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Union officials: POTUS betrayed them in rollout of ACA

Posted by Olog-hai on Sat Feb 1 13:23:49 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Labor union officials say Obama betrayed them in health-care rollout

By Steven Mufson and Tom Hamburger
Published: January 31, 2014

Labor leaders who have spent months lobbying unsuccessfully for special protections under the Affordable Care Act warned this week that the White House’s continued refusal to help is dampening union support for Democratic candidates in this year’s midterm elections.

Leaders of two major unions, including the first to endorse Obama in 2008, said they have been betrayed by an administration that wooed their support for the 2009 legislation with promises to later address the peculiar needs of union-negotiated insurance plans that cover millions of workers.

Their complaints reflect a broad sense of disappointment among many labor leaders, who say the Affordable Care Act has subjected union health plans to new taxes and mandates while not allowing them to share in the subsidies that have gone to private insurance companies competing on the newly created exchanges.

After dozens of frustrating meetings with White House officials over the past year, including one with Obama, a number of angry labor officials say their members are far less likely to campaign and turn out for Democratic candidates in the midterm elections.

“We want to hold the president to his word: If you like your health-care coverage, you can keep it, and that just hasn’t been the case,” said Donald “D.” Taylor, president of Unite Here, the union that represents about 400,000 hotel and restaurant workers and provided a crucial boost to Obama by endorsing him just after his rival Hillary Rodham Clinton had won the New Hampshire primary.

Taylor and Terry O’Sullivan, president of the Laborers’ International Union of North America, laid out their grievances this week in a terse letter to House Minority Leader Nancy Pelosi (D-Calif.) and Senate Majority Leader Harry M. Reid (D-Nev.), saying they are “bitterly disappointed” in the administration.

A White House spokeswoman declined to comment on the union leaders’ claims that they were misled. A person familiar with Obama’s meeting with the labor chiefs said he “listened to the group’s concerns with empathy” but explained that the law would not permit the administration to take the steps they requested.

Obama administration officials and some outside experts said that if the unions got their way, people enrolled in their plans would be indirectly getting two tax benefits while most Americans get only one.

In December, Labor Secretary Thomas Perez proposed some changes for plans that cover unionized and other workers.

But in the letter to Reid and Pelosi, O’Sullivan and Taylor wrote, “If the administration honestly thinks that these proposed rules are responsive to our concerns, they were not listening or they simply did not care.”

Many labor leaders hope to make headway in talks with the administration and have opted to withhold sharp criticisms of the White House. AFL-CIO officials declined to comment, referring reporters to a resolution passed at the organization’s last convention that echoed the policy concerns expressed in the Reid-Pelosi letter.

The rejections by the White House follow previous disappointments for the labor movement, which poured money into pro-Obama campaigns in 2008 and 2012 and deployed millions of grass-roots volunteers motivated largely by their support for Obama’s push to bring about near-universal health insurance. Another major goal of the labor movement — card-check legislation to make it easier for workers to form unions — failed to win support after what many labor officials thought was a lackluster effort by the White House.

Union officials expect the health-care controversy to intensify a raging debate within the labor movement over how deeply labor should invest in Democratic Party candidates.

Already, the Laborers’ International Union has established warm relations with one potential GOP presidential candidate, Chris Christie, endorsing his 2013 reelection as New Jersey’s governor. The union gave $300,000 to the Republican Governors Association, now headed by Christie. And there have been preliminary discussions between labor officials and aides to the governor over a possible appearance by Christie at a union convention.

Taylor said that he doesn’t think his union will embrace Republicans but that it may lack enthusiasm for Democrats. Unions have been a major source of funding and ground-level efforts on behalf of Democratic candidates.

“You can’t just order people to do stuff,” Taylor said. “If their health plan gets wrecked, why would they then go campaign for the folks responsible for wrecking their health care?”

About 20 million people are covered by union-negotiated trust funds often referred to as “Taft-Hartley funds” because they are regulated by the Labor Management Relations (Taft-Hartley) Act of 1947, as well as by the Employee Retirement Income Security Act. These funds, jointly managed by unions and employers, are particularly important for construction unions, whose members often move from project to project.

Many churches and large corporations also have their own self-funded, nonprofit plans. Nineteen companies, including Caterpillar, General Electric, Intel and the big automakers, have formed a Corporate Health Care Coalition. Several unions have joined the coalition’s call for an end to a special tax levied on self-funded plans.

The Treasury Department has determined that Taft-Hartley plans cannot receive the tax break given to such health plans and the subsidies for insurance companies in the exchanges set up for those who can’t get affordable insurance through their jobs.

“The unions here are asking to double dip,” said Robert Laszewski, a health policy consultant in Washington. “It is an unfair request. The Obama plan is very simple: If your employer pays for your health plan, you are not eligible for a government subsidy. What the unions are asking for is government and employers to fund their benefits.”

Union officials acknowledge that their plans are unique but say the health-care law didn’t take that into account. As a result, they say, commercial insurers can cover anyone through the individual or group markets, while their funds cannot. They add that the law provides incentives for employers to drop coverage and shift their employees to the exchanges.

The legislation also imposes a $63-a-person annual tax on nonprofit, self-funded plans, including unions’ plans, and uses that money to subsidize insurance companies that take on costly patients. The union plans do not get any of that subsidy money, a source of union outrage.

Labor leaders also complain the law hurts in other ways. In the Las Vegas area alone, the Unite Here health fund has absorbed about 13,577 new young-adult dependents at an annual cost of $16.3 million because of the rule allowing young adults to stay on their parents’ health plan until the age of 26, union leaders said.

Unions also complain that their plans are not allowed to compete with for-profit insurance companies on the new exchanges, where they might offer lower-cost options.

The unions’ frustrations have captured the attention of the White House.

During preparations for a September meeting of the AFL-CIO, administration officials lobbied to alter a resolution so that it called for repair, not repeal, of the health-care legislation. The resolution passed unanimously. At the meeting, O’Sullivan said, “We’ll be damned if we’re going to lose our health insurance because of unintended consequences in a law. It needs to be changed, it needs to be fixed, and it needs to be fixed now.”

On Sept. 13, top labor leaders met for more than an hour with Obama and top administration officials at the White House. But they later learned that the administration had written to two leading GOP lawmakers to say that Taft-Hartley plans would not get subsidies.

Although other labor leaders did not sign the letter, many of them also are upset about the treatment of their health plans under the legislation — including the heads of the International Brotherhood of Electrical Workers and the Building Trades Unions.

Taylor said Unite Here officials have met with White House officials 48 times. At the time the health-care bill was being considered, he said, “we were told that ‘if there were problems, don’t worry; we’ll get them fixed.’ ”

“We thought that if we made the case to the agencies dealing with regulations to correct problems that hurt, really destroy, self-funded nonprofit health plans, it would be resolved,” Taylor said. “That clearly was naïve or stupid.”

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Universal Health Care? Covered California patients can't find doctors

Posted by Olog-hai on Wed Feb 5 03:08:20 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Obamacare enrollees hit snags at doctor's offices

Many consumers faced hurdles signing up for Covered California health plans. Now they're having trouble finding in-network doctors.

By Chad Terhune
February 4, 2014, 6:41 p.m.

After overcoming website glitches and long waits to get Obamacare, some patients are now running into frustrating new roadblocks at the doctor's office.

A month into the most sweeping changes to healthcare in half a century, people are having trouble finding doctors at all, getting faulty information on which ones are covered and receiving little help from insurers swamped by new business.

Experts have warned for months that the logjam was inevitable. But the extent of the problems is taking by surprise many patients — and even doctors — as frustrations mount.

Aliso Viejo resident Danielle Nelson said Anthem Blue Cross promised half a dozen times that her oncologists would be covered under her new policy. She was diagnosed last year with non-Hodgkin's lymphoma and discovered a suspicious lump near her jaw in early January.

But when she went to her oncologist's office, she promptly encountered a bright orange sign saying that Covered California plans are not accepted.

"I'm a complete fan of the Affordable Care Act, but now I can't sleep at night," Nelson said. "I can't imagine this is how President Obama wanted it to happen."

To hold down premiums under the healthcare law, major insurers have sharply cut the number of doctors and hospitals available to patients in the state's new health insurance market.

Now those limited options are becoming clearer, and California officials say they are receiving more consumer complaints about access to medical providers. State lawmakers are also moving swiftly to ease some of the problems that have arisen.

"It's a little early for anyone to know how widespread and deep this problem is," said California Insurance Commissioner Dave Jones. "There are a lot of economic incentives for health insurers to narrow their networks, but if they go too far, people won't have access to care. Network adequacy will be a big issue in 2014."

The latest travails come at a crucial time during the rollout of Obama's signature law. Government exchanges and other supporters of the healthcare law are trying to boost enrollment, particularly among young and healthy people, ahead of a March 31 deadline.

Of course, complaints about outdated provider lists and delays in getting a doctor's appointment were common long before the healthcare law was enacted. But some experts worry the influx of newly insured patients and the cost-cutting strategies of health plans may further strain the system.

Maria Berumen, a tax preparer in Downey, was uninsured for years because of preexisting conditions. The 53-year-old was thrilled to find coverage for herself and her husband for $148 a month after qualifying for a big government subsidy.

She jumped at the chance in early January to visit a primary-care doctor for long-running numbness in her arm and shoulder as a result of bone spurs on her spine. The doctor referred her to a specialist, and problems ensued. At least four doctors wouldn't accept her health plan — even though the state exchange website and her insurer, Health Net Inc., list them as part of her HMO network.

"It's a phantom network," Berumen said.

It was no surprise to her family doctor, Ragaa Iskarous. She has run into this problem repeatedly with other patients in the last month, the doctor said. "This is really driving us crazy."

Berumen said she was seen by a neurosurgeon Thursday — after state regulators intervened on her behalf.

Insurers say they are working hard to resolve customers' problems as they arise, and they continue to add physicians to augment certain geographic areas and medical specialties.

"Any huge implementation like this comes with a lot of moving parts," said Health Net spokesman Brad Kieffer. "There is a learning curve for everyone, and we expect as time goes on these issues should dissipate."

Looking to head off potential problems, government regulators and patient advocates are pushing for tougher rules to ensure health plans provide timely access to care.

Last week, the California Assembly approved legislation enabling people who lost coverage because of the overhaul to keep seeing their doctors if they're pregnant or undergoing treatment for cancer or other conditions.

Nelson, the cancer patient in Orange County, and her family lost their previous coverage when Aetna stopped selling individual policies in the state last year. After numerous complaints to her new insurer, Anthem, and to public officials, the company said it would cover visits to her current oncologist through March 31.

Nelson said such a temporary extension doesn't solve the problem, and as a result, she's rushing to check out other policies for herself before open enrollment closes in March.

A spokesman for Anthem said the company "continually works to update its provider directories to ensure accuracy" and helps customers with these issues on a case-by-case basis.

Nationwide, about 70% of new insurance plans under the healthcare law feature relatively narrow hospital networks compared with many existing plans, according to consulting firm McKinsey & Co.

"It's pretty clear insurers responded to greater competition by trying to hold down costs through narrower networks," said Larry Levitt, senior vice president at the nonprofit Kaiser Family Foundation. "Insurers have made the judgment that people prefer lower premiums to broader networks."

Health policy experts and some consumer advocates say the trade-offs may pay off. Despite some consumer complaints, the exclusion of some higher-priced hospitals such as Cedars-Sinai Medical Center from nearly all exchange plans is a positive sign, they say.

"The Affordable Care Act often gets accused of not doing enough to control costs," said Ian Hill, senior fellow at the Urban Institute, a Washington think tank. "Excluding some of the most expensive hospitals and providers who don't demonstrate high-quality outcomes is one ripple effect that may help."

The Covered California exchange began enrollment in October without the provider directory it had promised. Delays and glitches ensued for weeks, frustrating many consumers who complained that it was impossible to compare health plans without details on what hospitals and doctors were included. In November, the exchange updated its directory.

The exchange said its 11 health plans offer more than 58,000 physicians to choose from, representing 80% to 90% of practicing physicians in the state.

The California Medical Assn. credits the exchange for fixing many of the initial problems but maintains that the state's data are still flawed, often because of incorrect information from health plans. Insurers blame doctor's offices for frequently giving wrong information.

Scott Marshutz of Dana Point said he picked a Blue Shield PPO plan in the exchange so he and his wife would have greater choice of doctors.
But when he booked an appointment recently with his orthopedic surgeon, the doctor's office said it wasn't taking Covered California plans.

"I'm wondering how many other people have experienced this," he said, "and if it will backfire on the whole system."

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Democrats are "bed-wetting" over 2014 and ACA fallout?

Posted by Olog-hai on Wed Feb 5 14:28:56 2014, in response to Universal Health Care is HERE in these USA! Apply Now. www.healthcare.gov, posted by SMAZ on Tue Oct 1 13:19:06 2013.

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Bill Clinton Arrives to Calm Democratic ‘Bed-Wetting’

By Jeff Zeleny
Feb 5, 2014 12:42pm

The bed-wetting has begun. It may not be a pleasant image, but that’s the phrase used inside Obamaworld when Democrats start worrying about their political fortunes. And nine months before the midterm elections, the worry is intensifying, particularly given the latest batch of bad news for the new health care law.

David Plouffe, the president’s former campaign manager and top political adviser, first coined the term “bed-wetting”‘ back in 2008 when Democrats began openly fretting about their political challenges. He said the mood today inside the party is starting to remind him of the same moment.

When asked whether the bed-wetting phase of the 2014 campaign season was starting, he laughed and declared: “Ha. Of course it is.”

Democrats are indeed anxious, particularly with Republicans only six seats away from winning control of the Senate in November. By any calculation, it’s a tough political map. Democrats are defending Senate seats on unfriendly terrain across the South and other states where President Obama either lost decisively or struggled to win. This sets the stage for a contentious closed-door policy retreat and strategy session today that Senate Democrats are having with the president. In addition to Obama, the guest speaker is Bill Clinton, who is poised to deliver a speech, take questions and try to coach jittery Democrats how to keep their heads up during a rocky midterm election year.

Only a week after the president urged Democrats in his State of the Union address to get back on the offensive in the health care fight, a new CBO report puts them back on defense. While the analysis from the Congressional Budget Office is far more nuanced than some early headlines suggested, some Democrats worry the argument is too complicated to cut through political attack ads that are already in the works.

But Plouffe said today it’s too early for Democrats to panic — or start bed-wetting. “There will be 10 more moments, at least, that will be declared to be decisive moments that will determine the 2014 election,” Plouffe told ABC News. “And none of them will be.” He argued that voters across the country do not share the Republican “obsession” with the health care law.

He said the report from the non-partisan budget office, which predicted the Affordable Care Act would shrink the work force by the equivalent of 2 million full-time positions, would not automatically spell doom for Democrats. He said it would be “a big mistake” for Republicans to build their midterm election campaign message solely around health care.

Still, Democrats go into their strategy session with anxiety about their standing. Their concerns are not entirely rooted in health care, but that remains a big share of the apprehension. Take Sen. Mark Pryor of Arkansas, a two-term Democrat who is facing the most difficult re-election fight of his political career. Health care is one of the key issues in the race. Asked how big of a political weight the law would be, Pryor said in a recent interview: “Time will tell.”

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