[NYAPRS Enews] Crain's: ACA Reinspires Single-Payer Hopes

[Briana Gilmore]

NYAPRS Note: The movement toward a single-payer NY system through ACA exchange plans may mirror the drive toward an integrated delivery system for all that DOH has recently announced as an ultimate goal of the 1115 waiver reinvestment. The needs of labor unions and legislators that support single-payer arrangements will have to balance their goals, however, with the shift of the marketplace to a competitive managed care marketplace that emphasizes quality care. They are not irreconcilable visions, but the ultimate goals of lower costs, higher quality, and better outcomes must be the emphasis of any concerted state vision.

ACA Reinspires Single-Payer Hopes
Crain's New York Business; 4/24/2014

The Affordable Care Act has inspired the revival of a single-payer movement-at least among labor advocates.
Assembly member Richard Gottfried, who has introduced a single-payer bill for more than two decades, spoke to union members yesterday in Manhattan as part of a panel on the ACA's consequences for unions. Mr. Gottfried's bill (A.05389/S.02078) counts nearly 30 unions and physicians' groups as supporters.
Many feel the time is ripe for the bill, given Vermont's moves toward a state-sponsored plan as well as some of the ACA's unwelcome consequences. The reform law creates a financial incentive for businesses to drop their employee health coverage and encourage workers to purchase their own insurance on the health exchanges, union leaders said yesterday. And in 2018, generous health plans-including union plans-will be subject to a hefty 35% federal tax.
"Many of our bargaining agreements have been put on hold, or we've gotten one year, because there's so much uncertainty over what will happen with this law," said Gemma de Leon, executive vice president of the Retail, Wholesale and Department Store Union. Many of its members lost their employer coverage, and "the bargaining table is the most difficult I've seen in 25 years," she said.
James McGee, executive director of the Transit Employees Health & Welfare Fund in Washington, D.C., spoke of single-payer as a "multi-employer plan writ large." Multi-employer plans often are offered by unions whose members have irregular periods of employment for several employers, such as those in construction or performing arts.
Some unions are reluctant to support a single-payer system, said Glenn Carroll, co-director of the Cornell Union Leadership Institute. Union membership has been dropping for decades, and "for some unions, connection to members is that they're seen as providing health care," he said.
Union membership that crosses state lines could also have trouble with a state-based system, some plan administrators said. Still, unions increasingly are amenable to a single-payer system because the ACA has not yet lowered costs. Labor feels emboldened to support single-payer now that the ACA has withstood a Supreme Court challenge and is implemented, said Laurie Wen, the executive director of Physicians for a National Health Program. "We have a real chance of actually passing the bill in the Assembly right now," she said.
The physicians group will travel to Albany May 6 to lobby for the bill.
http://www.crainsnewyork.com/article/20140424/PULSE/140429939/aca-reinspires-single-payer-hopes
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://kilakwa.net/pipermail/nyaprs_kilakwa.net/attachments/20140425/75dea001/attachment.html>