan, not surprisingly, falls somewhere in the middle. It contains long term efforts to control costs such as disease prevention and early treatment and more efficient use of technology to track medical histories and disseminate research and treatment results. But, its central provision is a new, national low cost insurance program subsidized by a progressive tax on manufactured goods and services. Government would go into the insurance business in competition with private insurers with, either unfair economic advantages as the insurers claim, or the moral and economic wherewithal of good government, according to the President and the electorate which put him in office.

The Public program will be at the center of the argument, with free market economists and private insurers saying it will unfairly put them out of business and those who see profit in this particular instance as an unnecessary evil, saying, "good." The Obama initiative will try to strike a balance, by creating an insurance plan that average citizens can afford and that will attract a large enough risk pool of healthy and sick, young and old to be financially stable.

Putting private insurance out of business is less a goal than a possible outcome after many years. More to the point would be the ability of a less expensive, but comparable Public insurance policy to set the bar for private insurance on premiums costs, benefit packages, prescription drugs, clarity of regulations and the priority of medical judgment over financial considerations when determining proper treatment.

Health Care Remains Growth Area

Complicating the task for President Obama and even the most reform-minded Congress members is the fact that health care appears to be one of the few growth areas in the economy. While near record unemployment puts pressure on Government to fill the gap in insurance left by disappearing jobs that used to provide coverage, the reality is also that legislators will be very careful about delivering yet another blow to the general economy by undermining those few sectors that appear to be relatively robust.

The stakes are high. A recent econometric study commissioned by the California Nurses Association states that the current health care industry:

  • Generates 45 million jobs, directly and in other industries.
  • Accounts for 10.5 percent of all U.S. jobs and 12.1 percent of all U.S. wages.
  • Totals 9.2 percent of the nation's Gross National Product.
  • Contributes about 25 percent of all federal tax revenues. Federal, state, and local taxes from the healthcare sector in 2006 added up to $824 billion.

According to the study, a Medicare-for-all single payer-type national system would create 2,613,495 million new permanent good-paying jobs (slightly exceeding the number of jobs lost in 2008), boost the economy with $317 billion in increased business and public revenues, add $100 billion in employee compensation, infuse public budgets with $44 billion in new tax revenues. With these kinds of figures in play and the worst recession since the great Depression, the President and Legislators will be treading carefully when, real reform requires boldness.

What Can Equity Do?

The Daschle withdrawal and the spreading economic crisis have engendered a new sense of urgency to move ahead with significant comprehensive reform as soon as possible. What can Equity, with its relatively small numbers, do to move the process along in the right direction? John Connolly and Councillors such as Arne Gundersen, Francis Jue and Sharon Wheatley are effective and intelligent speakers who can articulate Equity's positions to a political audience. Equity's position is ethically sound, principled and easily understood. A single payer approach is the ideal way to accomplish universal, affordable health care, but getting there may be an incremental process. The membership should be given all the information it needs to understand and discuss the issues and this conversation should be taking place in theatres across the country. Alliances with other entertainment and labor groups, consistent action within the larger labor community and outreach to management will all make for a higher profile and sensible debate.

Unanimity, common sense and visibility are the three most important conditions for a successful outcome.


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November 2008 Update

Equity Steps Up Efforts to Achieve Health Care Reform

By Jack Goldstein

Actors' Equity Association has begun to participate in a series of meetings with Congressional leadership to discuss health care reform. To date, the Union has joined with other labor groups in seeing Representative Edolphus Towns, of New York's 10th Congressional District, a senior member of the House Sub-Committee on Health, and Representative Gregory Meeks, of the 6th District who holds senior positions on key House finance and banking committees. Other meetings are being scheduled for the Eastern region and are in the planning phase for the Western and Central regions.

While these meetings have been preliminary, everyone is keenly aware pf the urgency of meaningful health care reform and Equity's message to the legislators has been two-fold.

First, as Eastern Vice President Arne Gundersen stated recently, "The Equity health care plan and those of other unions have been progressively under siege. Too many of our members and too many other Americans cannot afford even the most basic health coverage. The time for decisive action is now and we are looking to our Congressional Representatives to take a leadership role."

The second point was articulated by Councillor Francis Jue. "Health care is a human right, and not a commodity to be bought and sold and bartered for across a bargaining table. It ought to be a part of the role of government, of our national identity."

We are likely to see significant health care reform in 2009, certainly despite, and perhaps because of a worsening economy in which we can expect hundreds of thousands of Americans to loose their jobs and hence the health coverage they have been used to taking for granted.

Encouraging Signs
There are, however, some encouraging signs for reform.

Most importantly, President-elect Obama thinks that universal, affordable health coverage is important and doable, and he will put the weight of Government behind it. That cannot be said of his predecessor or his recent opponent.

In addition, while the economy is clearly the highest and most immediate agenda item for the new Administration, health care reform has not been side-lined so far, and all the signals are good that it will not be.

The first item to be moved will undoubtedly be the expansion of the State Children's Health Insurance Program (SCHIP), which President Bush vetoed several times, that will both grow the number of children covered under the Federal program through increased funding and expanded eligibility to include the children of moderate income as well as low income families. But soon after that will come more far-reaching steps.

Administration's Plan
There is a deep philosophical divide between those who support a pure Single Payer option and those who favor maintaining a role for private insurance in a revamped national system. However, the practical difficulties of creating a Single Payer plan may impose a phased-in transition, over the course of several years, and that may look very much like the outlines of some of the partial reform programs suggested by President-elect Obama and some members of Congress who are already preparing legislation.

Even the most skeptical about the chances of a Single Payer proposal expect, at the very least, President-elect Obama to unveil a huge new Federal program, based on the menu of health plans currently available to members of Congress and their families. The program would be available to every American and priced to be particularly attractive to the uninsured and the underinsured. Instead of replacing the private insurance industry totally, the plan could out-compete it with the significant advantages of operating as a non-profit tax subsidized entity.

That may not be aggressive enough for those who, like Equity, are on the record as supporting a complete restructuring of American healthcare. There is already a Single Payer Bill in Committee in the House of Representatives called the United States National Health Insurance Act (H.R.676). It was drafted and introduced by Representative John Conyers of Michigan and currently has 93 Congressional Cosponsors, including Representatives Towns and Meeks. It has been endorsed by 473 union organizations in 49 states including 117 Central Labor Councils and Area Labor Federations and 39 state AFL-CIOs (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC,MO, MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA,AK, MI, MT, NE, NY, NV and MA).

Were this Bill to be enacted, private insurance companies would be eliminated from the health insurance market place; employer-based insurance as we know it, would become obsolete, the Federal Government would tax everyone and pay everyone's medical bills. Private doctors, hospitals and drug companies would remain private; public facilities such as Veterans Hospitals would remain public and basically, the entire nation would be covered under a vastly expanded Medicare-type plan. There is a strong and well-organized national constituency, which is going to try to convince Congress and the President to follow this course.

Labor is Divided
Labor is divided on the subject. Equity, SAG and AFTRA support Single Payer as do most health provider unions such as nurses and other hospital workers. The California Nurses Association has taken a leadership role in the debate. Multi-employer Taft Hartley plans such as the Equity/League Health plan and those in the construction trades however, have special obligations to ensure that Trust Funds will somehow be incorporated into a national system. They have been used to managing their own health plans. Even if they are now facing increasingly hostile circumstances, the patterns within these industries are set by custom and contract.

While whole sectors of organized labor constantly weigh wages against health care benefits in the regular negotiations, there is no guarantee that giving up those benefits will result in higher salaries and ultimately a system of universal health care means the working are taxed to pay for the unemployed and, in some scenarios, unregistered workers as well. To many, that is a major drawback to universal coverage of any kind,

Other groups are simply concerned about a major Government intervention, seeing it mistakenly as "socialized medicine," or mistrusting the Government to be able to manage so vast a system without a costly and cumbersome bureaucracy inevitably taking control of it.

Single Payer advocates point to the success of the Medicare program over many decades. They also point to the cost savings which would be effected by the simplicity and efficiency of one billing and record keeping system that would follow people from cradle to grave, from job to job, and state to state.

And, as Francis Jue notes, "To those who say they don't want government making medical decisions for them, I say that the private health insurance industry already does that for them, and we currently pay far more per capita for health care than any other industrialized country in the world."

Chronic Care
As if to confirm grave disparities in the American health system, an Editorial in the November 18, 2009 issue of The New York Times cited a new study by the Commonwealth Fund comparing chronic care in the United State and other industrialized countries. The Editorial stated, "…The care they received in this country - or more often did not receive - ought to be a cause for shame. More than half of the American patients went without care because of high out-of-pocket costs. They did not visit a doctor when sick, skipped a recommended test or treatment or failed to fill a prescription. The uninsured suffered most, but even 43 percent of those who had insurance all year skipped care because of costs."

Labor has a right to congratulate itself for keeping its differences of opinion to a minimum and in the background for the past year. But principled disagreements will be, and should be, aired now. The last time that happened during the first Clinton Administration labor fractured into hostile camps that helped doom the Clinton plan. It could happen again.

The implementation of a Single Payer system, without a period of transition could potentially involve the loss of thousands of jobs in the health insurance sector, and to the extent that sector plays into the economic success of the large health care industry, it would be eroding one of the few bright spots in the economy at the moment. While most of the lost jobs would be white collar, there could still be a sizeable reduction in consumer spending and that would have an impact on manufacturing and retail jobs. All of that will have to be taken into consideration. It is a complicated dynamic made more so, by the broader economic crisis and the need to take action soon.

If there are answers to all of these concerns, perhaps the key to finding them lies in keeping a steady eye on the moral core of the issue. As Francis Jue, stated, "Even in our current economic crisis, I believe that Equity's members, indeed the vast majority of workers, are willing to pay their fair share if it would mean true universal health care."

Equity will continue to play a prominent role in the discussions. Speaking on behalf of Executive Director John Connolly, Arne Gundersen and Francis Jue remarked that, "We're ' proud of Equity's efforts to continue the fight for meaningful health care reform in this country."


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September 2008 Update

AEA Health Care Update: McCain and Obama Health Plans Side by Side

In previous months, we have examined McCain's and Obama's health care proposals. This month, we compare the two side-by-side. Health care reform will be a priority for the next President and Congress. Equity's official position regarding health care is to support a single-payer system and steps to achieve that goal. What each candidates proposes now, the direction in which he promises to take the discussion, will have an impact on the viability of single-payer.

Of greatest importance is that every Equity member vote in November. There is a substantial difference on health care between the two candidates on this issue. Exercise your right to affect the outcome of the next election.

Click here for the McCain-Obama comparison (opens pdf)


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July/August 2008 Update

Obama Sees Expanded Role for Government in Helping Individual Americans Pay for The Cost of Their Health Insurance.

Can America join the list of nations with affordable and effective insurance coverage for all its citizens? Senator Barack Obama has announced the centerpiece of his strategy to achieve universal coverage will be to offer the Federal Employees Health Benefits Program, the same plan that currently insures U.S. Senators, Representatives their families, to any American who wants to purchase it. Under the Obama plan, health care professionals, hospitals and other medical facilities would remain largely private as they now are, but open enrollment in the Congressional insurance plan would hang a National health insurance safety net in place of the gap in coverage that has left 50 million Americans without health insurance.

In addition, the Obama plan would employ many of the elements of the health insurance reform model largely pioneered by various States:

  • Employer mandates: requiring employers to provide health insurance or contribute to a government subsidy fund.
  • Financial assistance to those who cannot afford market rate insurance.
  • A central information clearinghouse, the National Health Insurance Exchange, to set national minimum standards and share information on all available plans.
  • Expanded eligibility of Federal programs such as Medicaid and State Children's Health Insurance Plan (SCHIP) to insure more low income adults and children.

The Obama plan however departs from most state reform plans in its omission of an Individual Mandate. This is a legal requirement that everyone must carry some form of insurance or pay a fine. Sen. Obama's position is that effective cost saving measures will make insurance premiums affordable enough that most people will voluntarily opt for coverage over the risk of going without insurance. In the absence of lower prices, individual mandates are likely to be ignored or unfairly punish low and moderate income Americans.

The Senator recommends improved prevention to contain costs- a healthier populace reduces demands on the health care system- and more technology advanced information exchange and record keeping. The application of internet storage and communication of health records and treatment protocols has an avid following and is popular with policy makers.

While the use of new media is attractive, the real cost of transferring the nation to a single billing and health data management system is unclear as are or the cost savings once such a system were in operation. The staging of so vast a database might prevent a full and accurate accounting of the benefits for many years to come.

The Obama plan does, however, offer more immediate financial relief. In addition to subsidizing those who cannot afford the going rate for insurance premiums, Obama proposes to create a Government assistance program to help employer-based plans offset the high costs of treating catastrophic illnesses such as cancer and heart disease.

The cost to the tax payer of the Obama reform package would be considerable, but many experts believe that only an infusion of Public money will be able to slow, then reverse the negative trends of spiraling costs and growing population of the uninsured. The source of those extra revenues is still under consideration. To date, the Obama campaign has rejected the idea of taxing employee benefits as one method of raising new funds.

Senator Obama has made it clear that he does not endorse a Single Payer Insurance reform solution. His philosophical approach, however, does envision the Federal Government as a major player in setting the proper conditions for success and that Public policy makers, insurance operators and the general public will have to work together to achieve affordable, universal coverage.


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June 2008 Update

Senator McCain Backs Free Market Solution to Health Care Reform Targets Employer Based Coverage

By Jack Goldstein

On campaign stops in Florida and Pennsylvania in April, Senator John McCain fleshed out some of his proposals for National health care reform. The presumptive Republican presidential candidate proposed a sweeping challenge to employer based insurance coverage that would affect the 71 percent of Americans who currently get their insurance in the workplace. Central to his proposal are the following.

  • Health care benefits would be treated as wages and taxed as income producing an estimated 212 billion dollars in new taxes.
  • Individuals would be given $2500 and families a $5000 income tax credit to offset the higher taxable income if they remain insured through their employers or against the cost of private insurance.
  • Insurance companies would be able to do business across state lines.

The avowed intention of the plan is to move more Americans out of employer-based health care plans into the private insurance market as individuals. Supporters of free market reform maintain that with more people in the marketplace shopping for coverage, and fewer regulations governing the industry, insurance companies will become more competitive and hence the cost of insurance will come down.

By taxing health care benefits as wages, the McCain plan would also eliminate the corporate tax deduction businesses currently take for insurance expenses and hence remove the major incentive companies have for offering such benefits. The impact could be wide spread throughout the American economy, forcing millions of employees to seek coverage in the private market. The plan would potentially result in the proliferation of new insurance companies and increase the number of policies. That, some analysts say, would bring the price of insurance down through competition while others say it would only further benefit an industry whose need for profits many already see as a major inflationary factor in the cost of premiums

Other concerns with the McCain plan focus on insurance regulations and the possibility of increased medical discrimination as more individuals face off against insurance companies and those companies are allowed to do business across state lines. Most employer based plans cannot discriminate against individuals with pre-existing conditions while in many states insurance companies may refuse to cover such individuals seeking coverage. Insurers could be encouraged to relocate to states with weak insurance regulations, and many of those who most need insurance will be less likely to find it.

The McCain plan reflects the basic principles of a market driven approach to the health care crisis. While it is unclear how much of his proposal would be able to pass Congressional or voter muster, it does signal the Senator's strong willingness to work through an expanding private insurance industry to solve the Nation's health care ills.

This column will report briefly on the health care proposal of the presumptive Democratic candidate in the next issue. .


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May 2008 Update

Support for a single payer system of national health care is gaining momentum throughout the Labor movement. Equity first endorsed the single payer concept - or government provided health insurance - in the early 1990's. Council resolved at that time to "… participate in the formation of a national coalition of labor organizations, health care suppliers and public interests groups…, the goal of which is the adoption and implementation of a single-payer, universal, comprehensive national health care plan."

With the defeat of President Clinton's health care initiative and a period of economic growth in which health care costs remained steady, the call for a single payer plan lost momentum, an interest which is now coming to the forefront again with health care costs rising out of control and over 47 million Americans unable to afford even basic coverage.

Health care advocates and Labor leaders are focusing their attention on House Resolution (HR) 676, Medicare for All, a bill introduced by John Conyers Jr. (D-MI) in 2003. HR 676 would provide universal health coverage by making every American citizen eligible for the Medicare system that is currently only available to people over 65.

None of the major Presidential contenders has endorsed HR676 as yet, but the Bill's supporters are encouraged by the fact that it has been inked by 400 union organizations including 103 Central Labor Councils or area Labor Federations and 33 state AFL-CIOs.

Equity's position in favor of a single payer system is consistent with the aims of HR676 and the Union is examining the Bill. At the same time, the Association is working with sister unions, advocacy groups and Government entities to improve the health care safety net at State and Local levels and supports incremental steps leading to National health care for all.

In the coming months, as the nation draws closer to the Presidential vote, this column will layout the various proposals for single payer and other reform proposals, take a look at each candidates' positions on health care and to report on the membership can help influence the nationwide efforts to reform health care.


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April 2008 Update

In March, the Health Care Reform power point presentation was given to the Western Regional Board. The presentation was developed to make the health care debate understandable to the membership at large, demystifying basic terms and concepts predominant in the health care reform discussion.

At press time, the Central Regional Board presentation is scheduled for April 7th with a future date for the Eastern Regional Board still to be confirmed. Over the coming months, staff members, trained in the power point, will travel to liaison cities to give the presentation.

Following the lead of Massachusetts, Maine and Vermont, New Jersey legislators unveiled a proposal in mid-March that will require all residents to have health care coverage within three years. We are researching how this will impact our members who reside in New Jersey.

California School Employees have endorsed HR 676, a single payer healthcare legislation introduced by Congressman John Conyers (D-MI). HR 676, which has 88 co-sponsors in the U.S. House of Representatives in addition to Conyers, has been endorsed by 387 union organizations in 48 states, including 95 Central Labor Councils and Area Labor Federations and 33 state AFL-CIOs.


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