Greetings,

• The AFT on Healthcare Reform
• AFL-CIO, AFT Push for Robust Public Option
• Medicare Part D Open Enrollment Begins Nov. 15
• Plain Talk About Healthcare Reform and Older Americans
• House Bill Includes Public Option, More Help for Doughnut Hole
• Healthcare Reform Update
• Healthcare Quality Slipped in 2008
• Shop Union for Holiday Cards
• Quotes of Note

AFL-CIO, AFT PUSH FOR ROBUST PUBLIC OPTION
The AFL-CIO Oct. 26 announced that the labor movement will step up its activities to make sure that the final bill will include a robust public option, require employers to pay their fair share and not include an unfair excise tax on working families. In a teleconference with reporters, AFL-CIO president Richard Trumka said the AFL-CIO, along with the Change to Win federation, plans to make Nov. 5 a day of action in which leafleting will take place at worksites nationwide urging workers to call and write their members of Congress demanding real reform. The AFT is strongly supporting the AFL-CIO’s efforts and targeting key states as well as nationwide contacts with representatives and senators. Since the summer, AFT activists have contacted elected federal officials more than 30,000 times, including a national retiree lobby day in October that included some 120 leaders from 23 states. Trumka credited a grassroots effort for getting the public option back on the table. He called the Senate Finance Committee’s 40 percent tax on so-called Cadillac plans “totally unacceptable.” The AFL-CIO president said, under the Finance bill, an excise tax could be put on as many as 40 percent of current health plans. An analysis issued Oct. 16 by the Joint Committee on Taxation found that 31 percent of families' health insurance plans would be classified as Cadillac plans by 2019.

MEDICARE PART D OPEN ENROLLMENT BEGINS NOV. 15
Enrollees in Medicare Part D private prescription drug plans can change plans during this year’s Annual Coordinated Election Period, between Nov. 15 and Dec. 31, 2009. If you make a change during this time, your new coverage will begin Jan. 1, 2010. If you are satisfied with your current drug coverage, you need not do anything. When choosing a Medicare private drug plan, make sure to look at all the costs, not just the premium. Your costs throughout the year will depend on the drugs you take, whether your plan covers them, and whether there are any coverage restrictions. To enroll in a plan, you can call 800-MEDICARE. Counselors are available to guide you through your plan options and enroll you in a plan. Or go to www.Medicare.gov, Medicare's consumer Web site, which has a plan-finder tool that lets you compare and enroll in a plan. It is best to enroll through 800-MEDICARE to avoid administrative errors. Be sure to contact your benefits administrator before leaving an employer plan. You may not be able to return. You can also compare plans on Medicare Interactive, the Medicare Rights Center’s consumer Web site. Click www.medicareinteractive.org/teachers to visit the special MRC site sponsored by the AFT and NYSUT. If you are still uncertain about what to do, call your local union for help.

PLAIN TALK ABOUT HEALTHCARE REFORM AND OLDER AMERICANS
The AFT Program on Retirement and Retirees has joined labor and seniors groups in sponsoring SeniorstoSeniors, www.seniorstoseniors.org, a newly formed coalition of senior citizen advocacy organizations committed to keeping older Americans informed about the impact of current healthcare reform legislation on their coverage. The coalition’s goal is to filter through the clutter and hype to explain to seniors how health reform can help keep doctors in Medicare, stop physician payment cuts, improve long-term care choices, keep Medicare affordable and close the prescription drug “doughnut hole.” The Web site includes short videos featuring healthcare professionals and seniors touching on the key areas of the healthcare reform bills. The 19 sponsoring organizations include the Alliance for Retired Americans, AARP, Center for Medicare Advocacy, Families USA, National Caucus and Center on Black Aged, National Committee to Preserve Social Security and Medicare, National Council on the Aging, National Organization for Women and several other unions. More information.

HOUSE BILL INCLUDES PUBLIC OPTION, MORE HELP FOR DOUGHNUT HOLE
The House of Representatives’ healthcare reform bill (HR 3200), released Oct. 29, includes a public option, stepped-up efforts to close the Medicare Part D doughnut hole and a historic expansion of Medicaid. The $894 million package, formed by combining three committee bills, would begin closing the doughnut hole in 2010, a year earlier than originally proposed. As of Jan. 1, 2010, the legislation would give a 50 percent discount for brand-name drugs purchased by recipients in the doughnut hole—a coverage gap in which beneficiaries now pay the full cost of prescription drugs until they reach the plan's catastrophic limit. The legislation also would reduce the size of the doughnut hole by $500 starting that same year. The revised provision would also phase out the doughnut hole by 2019, five years sooner than originally proposed. The measure includes a new provision that would require the secretary of Health and Human Services to negotiate drug prices on behalf of Medicare beneficiaries, a proposal that is anathema to pharmaceutical companies. The public option would require the administering agency to negotiate rates with providers rather than rely on Medicare-based reimbursements, the approach strongly favored by the AFT and AFL-CIO. The change is estimated to cost about $85 billion more, but House leaders doubted the Medicare-based approach would pass. The bill would cover an additional 35 million to 36 million of an estimated 47 million uninsured and includes a surtax on high-income earners—those making $1 million as a married couple or $500,000 on individuals, about three-tenths of 1 percent of all households in the U.S. Both House and Senate bills would establish insurance exchanges where individuals, families and small businesses could shop for insurance complying with new federal standards. The exchanges would have to be in operation by 2013. The House bill would also require all those eligible to sign up by 2013 for insurance through their employer, a government program or a purchasing pool called an exchange and includes a $750 penalty for individuals who fail to sign up and a 2 percent to 8 percent of payroll penalty for eligible employers who do not cover their employees. Some benefits, set to take effect in 2013, have been moved up so that Americans would see the benefits of the legislation more quickly. The next step will be for the merged bill to go to the Congressional Budget Office for a cost estimate, before lawmakers vote.

In the Senate, majority leader Harry Reid is awaiting a Congressional Budget Office analysis of his bill, combining elements of the Senate Finance and Health, Education, Labor and Pensions Committees, before taking it to the floor.

HEALTHCARE REFORM UPDATE

The Cost of Doing Nothing: Since 1999, insurance premiums have jumped 131 percent, while wages increased 38 percent, according to the Kaiser Family Foundation. This year, the average premium for all family policies rose about 5 percent, to $13,375 annually, the foundation reported, while workers’ wages rose 3.1 percent.

Senate Bill To Contain Public Option: Majority leader Harry Reid (D-Nev.) said Oct. 26 that healthcare reform legislation to be considered on the Senate floor will contain a government-run health insurance option to compete with private insurers and that states would be able to opt out of such a plan. The Senate bill is also likely to contain a provision allowing states to establish cooperatives to compete with private insurance companies.

Lieberman, Snowe To Oppose Public Option: Sens. Joseph Lieberman (I-Conn.) and Olympia J. Snowe (R-Maine) Oct. 27 said they would vote against healthcare overhaul legislation containing a public health insurance option. Most conservative Democrats withheld judgment on the legislation until they saw the details. The Connecticut senator says his concern about the Senate bill is based on the national deficit rather than the insurers that dominate his state. Snowe, the lone Republican to vote for the Finance Committee reform package, told reporters she would vote against a motion to begin debate on reform legislation if it included a public option. If you vote in Connecticut or Maine, please use the AFT toll-free number 866/327-8670 to contact your senator and urge him/her to support a robust public option. According to the latest Washington Post/ABC News poll, released Oct. 19, 57 percent of Americans support the public option.  Only 40 percent oppose it.

Insurance Industry Mum on Protest: Hundreds of people, including dozens of AFT activists, protested Oct. 21 outside the hotel in Washington, D.C., where America's Health Insurance Plans, the industry trade group, was meeting. The event was organized by Healthcare for America Now, a labor and community organization that supports a government-run public option as part of healthcare reform—a position strongly opposed by AHIP. At the rally, several families shared stories of denied care and signed a letter asking AHIP president and CEO Karen Ignagni, to meet with them. Neither Ignagni nor any AHIP official responded. No one in the insurance industry group, including their spokesperson, was interested in commenting.

Healthcare Lobbyists Hit New Spending Records: Healthcare lobbyists are on track to hit new spending records this year, with some individual companies nearly doubling their investment compared to previous periods. The Pharmaceutical Research and Manufacturers of America (PhrMA), the lobbying arm of the big drug companies, spent almost as much by September as it did in all of 2008. America's Health Insurance Plans has spent $1 million more so far this year than over the same period last year. In the first six months of this year alone, drug and biotech companies and their trade associations spent more than $110 million—about $609,000 a day—to influence lawmakers. Meanwhile, with your help, organized labor, patient advocates and other groups are trying to take apart some of the deals already cut with top healthcare industry groups. Is there a better reason to get active to protect your health coverage?

HEALTHCARE QUALITY SLIPPED IN 2008
For the first time in more than 10 years, the overall quality of healthcare for Americans insured through commercial and public plans appears to have slipped. The across-the-board trend in care quality provided to people with private coverage as well as in Medicare and Medicaid was virtually stagnant in 2008, according to an annual “State of Healthcare Quality” report from the National Committee for Quality Assurance (NCQA). Richard Sorian, vice president of public policy with NCQA, attributed the slowing performance of health plans to the economy and the focus on cost-cutting. He added that the health industry's pay-for-service model does not create an incentive to improve the quality of care. The report, which was released Oct. 21, found that the quality of care for many health conditions remained under 50 percent, including screening for colon cancer, care for mental health and substance abuse and follow-up care for patients taking anti-depressant drugs. It also found improvements among insurers, including near universal high-quality care for Americans with asthma and a 12 percentage-point increase in the number of Medicare beneficiaries who regularly received essential medication for six months after a heart attack. The annual NCQA report says that employers and health plans have shifted their focus almost entirely to the cost of coverage, taking attention away from marked improvements that have been achieved since the group began evaluating healthcare quality.

SHOP UNION FOR HOLIDAY CARDS
Looking for something different this holiday season? You can send a message and support union workers by sending union-made cards to your family and friends. The AFL-CIO’s online Union Shop https://unionshop.aflcio.org/Holiday_Cards_C123.cfm offers a wide selection of cards. And while you’re there, check out the rest of the site for thoughtful, union-made holiday gifts. You’ll brighten a union family’s holiday, too.

QUOTES OF NOTE
“We cannot be in favor of reform for reform's sake. This is the moment to make sure it is real, that it will relieve the daily stress of Americans in paying for healthcare, that it will truly break the stranglehold of the insurance companies.”

                                                                  AFL-CIO president Richard Trumka
                                                                  Teleconference with Reporters
                                                                  Oct. 26, 2009

“The only citizens who will have to worry about their participation in Medicare being cut [under the House healthcare reform bill] are the insurance companies.”

                                                                  U.S Rep. John Dingell (D-Mich.)
                                                                  Oct. 29, 2009

Contributors and sources: Bill Cunningham, Bernadette Bailey, New York Times, Wall Street Journal, USA Today, Washington Post, National Public Radio, CNNMoney, Associated Press, The Hill, Inside AFT, AFL-CIO Now, BNA Healthcare Daily Report, Kaiser Health Policy Report. Frank Stella, editor; Mary Boyd, copy editor; Janelle Bowe, design.