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Labor’s civil war over ‘Medicare for All’ threatens its 2020 clout

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Ian Kullgren March 9, 2018. (M. Scott Mahaskey/Politico)Alice Ollstein“Medicare for All” is roiling labor unions across the country, threatening to divide a critical part of the Democratic base ahead of several major presidential primaries.

In union-heavy primary states like California, New York, and Michigan, the fight over single-payer health care is fracturing organized labor, sometimes pitting unions against Democratic candidates that vie for their support.

“It’s a discussion at every single bargaining table, in every single union shop, every single time it’s open enrollment and people see their costs going up,” said Sara Nelson, president of the Association of Flight Attendants, a vocal single-payer advocate and one of a number of union officials who spoke to the divide.

The rift surfaced last week, when the 60,000-member Culinary Workers Union declined to endorse any Democrat in this week’s Nevada caucuses after slamming Bernie Sanders’ health plan as a threat to the hard-won private health plans that they negotiated at the bargaining table. But the conflict extends well beyond Nevada.

On one side of the divide are more liberal unions like the American Federation of Teachers and the Service Employees International Union, which argue that leaving health benefits to the government could free unions to refocus collective bargaining on wages and working conditions. On the other side are more conservative unions like the International Association of Fire Fighters and New York’s Building & Construction Trades Council, which don’t trust the government to create a health plan as good as what their members enjoy now.

“It’s an extremely divisive issue within the labor movement,” said Steve Rosenthal, a former political director for the AFL-CIO. “Nobody’s opinions will be changed during the presidential nominating fight, and unions may well be divided over Democratic candidates until the end.”

In New York, the New York State Nurses Association and Local 1199 of the Service Employees International Union pressed hard in 2018 for a state single-payer system. But other unions, including the New York State Building & Construction Trades Council, joined forces with private health insurers to kill the bill, funding polling to show opposition to the tax increases needed to implement it and writing op-eds calling the plan a “folly” that would “send jobs and people fleeing” the state.

Now some of those same New York labor leaders are saying much the same about Sen. Elizabeth Warren and Sanders’ Medicare for All plans. Gregory Floyd, president of the Teamsters Local 237, called the policy a “disaster” and predicted that few of his 24,000 members will vote for a candidate who supports it. Floyd declined POLITICO’s request for an interview, but said his opposition to Medicare for All is “based on what is best for our members.”

In California, the aggressively pro-Sanders California Nurses Association has long pressed for state-level single-payer, to the point of circulating in 2017 an image of the state mascot, the California grizzly bear, with a knife in its back after the state Assembly leader shelved a single-payer proposal.

The union’s parent organization, National Nurses United, is deeply involved in the 2020 race — endorsing Sanders, criticizing any candidate who doesn’t embrace Medicare for All, and sending armies of members and supporters to phone banks and doorsteps in all 50 states to press for a House vote on single-payer. Earlier this month, National Nurses United announced a new campaign to pressure presidential and congressional candidates to refuse donations from a health industry lobby group that’s spending heavily to kill any possibility of single-payer — a pledge most moderate candidates are likely unwilling to take in an election marked by record fundraising and spending.

Medicare for All is notably unpopular with swing voters in the battleground states of Michigan, Minnesota, Pennsylvania and Wisconsin, according to a December poll by the Kaiser Family Foundation and Cook Political Report.

In Michigan, where 28 percent of the electorate belongs to a union, and where Sanders stunned Hillary Clinton with an upset in 2016, unions have stayed largely silent on the issue. “There is very clearly a split between union leadership and the union rank and file,” said Eli Rubin, president of Michigan for Single Payer Healthcare.

According to a poll released in July by the Detroit Regional Chamber of Commerce, a 58 percent majority of “strong Democrats” favored Medicare for All but only a 48 percent plurality of Democratic-leaning voters. Among all voters, 52 percent opposed Medicare for All. Elderly voters (who turn up at the polls disproportionate to their numbers) were especially resistant, with 59 percent opposing single-payer plans.

Reflecting the divide is Gov. Gretchen Whitmer, a centrist Democrat who opposed single-payer during her 2018 campaign but has since vaguely said she supports the idea “in concept.”

Compounding this ambivalence inside the state is labor’s ties to health care. Leaders of the AFL-CIO, the Michigan Education Association, the United Auto Workers, and Teamsters serve on the board of Blue Cross Blue Shield, the state’s largest insurance company. Whitmer’s own father, Richard Whitmer, was the longtime president of Blue Cross Blue Shield, and the company was among the top donors to her gubernatorial campaign.

Meanwhile, in Nevada, the war over Medicare for All is in full swing in Nevada ahead of the Feb. 22 caucuses. Sensing an opening after Culinary 226’s public rebuke of Sanders, many of his Democratic primary rivals swiftly and loudly sided with the union, with some (Joe Biden, Pete Buttigieg) emphasizing that they would give labor a choice of whether to keep the health plan they bargained for or switch over to a government-run public option, and with Warren promising that unions will be at the table when the details of overhauling the U.S. health system are hammered out.

But supporters of Medicare for All have successfully persuaded some unions to back the policy, or at least remain neutral. When Sanders and Rep. Pramila Jayapal (D-Wash.) rolled out revamped versions of their single-payer bills in 2018, they did so with the official backing of the Service Employees International Union, the American Federation of Teachers, National Nurses United, the American Federation of Government Employees and others.

In an interview, Jayapal said her main argument to unions is this: Even if they fear the unknown, the current system is unsustainable.

“Look, I respect where they’re coming from,” Jayapal, the lead author of the House Medicare for All bill and the health policy chair of Sanders’ campaign. “They bargained hard and gave up wages for these health care benefits and they’re worried. But health care costs continuing to rise is a certainty. And when that happens, wages are going to decline.”

Local unions, which tend to be more outspoken than their national counterparts, are playing an outsize role in the 2020 race. That’s because so many national unions have thus far held back or pledged to remain neutral in the primary. It’s a backlash from 2016, when several big unions endorsed Hillary Clinton early on, only to witness a revolt from their rank-and-file members who supported Sanders.

With locals’ growing influence is a tendency for organized labor to balkanize its support. For example, the independent group Labor for Bernie said Tuesday that more than 1,200 members of the International Brotherhood of Electrical Workers have signed a petition calling on the national union to retract its endorsement for Biden.

“I don’t know where these people are coming from,” said Rand Wilson, a co-founder of the independent group Labor for Bernie and an organizer for SEIU Local 888 in Massachusetts. “Do they go to the negotiating table? Because they’re on a different planet than me.”

But Nelson, who represents more than 50,000 flight attendants across the country, says Medicare for All supporters are only hurting their own cause when they criticize labor groups that aren’t yet on board.

“If you are not approaching this as an organizer and building a supermajority for this change, it’s not going to happen,” she said. “You have to open your arms wide and give space for everyone to share their concerns and ask questions, and you provide information and find common ground. You don’t shut down conversations.”

Jeremy B. White contributed to this report.

This article was originally published by Politico on February 18, 2020. Reprinted with permission. 

About the Author: Ian Kullgren is a reporter on POLITICO’s employment and immigration team. Before joining POLITICO, he was a reporter for The Oregonian in Portland, Ore. and was part of a team that covered a 41-day standoff with armed militants at the Malheur National Wildlife Refuge. Their efforts earned the Associated Press Media Editors grand prize for news reporting in 2017. His real beat was politics, though, and he spent most his time at the state capitol covering the governor and state legislature.

About the Author: Alice Ollstein is a health care reporter for POLITICO Pro, covering the Capitol Hill beat. Prior to joining POLITICO, she covered federal policy and politics for Talking Points Memo.

Alice graduated from Oberlin College in 2010 and has been reporting in D.C. ever since, covering the Supreme Court, Congress and national elections for TV, radio, print, and online outlets. Her work has aired on Free Speech Radio News, All Things Considered, Channel News Asia, and Telesur, and her writing has been published by The Atlantic, La Opinión, and The Hill Rag. She was elected in 2016 as an at-large board member of the DC Chapter of the Society of Professional Journalists. In 2017, she was named one of the New Media Alliance’s “Rising Stars” under 30.

Alice grew up in sunny Santa Monica, California and began freelancing for local newspapers in her early teens. When not working on a story, she can be found riding her bicycle around the region, attempting to grow vegetables in her backyard, and playing with her nephews.


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“I Would Love Medicare for All”: A Nevada Culinary Union Member on Why She Supports Bernie Sanders

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Bernie Sanders is leading in the Nevada polls, but he faces a major obstacle: One of the most powerful actors in state politics has come out swinging against his signature proposal—Medicare for All.

The 60,000-member Culinary Workers Union announced last Thursday that it will remain neutral in the Democratic primary this year. But in the past week, the union has sent out a series of communications to members warning, both directly and indirectly, that Sanders’ plan threatens its hard-won healthcare benefits.

One flyer circulated by the union read, “Some politicians promise … ‘You will get more money for wages from the company if you give up Culinary Health Insurance.’ These politicians have never sat at our bargaining table … We will not hand over our healthcare for promises.”

Sanders’ opponents have seized on the opening to double down on arguments for preserving private health insurance—a position the union shares.

“There are 14 million union workers in America who have fought hard for strong, employer-provided health benefits,” tweeted former South Bend Mayor Pete Buttigieg. “Medicare for All Who Want It protects their plans and union members’ freedom to choose the coverage that’s best for them.”

Billionaire Tom Steyer, meanwhile, has started airing an ad in Nevada telling voters that “unions don’t like” Sanders’ healthcare plan.

Known nationally as a standard-bearer for militant workplace organizing, the Culinary Union hasn’t just won healthcare benefits—it runs its own 24-hour healthcare center and pharmacy, exclusively for members.

But some members are disillusioned that the union is flexing its muscle against a healthcare policy they believe could deliver a windfall to unions by freeing them to focus on other issues at the bargaining table.

In These Times spoke to Marcie Wells, a shop steward with Culinary Workers 226 who has worked at Jimmy Buffet’s Margaritaville inside the Flamingo Hotel and Casino for 16 years. Wells discussed Medicare for All, the union’s endorsement decision and her support for Bernie Sanders.

There was a lot of speculation as to whether the union might still endorse Joe Biden. What was your reaction to the decision not to endorse anyone in the primary? 

[Union leaders] said early on that they were not sure if they were going to endorse. When they called this press conference, everyone expected that they were going to go ahead and endorse Biden, because they already said they weren’t endorsing. So why would you put together all that just to repeat yourself?

The literature they put out the night before was not so subtle. It had the words “one, two, three,” and three candidates in order [Editor’s note: Joe Biden, Pete Buttigieg and Amy Klobuchar are listed first on the flyer]. Everyone knows in the caucus, you rank your top three choices. But they’re not officially endorsing.

I think it sends mixed signals, and it’s disappointing that they’re not being straightforward.

Did the union poll members about the endorsement?

No, they didn’t. Typically, I get called for those types of things, because I’m a shop steward.

Talking one-on-one, a lot of members want Bernie. But when we’re in the setting of citywide meetings or things that are exclusive to shop stewards, there’s a clear message that, “the person who wants Medicare for All wants to take away our hard work.”

It’s disappointing as a progressive.

At a town hall the union held with Sanders in December, some members heckled over the issue of healthcare. Can you describe what you saw happen?

At this type of event, all the questions are planned. When Bernie started talking about healthcare, almost on cue, a group started chanting, “Union healthcare! Union healthcare!”

When a speaker said, “I don’t want to give up my insurance,” I yelled back, “I do!”

But aside from what felt like a staged protest, Bernie got a great reception, people were cheering. I mean, he’s the frickin’ union guy.

The culinary union has the reputation of having some of the best healthcare in Las Vegas. How well does it work for you?

Relatively speaking, it is some of the best. But it doesn’t work well for me, because I have chronic illness. I have ankylosing spondylitis and bilateral uveitis that’s recurring. I’ve had this condition since high school, and I’ve been misdiagnosed, delayed diagnosed, not believed as a Black woman, told that I was exaggerating my symptoms.

Most recently, my eyes were so inflamed that my eye doctor called a rheumatologist in the Culinary network, and she wasn’t going to be able to see me for 7 months. I had to do a GoFundMe to pay for a doctor outside of my network so I could not go blind.

I don’t think the private insurance market is good for people with chronic illnesses, and I think it’s pretty ableist to pretend that it is. If I’m waiting 8 months to see a specialist but I’m having symptoms throughout that time, nine times out of 10 I’m going to get fired for missing work. And to even start getting that insurance in the first place, you have to work 360 hours within a certain time frame.

There’s also a copay every time I go to a specialist. More likely than not, I’ll skip something most months. I would love Medicare for All right about now.

Why do you think the union has come out so strongly against Medicare for All?

I think there’s a conflict of interest there. We have a labor union, and a political lobby with a PAC, and a healthcare business, all wrapped up in one.

They built the Culinary Health Center, so that’s theirs. Word on the street is they’ve already paid for the parcel of land to build the next one. So they’re in the business now—they’re the establishment to an extent. So I think capitalism is the reason that they’re coming out against Medicare for All, and it’s just really troubling.

Nevada’s uninsured rate is 14%, and there are big racial disparities in who doesn’t have insurance—in Nevada it’s indigenous people, Black people, Latino people. Medicare for All is a racial justice issue. For the union to have an 80% demographic of [people of color] and be pulling this, it’s just unbelievable. I’m disgusted.

Do you think the messaging against Medicare for All will impact how members vote in the primary?

That’s what’s shitty about this whole thing. Some of these people are going to vote against their best interest because they trusted the Culinary Union.

But a lot of members do want Bernie. The younger members, the members whose young kids are getting them involved. I think I flipped a dishwasher the other day. So we’re all doing our best, but it’s just disheartening that we’re fighting against both the GOP and the union.

This article was originally published at In These Times on February 18, 2019. Reprinted with permission. 

About the Author: Rebecca Burns is an award-winning investigative reporter whose work has appeared in The Baffler, the Chicago Reader, The Intercept and other outlets. She is a contributing editor at In These Times. Follow her on Twitter @rejburns.


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