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A Closer Look at the House Bill: Taking on the Insurance Industry

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Over the next few days, I’ll be taking a closer look at the provisions on the House health care bill – H.R. 3962, the Affordable Health Care for America Act. As was the case when the original tri-committee bill was released, the House committees have a ton of fact sheets on the bill that are required reading for folks looking to learn more.

Overall, the House bill is a bill that takes on the insurance industry. Here’s how:

A Public Health Insurance Option

First and foremost, the House bill creates a public health insurance option, available in the new health care marketplace called the “Exchange,” that would compete directly with private insurance. The public option won’t have to worry about profits or stockholders, and because it is run by HHS, it will have huge bargaining clout to get good rates from providers. Overall, while the public option in the House bill won’t save taxpayers as much money as a public option based on Medicare rates, it will still save money according to the CBO.

Because of all that savings, and because the public option will have a mandate to provide health care to people, not maximize profit, it will be a strong competitor to private insurance, keeping prices down and attracting customers. Private insurance will be forced to compete or face losing their most profitable customer base – the individuals and small group customers who are in the Exchange from the start.

Insurance Industry Regulations

The House bill puts new regulations on the insurance industry to curb their bad practices.

The practice of rescission – terminating someone’s insurance plan because they get sick – would be outlawed immediately. Similarly, as soon as this bill is signed, lifetime caps on insurance coverage would be outlawed.

After the Exchange is set up in 2013, all insurers, not just the ones in the Exchange, will be barred from denying care for pre-existing conditions, charging more if your are a woman or sick, or employing annual benefits caps. They will have to cap out-of-pocket expenses at a standard level, keep administrative costs down to below 15%, and publicly disclose and justify their rate increases.

Medicare beneficiaries and the unemployed will benefit as well, with overpayment to private companies through Medicare eliminated and COBRA coverage extended until the Exchange is set up.

Finally, the House bill will eliminate the anti-trust exemption on health insurance companies, making it possible to finally prosecute them for their monopolistic practices.

Immediate Relief

The House bill also provides immediate relief for people at the mercy of the insurance industry by setting up an interim high risk pool open to people who have been uninsured for at least a few months or who have been denied insurance because of pre-existing conditions.

Though clearly not a long term solution, the high-risk pool, combined with the COBRA extensions mentioned above, would get people out from the trap the insurance industry has put them in until full reforms kick in.

Taking on Drug Companies

The House bill also gives us significant savings from drug companies, which according to the Washington Post would amount to between $125 and $150 billion in cuts to their profits.

It does this by eliminating the donut hole which forces seniors to pay unaffordable prices for prescription drugs, starting immediately and completely closing the hole by 2019. It also requires the Secretary of HHS to negotiate for better drug prices for Medicare and Medicaid, and makes it easier for Medicare Part D to offer free generic prescription drugs to enrollees.

Of course, some issues, like biologics (new drugs exempted from generic competition), are still unresolved.


There’s a lot to talk about in the House bill – employer responsibility, fair financing, a whole host of other reforms that take effect immediately. Over the next few days I’ll talk about those. However, the overall thrust of the bill is clear – it takes on the insurance industry for consumers, strengthening care for folks without insurance, on the individual market, in small and large businesses, and on Medicare and Medicaid.

About the Author: Jason Rosenbaum is a writer and musician currently residing in Washington D.C. He is interested in the intersection of politics and culture, media consolidation issues, and making sense out of our foreign policy disasters. He currently works for Health Care for America Now and he is also the webmaster for The Seminal.

This article originally appeared in Health Care for America Now on October 29, 2009. Reprinted with permission from the author.

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Speaker Pelosi Announces House Health Care Bill

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Pelosi.jpg“Today, we are about to deliver on the promise of making affordable, quality health care available for all americans,” said House Speaker Nancy Pelosi in her statement, announcing the House health care bill. The bill is based on the ideas of opportunity, choice and innovation.

Check out her speech live here. You can read the full text of the bill here, which will be available online for 72 hours prior to voting. Stay tuned to our blog to learn what the House bill means for American workers and their families.

This post originally appeared in SEIU Blog on October 29, 2009. Reprinted with permission by the author.

About the Author: Maria Tchijov is an online organizer & new media specialist in healthcare on SEIU’s New Media team. SEIU is the nation’s largest union of health care workers, with over half of the union’s 2.1 million members working in the field, including 110,000 nurses and 40,000 doctors.

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Baseball Stars Knock It Out of the Park for Employee Free Choice

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Image: Seth MichalsJust in time for the World Series, 12 members of the Major League Baseball Players Association (MLBPA) have added their names to the broad coalition in support of the Employee Free Choice Act.

The players have signed a statement and are appearing in print ads in Washington, D.C., papers today. World Series contenders Shane Victorino and Jimmy Rollins of the Philadelphia Phillies and Mark Teixeira of the New York Yankees are taking part. They’re joined by Heath Bell, Dave Bush, LaTroy Hawkins, Torii Hunter, John Lannan, Andrew Miller, J.J. Putz, Justin Verlander and Adam Wainwright.

In a joint statement, these players say:

All Americans should have the same opportunity we’ve had—to be able to join a union without being fired and to negotiate with their employers without being penalized. Today, our country is facing some tough times. Health care costs are skyrocketing. Families are losing homes. Savings and retirement income are disappearing overnight.

Now more than ever, we need a strong union movement to protect our jobs, our pensions, and our future. The Employee Free Choice Act simply guarantees a level playing field for all workers. It makes sure everyone plays by the same rules. That’s as important in the workplace as it is in baseball.

The serious point here is that the choice to have a union on the job and bargain for a better life matters to workers no matter the sector—whether it’s a bus driver, a journalist, a casino dealer or a Major League Baseball player. The ability to bargain along with your co-workers for fair wages, good benefits and safe working conditions is a fundamental freedom that means a stronger economy for everyone.

This post originally appeared in AFL-CIO blog on October 29, 2009. Reprinted with permission from the author.

About the Author: Seth Michaels is the online campaign coordinator for the AFL-CIO, focusing on the Employee Free Choice campaign. Prior to arriving at the AFL-CIO, he’s worked on online mobilization for Moveon.org, Blue State Digital and the National Jewish Democratic Council. He also spent two years touring the country as a member of the Late Night Players, a sketch comedy troupe.

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Union-Made Treats for Halloween

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It’s almost Halloween, and you know what that means: buying tons of candy.

But why give your money to a company that treats its workers like Oompa-Loompas? They were slaves who got paid in beans, remember! (Don’t be fooled by their catchy songs; that’s just a show they put on for the boss. You should hear the things they say about him in the break room.)

UnionPlus has a great list of yummies made by members of the Bakery, Confectionery, Tobacco Workers and Grain Millers International Union (BCTGM), the United Food and Commercial Workers (UFCW), and the United Farm Workers of America (UFW). Among them are:

  • Hershey’s Kisses
  • Hershey’s Milk Chocolate Bars
  • Kit Kat Bars
  • Caramello
  • Cadbury Fruit & Nut Bar
  • Jelly Bellies
  • Red Vines
  • Jawbreakers
  • NECCO Wafers
  • Clark Bar
  • Ghirardelli squares
  • Baby Ruth
  • Butterfinger

(Note that some of these are made both in union shops in the U.S.A. and non-union shops in Mexico; the list has details on which ones you’ll want to check the country of origin labels on.)

It’s perfect for printing out and taking with you on your big candy run. So what are you waiting for? Get the list here.

This post originally appeared in Change to Win on October 27, 2009. Reprinted with permission from the author.

About the Author Jason Lefkowitz: is the Online Campaigns Organizer for Change to Win, a partnership of seven unions and six million workers united together to restore the American Dream for everybody. He built his first Web site in 1995 and has been building online communities professionally since 1998. To read more of his work, visit the Change to Win blog, CtW Connect, at http://www.changetowin.org/connect.

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Showdown in Chicago: Thousands Protest Bankers

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Image: Seth MichalsMore than 5,000 people are packing the streets of downtown Chicago this morning, chanting, marching and rallying against Big Bankers and financial institutions that have taken taxpayer money and are using it to give big bonuses to CEOs and to lobby against financial reforms that would ensure they don’t go back on the public dole.

The crowd is marching to the Sheraton Chicago Hotel & Towers, site of the American Bankers Association meeting, to protest the banking industry’s greed and irresponsibility that crippled our economy, leaving millions of workers behind.

Photo by SEIU
Photo by SEIU

After the house of cards they built collapsed, bankers and the financial industry took $700 billion in taxpayer funds for a bailout. But rather than reform their failed practices, they want to go back to business as usual—with the chance of again precipitating another financial collapse and need for taxpayer bailout in coming years.

AFL-CIO President Richard Trumka, who is joining union members and allies at today’s events, has a clear message to bankers: You work for us.

Business as usual is over. We are shutting it down. You work for us—not the other way around. Your job is to be stewards of our savings, to put and keep working families in homes, to lend the money companies need to create jobs. And you have failed. You’ve turned the American economy into your own private casino, gambling away our financial future with our money, and driving us to the brink of a second Great Depression—then sticking out your hand for taxpayers to bail you out.

Praising Barack Obama’s administration for trying to stop the out-of-control bonuses paid to executives at bailed-out banks, Trumka says we need to go further by setting tough new rules so that the financial industry can’t run our economy into the ground again.

Trumka calls for four key principles to be part of any financial reform:

  • A new Consumer Financial Protection Agency to monitor banks and credit card companies and prevent abuses.
  • Reform the Federal Reserve Board or create an agency capable of stopping systemic risk.
  • More transparency so that hedge funds, derivatives and private equity markets can have real oversight.
  • Reform of corporate governance and executive compensation to make the finance industry work on behalf of the real economy, not vice versa.

This shouldn’t be a moment, Trumka says, where we pretend we can go back to the old broken economy that benefited only a few at the expense of everyone else.

Our economy has been all but destroyed. We have to build a whole new one, based on good jobs, not on bad debt; with America investing in and exporting technology and world-class products, not financial crisis; where hard work is rewarded, not colossal failure; where workers have a real voice because they have the freedom to have a union if they want one; and where all of us have the health care we need.

Appearing on the local Fox affiliate this morning, Trumka said it’s an outrage the financial industry took billions in taxpayer dollars, yet uses its resources to lobby against regulations to prevent a crisis like this from happening again:

The bankers who took all the risk and now are doing everything that they can to block reform so that it doesn’t happen again. Now that’s the problem. They want to do the same things over and over again, and they want us to pay the price again.

This article originally appeared in AFL-CIO Now on October 27, 2009. Reprinted with permission from the author.

About the Author: Seth Michaels is the online campaign coordinator for the AFL-CIO, focusing on the Employee Free Choice campaign. Prior to arriving at the AFL-CIO, he’s worked on online mobilization for Moveon.org, Blue State Digital and the National Jewish Democratic Council. He also spent two years touring the country as a member of the Late Night Players, a sketch comedy troupe.

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Reid: Public Option Will Be in Health Care Bill

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Senate Majority Leader Harry Reid (D-Nev.) announced in a Capitol Hill press conference today that he will send a health care reform bill to the Senate floor that includes a public option. States will have until 2014 to decide if they want to participate in the public plan.

Reid said he was optimistic that health care reform will pass:

“I feel good about progress we have made within our caucus and with the White House, and we are all optimistic about reform because of the unprecedented momentum that exists.

“I believe that a public option can achieve the goal of bringing meaningful reform to our broken system. It will protect consumers, keep insurers honest and ensure competition. And that’s why we intend to include it on the bill that will be submitted to the Senate for consideration.”

In a telephone press conference this morning, AFL-CIO President Richard Trumka said any real health care reform bill must include a robust public option that helps lower premiums and keeps insurance companies honest by guaranteeing competition.

Real reform also must require employers to pay their fair share by providing health coverage or contributing to help pay for subsidies, Trumka said. Real reform should ensure that working families who already are struggling to pay for health care insurance are not asked to pay even more in the form of a new  excise tax on their coverage, he added.

There are still things that still need to be fixed in the Senate bill, according to the Health Care for America Now (HCAN) coalition, but Reid deserves thanks for including a public option. Click here to add your name to an HCAN the petition thanking Reid for fighting for America.

This post originally appeared in AFL-CIO blog on October 26, 2009. Reprinted with permission from the author.

About the Author: James Parks had his first encounter with unions at Gannett’s newspaper in Cincinnati when his colleagues in the newsroom tried to organize a unit of The Newspaper Guild. He saw firsthand how companies pull out all the stops to prevent workers from forming a union. He is a journalist by trade, and worked for newspapers in five different states before joining the AFL-CIO staff in 1990. He has also been a seminary student, drug counselor, community organizer, event planner, adjunct college professor and county bureaucrat. His proudest career moment, though, was when he served, along with other union members and staff, as an official observer for South Africa’s first multiracial elections.

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Objections to Kodak’s Proposed Race Discrimination Class-Action Settlement

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Image: Marcia McCormickIn 2004, a group of Black workers of Eastman-Kodak filed a class action against the company, alleging widespread discrimination in pay and a failure to promote on the basis of race. A second class action was filed by another group of workers in 2007. The two classes together consist of about 3000 past and current employees. This past July, the company proposed a $21.4 million dollar settlement with the class–with payouts between $1,000 and $75,000 for individual class members. Magistrate Judge Jonathan Feldman (W. D. N.Y.) held a hearing Friday on the fairness of the proposed settlement, and will hold another on November 5. At Friday’s hearing, several class members objected that the payouts were too low, that the attorneys were getting too much of the award, and that class members who left the company before 1999 would be excluded.

Some examples of the unfairness of the award include that one decades-long employee would be awarded $1000 while her daughter, employed for only 11 months, would be awarded $3000. For more details see news reports here and here.

Despite this example, it’s hard to predict without knowing more what the judge will likely rule on whether the settlement is fair overall. In addition to the money, the company promised to improve its diversity training for supervisors and hire an industrial psychologist and two labor statisticians to review its pay and promotion policies and to recommend improvements. As Jason Bent recently suggested, having an external monitor to report to the court and some sort of ongoing supervision would be even better.

This article originally appeared in Workplace Prof Blog on October 24, 2009. Reprinted with permission from the author.

About the Author: Marcia L. McCormick joined the SLU LAW faculty in 2009. Her scholarship explores the areas of employment and labor law, federal courts, and civil rights, broadly defined. She is also a co-editor and contributor to Workplace Prof Blog, which provides daily information on developments in the law of the workplace and scholarship about

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Why Do Many of Us Resist Change?

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Image: Bob RosnerThe pictures of people sitting on roof tops or being pulled out of their attics are permanently etched in all of our brains following Hurricane Katrina. And it raises a simple question, why didn’t people leave when the warnings were so clear of the dangers of the approaching storm?

Of course there are the obvious answers—many were poor and didn’t have a way to get out of town or a place to go once they did and many people had experience of surviving hurricanes and thought they’d weather this one.

These reasons make sense. But there is a bigger reason that I’ve not heard discussed; most of us are natural change resisters. Ask us to do something new and we’re ready to dig our heels in the ground and resist.

For example, as much as most of us complain about the status quo at work, we are often the first people who will be ready to fight when someone tries to change it. It’s sort of like that observation by Chico Marx, of the famous Marx Brothers comedy team, about his brother Harpo. Someone asked him if he loved his brother and Chico replied, “No but I’m used to him.” It’s how most of us are about the status quo at work, we don’t love it, but we’re used to it. And it’s usually tough to let go.

Which reminds me of a story that I heard from England. A man was caught by a police camera running a red light. He received in the mail a picture of his car running the light and a ticket from the police. He felt this was unfair, so he sent the police a picture of a check. The British police, according to an article in the newspaper, sent him a picture of a pair of handcuffs. The red light runner promptly sent in his check.

This story reminded me that no one should be surprised when people resist change. We should all come to expect it. We should give people a chance, like those British police did, to blow off some steam and to give the resisters compelling reasons to get with the program.

Resistance and resistors can often be won over. Let’s face it; we’ve all had to learn to accept spam, to pay part of our health care premiums, to survive cubicles and to accept that annoying button in the elevator that says “close door” but that never does. People can learn to accept change. Heck, they can learn to love it. But the people pushing the change have got to understand that how they approach people and what they approach people with to entice them to join the cause. This will have a huge impact on whether the change will be embraced or whether everyone will be drowning in a flood of problems.

About the Author: Bob Rosner is a best-selling author and award-winning journalist. For free job and work advice, check out the award-winning workplace911.com. If you have a question for Bob, contact him via bob@workplace911.com.

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Maine Union Members Tell Snowe to Support a Public Option, and More Health Care News

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Image: Seth Michals
Photo by Joe Kekeris/AFL-CIO

When Sen. Olympia Snowe (R-Maine) suggested she would block health care reform if it included a public option, Maine workers took action: The Maine AFL-CIO put its convention on hold so attendees could call her and tell her that a public option is essential to make reform work. (Recent polls in Maine suggest Mainers strongly support a public option.)

Here are some of the latest developments in the fight for real health care reform:

  • Momentum is building for a public option in final bills being crafted in the U.S. Senate and the House. This is a critical time to contact your senators and representatives.
  • Big companies like Wal-Mart are lobbying hard to exempt the coverage they provide from health care reform. That would leave tens of millions of workers stuck in the same high-cost, no-guarantee system we have today.
    Union members in Arkansas and across the country are telling their senators to support real health care reform.
  • 55 members of Congress who oppose giving America the choice of a public option are actually getting government-administered health care through Medicare.
  • Becky Moeller, president of the Texas AFL-CIO, writes in today’s San Antonio Express-News that the insurance companies are trying to stay in charge of our health care, but working families can’t afford the status quo.
  • Mark Froemke, president of Minnesota’s Northern Valley Labor Council, has a great op-ed today in the Grand Forks Herald that lays out the stakes on health care:

If Congress fails to enact reform, things won’t just stay the same-they’ll get worse…unless we enact changes now, those who manage to keep their coverage will pay an even heftier price over the next 10 years.

As it stands, insurance companies have a stranglehold on our health care system, driving up costs and coming between middle-class Americans and the care they need.

  • Minnesota union members rallied for heath care this week in Duluth, St. Cloud and Rochester.
  • Union members in Louisiana and Arkansas also are rallying and reaching out to their Senators to demand health care reform that works.
  • Yet another insurance company is playing with numbers, seeking to scare people about health care reform. This time it’s WellPoint fudging the facts and leaving out critical information. Check out this great chart from Think Progress that shows how the insurance companies are fighting reform.
  • The Center for American Progress Action Fund has a great new report out today detailing insurance company’s tactics to hide vital information about denying coverage.

This post originally appeared in AFL-CIO blog on October 23, 2009. Re-printed with permission from the author.

About the Author: Seth Michaels is the online campaign coordinator for the AFL-CIO, focusing on the Employee Free Choice campaign. Prior to arriving at the AFL-CIO, he’s worked on online mobilization for Moveon.org, Blue State Digital and the National Jewish Democratic Council. He also spent two years touring the country as a member of the Late Night Players, a sketch comedy troupe.

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Congress Introduces Age Discrimination Bill To Fix Supreme Court’s Gross Decision

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Age Discrimination Legislation Will Overturn Gross Decision

Last June, the Supreme Court issued the awful and controversial age discrimination opinion in the Gross v. FBL Financial Services case.

I wrote about the case at that time and predicted that it was just a matter of time until Congress fixed it with a bill that would overrule the decision and set the record straight on the fair standard of proof for age discrimination plaintiffs.

Last Tuesday, the Senate and House introduced legislation designed to do just that.

The bill — introduced as H.R. 3721 — and called the Protecting Older Workers Against Discrimation Act, will put age discrimination plaintiffs back where they were before the Gross decision.

The bill will apply to all cases pending on or after June 17, 2009,  the day before the Gross decision.

Senator Patrick Leahy, one of the authors of the bill had this to say (as reported in the New York Times):

What our bill does is restore the intent of Congress, an intent that I believe the Supreme Court negligently ignored.

In Gross, the Court held that the Plaintiff, Jack Gross, was required to prove that age was the “but for” reason he was demoted from his job.

In other words, the plaintiff would have to prove that “but for” his age, he would not have been demoted (fired, hired, etc.).

Most interpret this as a new and more stringent requirement that age be the sole reason for the adverse employment action (though the case has conflicting language on that issue).

What’s fundamentally flawed about the Court’s interpretation of the federal age discrimination statute (ADEA) is that it’s not consistent with all  of the other comparable civil rights statutes.

Simply stated, it makes no sense for an age discrimination plaintiff to be treated differently, and more harshly, than a plaintiff in a race or gender discrimination case. The method of proof and standard of proof has been, and ought to be, the same.

In other discrimination cases a plaintiff must prove that the alleged discrimination was “a motivating factor,” not the sole reason, for the challenged adverse employment decision.

This bill establishes that age discrimination cases are to be interpreted by the same “motivating factor” standard of proof.

The bill also explicitly recognizes the difficulty of proving discrimination cases and makes clear that victims of any kind of prohibited discrimination can prove their cases with direct or circumstantial evidence.

According to Senator Tom Harkin, one of the co-sponsors of the bill — as reported in Workforce Management:

The Court invented a new standard that makes it prohibitively difficult for a victim to prove age discrimination

This extraordinarily high burden radically undermines older workers’ ability to hold employers accountable.

It’s no secret that workers over 55 have been hit hard by the recession. According to the EEOC, 25,000 age discrimination cases were filed last year, a 30%increase from 2000.

The last thing these folks need is a more difficult standard of proof when age discrimination is at play.

Fortunately, Congress has the final say on what its legislation means and how it should be interpreted. That’s why it gets to say that all discrimination plaintiffs should be treated consistently by the courts.

Let’s hope that this important Congressional fix gets passed soon.

image:blog.prospect.org images1.wikia.nocookie.net

This article originally appeared in Employee Rights Post on October 15, 2009. Reprinted with permission from the author.

About the Author: Ellen Simon is recognized as one of the first and foremost employment and civil rights lawyers in the United States. With more than $50* million in verdicts and settlements and over 30 years of experience, Ellen has been listed in Best Lawyers in America and in the National Law Journal as one of the nation’s leading litigators. She has been lauded for her work on landmark cases that established employment law in both state and federal court. Ellen also possesses a wealth of knowledge as a legal analyst discussing high-profile civil cases, employment discrimination and women’s issues. Ms. Simon has been quoted often in local and national news media and is a regular guest on television and radio, including appearances on Court TV. She is the author of the Employee Rights Post, a legal blog devoted to employee and civil rights.

*prior results do not guarantee a similar outcome

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