Changing the Face of Health Care: Bringing Member-Driven Health Insurance to New York, New Jersey, and Oregon through CO-OPs

From http://www.freelancersunion.org/co-ops/

We’re excited to announce that Freelancers Union is sponsoring new, nonprofit, member-driven health plans in New York, New Jersey, and Oregon. This innovation, known as Consumer Operated and Oriented Plans (CO-OPs), brings back the classic meaning of “insurance” for today’s workers: joining together to build collective security and mutual support, free from the tethers of the profit-driven health insurance industry.

CO-OPs are nonprofit health insurance plans that are focused on the needs of the insured, not on making a profit – a belief that is core to our work. Widely regarded as one of the most innovative cost-containment solutions in the Patient Protection and Affordable Care Act (also known as the Health Care Reform Act), these nonprofit CO-OPs will compete with private insurers on the open market. The U.S. Department of Health and Human Services will provide $340 million in loans to the three CO-OPs we’ll be sponsoring. They will be open to everyone, with financial help available to lower-income Americans.

Fortunately, we’ve got a good bit of experience providing insurance to the self-employed, whose only other options are prohibitively expensive individual plans. When we launched Freelancers Insurance Company (FIC) in 2009, everyone said it couldn’t be done: the insurance industry was too dysfunctional, too expensive, and too complex. But we had an innovative vision, perseverance, talented staff and consultants, and a mission to bring the best possible benefits to our members. We raised $17 million in start-up funds to get FIC off the ground, and now, in its fourth year of operation, the social-purpose insurance company covers more than 23,000 New Yorkers at rates up to 40% less than other insurers.

CO-OPs are the future of health care in America – and the model to give tomorrow’s workforce the independence they need to thrive.

CO-OP background:

CO-OP stands for Consumer Operated and Oriented Plan.

Thanks to $340 million in low-interest and no-interest loans from the U.S. Department of Health and Human Services (HHS), Freelancers Union will sponsor CO-OPs in New York, New Jersey, and Oregon beginning in January 2014.

CO-OPs are private, nonprofit health insurers whose plans are designed to offer quality, affordable, consumer-friendly health plans in every state.
The government has set aside a total of $3.8 billion for CO-OPs in the Patient Protection and Affordable Care Act (also known as the Health Care Reform bill).

CO-OPs will be open to all comers, including independent workers typically shut out of the traditional healthcare market. Americans making less than 400% of the federal poverty level will be eligible to receive financial support from the government to pay for their CO-OP health plan.

How CO-OPs will work:

Nonprofit insurance plans in different states enter the market and compete with private insurers. This state-level market is called the Exchange, and it’s designed to make it easier for consumers to shop for and understand insurance plans.

CO-OPs will level the playing field for individuals and small groups – who are ignored in the current health insurance market, which is largely geared toward large companies.

CO-OPs offer more, better, and less expensive health insurance options to consumers.

Freelancers Union expects to start enrolling people in the CO-OP in Fall 2013 and begin offering coverage in January 2014.

Freelancers Insurance Company health plans will not be impacted by CO-OPs at all. Enrollees on FIC plans can continue to get insurance through FIC as they currently are.

Read more:

HHS on CO-OP background: http://www.healthcare.gov/law/features/choices/co-op/index.html
HHS Fact Sheet on CO-OPs: http://www.healthcare.gov/news/factsheets/2011/07/coops07182011a.html
HHS on the State Exchange: http://www.healthcare.gov/law/features/choices/exchanges/index.html
National Alliance for CO-OPs: http://www.nashco.coop/index.php?option=com_content&view=article&id=45&Itemid=53
Centers for Medicare & Medicaid Services: http://cciio.cms.gov/programs/coop/index.htmlv
National Cooperative Business Association on health care cooperatives: http://www.ncba.coop/ncba/about-co-ops/co-op-sectors/146-healthcare
Wikipedia on health insurance cooperatives: http://en.wikipedia.org/wiki/Health_insurance_cooperative

PEF Raises Concern over the Future of Services for New York’s Most Vulnerable Citizens

ALBANY, NY — New York State is on the fast track toward Medicaid managed care that would nearly, if not totally eliminate state-provided mental hygiene services. Today, Pat Baker, vice president of the New York State Public Employees Federation (PEF), warned lawmakers of the long-term implications on the most vulnerable New Yorkers if these proposals go forward.

“Several elements of the proposed Executive Budget aim to provide integrated health care at a much lower cost,” Baker said. “What we should pay attention to is a diminishment of quality in services and the unraveling of the safety net on which our most vulnerable citizens rely in times of crisis.”

Baker testified at the state Assembly Ways and Means and Senate Finance Committees’ hearing on Mental Hygiene in Albany. The proposals include giving the state Office of Mental Health (OMH) unlimited authority to reduce beds and close facilities statewide with only 30 to 60 days notice and virtually no input from the people who depend on these services or the professionals who provide them.

“One facility slated for closure is Kingsboro Psychiatric Center in Brooklyn, which is identified as the single highest user of mental health services in the state,” Baker testified.

Similarly the state Office for Persons with Developmental Disabilities (OPWDD) would provide managed care for the disabled by a network of not-for-profit providers.

“Long-term residents of state-operated group homes are being moved out of their homes to make room for individuals being discharged from institutions. For some, these are the only homes they have known for decades. OPWDD claims to put “people first,” yet here the people are last, and the money is first. It is shameful,” Baker said.

Additionally, the state hopes to privatize the care and security services for sexual offenders now in OMH units. Baker warned lawmakers the state determined these offenders to be too dangerous for release into the community at the end of their prison terms and not to become complicit in creating this threat to public safety.

PEF is the state’s second-largest state-employee union representing 54,000 professional, scientific and technical employees and other public and private employees.

In Memoriam: Dr. Stephen Levin

It is with great sadness that we write to inform you of the death of our dear colleague Stephen Levin, MD, Professor of Occupational Medicine in the Department of Preventive Medicine of the Mount Sinai School of Medicine, and for many years Medical Director of the Mount Sinai Irving J. Selikoff Center for Occupational and Environmental Medicine.

Dr. Levin was a 1967 graduate of the New York University School of Medicine. After a decade of practice in General Medicine in Pennsylvania, he came to Mount Sinai to receive his training in Occupational Medicine. Following completion of his training, he joined our faculty. He spent the remainder of his career at Mount Sinai, rose through the academic ranks and was promoted to full Professor in 2011

Dr. Levin became Medical Director of the Mount Sinai Selikoff Center in 1987. He was active in the Occupational Medicine teaching program for medical students and residents. His research interests focused on asbestos-related disease, other occupational lung diseases and heavy metal toxicity.

Dr. Levin served as a consultant to the New York State, New Jersey, and New York City Departments of Health on the health hazards of environmental pollutants.

In response to the events of September 11, 2001, Dr. Levin devoted his expertise for over a decade to the evaluation and treatment of patients who developed respiratory and psychological illnesses as a consequence of their exposures and experiences at or near the site of the World Trade Center (WTC) disaster. He was Co-Director of the WTC Worker and Volunteer Medical Screening Program, funded by the Centers for Disease Control and Prevention, which provided medical assessments, diagnostic referrals and occupational health education for over 20,000 workers and volunteers who performed rescue and recovery work at the WTC site. He served as Principal Investigator and Director of the Data and Coordination Center for the federally funded WTC Medical Monitoring Program that provides repeat examinations for the WTC responder cohort. Dr. Levin was an active member of the Collegium Ramazzini.

A memorial service will be held on Tuesday, February 21, 2012 at 4pm at the Mount Sinai School of Medicine’s Stern Auditorium, 1468 Madison Avenue (@ E. 100th Street), New York, NY 10029.

The Mount Sinai family has lost a beloved friend and cherished colleague, and we extend our sincere condolences to Dr. Levin’s family and friends who also feel this deep loss.

Statement by NYS AFL-CIO President Mario Cilento on the Passing of Dr. Stephen Levin:

Working New Yorkers lost a selfless champion this morning when Dr. Stephen Levin, co-director of the Mount Sinai-Selikoff Center for Occupational and Environmental Medicine, passed away. Dr. Levin dedicated his medical career to improving the safety and health of workers. Through his care, research, and advocacy he bettered the lives of so many. His efforts on behalf of workers and volunteers at Ground Zero were simply inspirational and invaluable. The labor movement offers its most heartfelt condolences to his loved ones. He will truly be missed.

Statement of U.S. Rep. Carolyn Maloney (D-NY) on the Passing of Dr. Stephen Levin:

“It was with tremendous sadness that I learned today of the passing of Dr. Stephen Levin. Dr. Levin was one of our nation’s foremost experts in occupational and environmental medicine and in his career cared for thousands of Americans with work-related injuries and illnesses. But New Yorkers may know Dr. Levin best as the Director of the World Trade Center Worker and Volunteer Medical Screening Program, where he helped identify the emergence of 9/11-related illnesses and led the medical community’s response to this unprecedented health crisis.

“The Medical Screening Program was a precursor to the current World Trade Center Health Program, which was enshrined in law by the James Zadroga 9/11 Health and Compensation Act, a bill I authored with Congressmen Nadler and King and on which I worked with Dr. Levin to pass. Without Dr. Levin’s pioneering research, service, and dedication to 9/11 responders, volunteers, and survivors, we may never have passed the Zadroga Act.

“This is no doubt a terribly sad time for Dr. Levin’s loved ones, but I hope they will be comforted by the fact that his life was so well-lived, and by the thoughts and prayers of thousands of Americans whose lives are immeasurably better because of his work.”

NYS Health Foundation Releases Positive Report on Health Reform

“Health Reform Works: How the Affordable Care Act Is Already Making a Difference for New Yorkers”

By creating new options for health coverage and building on existing sources of public and private health coverage, the Affordable Care Act (ACA) will give many people an opportunity to access affordable and comprehensive coverage. Important provisions of the health reform law have already taken effect, benefiting millions of New Yorkers as a result.

A new NYSHealth-funded publication by Health Care for All New York and the Community Service Society shares the personal stories of families, small business entrepreneurs, senior citizens, and students across New York who have already been helped by the ACA. The report offers a window into the impact that the new law has had on New Yorkers and shows how changes to the health insurance system can improve the lives of those dependent upon it.

ACCESS the report.

Montefiore Nurses Win New Contract, January Strike Averted

2,300 Bronx nurses make gains on staffing, wages, affordable health care

BRONX, Dec. 30, 2011 – The New York State Nurses Association has successfully negotiated a new, four-year contract with Montefiore Medical Center in the Bronx.

The 2,300 professional registered nurses who work in the hospital made important advances in safer patient staffing, affordable health care, and fair wages, comparable to their colleagues at other New York City unionized hospitals. The nurses had given the hospital a strike notice for Jan. 10, 2012, because of their staffing concerns.

“Our members at Montefiore stood together to get a contract that’s good for our patients, our nurses and our families,” said Judy Sheridan-Gonzalez, RN, president of the Montefiore’s Moses Division bargaining unit. “The nurses give their very best every day to patients, and deserve a contract that treats them and their work with dignity and respect.”

The contract will provide about 125 new RN positions, salary increases of 7.5 percent over four years, a $750 lump sum payment on ratification and affordable prescription benefits.

The strike notice for Tuesday, Jan. 10, has been withdrawn.

The nurses will vote on the proposed contract in January.

The New York State Nurses Association is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest professional association and union for registered nurses. The association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, research, legislative advocacy, and collective bargaining.

Flushing Hospital Threatens to Terminate Nurses’ Health and Pension Plans

RNs to protest with informational picketing on Jan. 5

FLUSHING – Upset that management plans to stop payments to their health and pension plans, registered nurses at Flushing Hospital Medical Center are planning a protest for next week.

The RNs are currently negotiating a new contract with management and are seeking to improve their working conditions. But hospital CEO Robert Levin has refused to sign interim agreements that continue the benefit plans.

To show management they won’t be intimidated, the nurses will conduct an informational picket from 11:30 a.m. to 1 p.m. Thursday, Jan. 5, in front of the hospital at 4500 Parsons Blvd.

The current contract for the 350 nurses, who are represented by the New York State Nurses Association, will expire on Dec. 31, 2011. The interim agreements would guarantee continuation of both for six months after contract expiration while the parties continue to negotiate. Health benefits continue 90 days after expiration whether the interim agreement is signed or not. But their pension plan would end on Jan. 1, 2012.

The RNs say that comprehensive health and pension coverage is necessary because RNs are likely to suffer from health problems developed while on the job – such as neck and back injuries, high stress, and risk of exposure to contagious disease – and often cannot continue working until the average retirement age of 65.

Quality health coverage is also a key element in encouraging RNs to come to Flushing Hospital and convincing experienced nurses to stay. Improving recruitment and retention, in turn, is crucial to improving RN-to-patient staffing. Studies have shown that hospitals with better staffing have better patient outcomes.

CEO Levin has also put proposals on the table that would cost each nurse $150,000 in lost lifetime pension benefits, while offering no wage increase for three years.

The New York State Nurses Association is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest professional association and union for registered nurses. The association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, research, legislative advocacy, and collective bargaining.

NYSNA, St. Luke’s-Roosevelt Reach Agreement-Strike Notice Withdrawn Pending Ratification

MANHATTAN – The New York State Nurses Association, which represents the 1,300 registered professional nurses at St.Luke’s-Roosevelt Hospital Center in Manhattan, has reached a tentative agreement with hospital management.

Members will vote on the proposed four-year contract on Wednesday, Jan. 4, 2012.

The tentative agreement addresses the nurses’ principal concerns throughout the negotiations – affordable health care, relief for members with high prescription costs, safe staffing levels for patients and nurses, and fair wages.

With this tentative agreement, negotiations continue at two remaining major New York City hospitals – Mount Sinai Hospital in Manhattan and Montefiore Medical Center in the Bronx.

An agreement was ratified by the nurses at New York-Presbyterian Hospital earlier this month.

The New York State Nurses Association is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest professional association and union for registered nurses. The association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, research, legislative advocacy, and collective bargaining.

St. Luke’s-Roosevelt Nurses to Strike on January 3, 2012

St. Luke’s-Roosevelt Nurses to Strike on January 3, 2012

Fighting for Affordable Health Care and Fair Pay

MANHATTAN – Early Thursday morning, the registered nurses of St. Luke’s-Roosevelt Hospital Center in Manhattan filed notice with hospital representatives that they will strike at 7.30 a.m. on Tuesday, January 3, 2012.

The 1,300 nurses – members of the New York State Nurses Association – have been working without a contract since December, 2010, and have had 25 bargaining sessions trying to reach a new agreement.

The strike notice was given during a marathon 18-hour bargaining session that ended at 4:00 a.m.

“The hospital’s response to our concerns about affordable health care did not meet our members’ needs. We are now mobilizing in the hospital for the January 3 strike,” said Nancy Kaleda, NYSNA’s bargaining director. “While we made some progress on staffing issues in the talks, the healthcare issue carries huge weight for our members and their families.”

Two other major New York City hospitals are also in the middle of intense contract bargaining — Mount Sinai and Montefiore. The Mount Sinai negotiations continue today, Montefiore talks resume next Tuesday. Those NYSNA members have also authorized strikes, but the union has not presented the strike notice yet.

The New York State Nurses Association is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest professional association and union for registered nurses. The association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, research, legislative advocacy, and collective bargaining.

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Key Lawmakers Urge Cuomo To Include Health Exchanges In Budget Proposal

By Laura Nahmias

Several key lawmakers hope Gov. Andrew Cuomo will re-start the process of creating health insurance exchanges in New York next month by including the stalled plan in his budget proposal.

The exchanges were a priority of Cuomo’s first legislative session, but failed in the Republican-led Senate amid lawmakers’ concerns that voting to create the exchange – part of President Barack Obama’s health care reform – could become a political liability in the 2012 elections.

The Supreme Court is scheduled to hear a challenge to health care reform in the spring, but Sen. Jim Seward and Assemblyman Joseph Morelle, chairs of the insurance committees in their respective chambers, said they hoped the governor would not wait until then before passing the bill. The closer the state gets to presidential elections, they warned, the more politically charged the issue becomes.

“I think it’s been so identified with the president and the politics of the presidency, that they’ve avoided or not really focused on the real benefits this provides, not only in terms of benefits to small businesses, but quality of care, improving patient outcomes,” Morelle said Friday at a City & State forum on health insurance exchanges sponsored by HealthPass New York.

“My fear is that this gets played out over the next year-and-a-half, and I think that would obviously put New York in a very, very bad position,” he said.

Without a bill authorizing the insurance exchanges, the logistics of running the program, such as renting office space, or hiring staff, have been delayed. Federal law requires the exchanges be functional by Jan. 1, 2014, leaving New York with less time to make decisions. The bill passed the Assembly earlier this year, but remains stalled in the Senate.

Seward said the Republican conference decided to wait to pass the bill – which he considered soundly written – until more details came from the federal government about what services the state would be required to insure.

“In New York, let’s face it, we have a number of mandates in our policies, more than perhaps anywhere else in the country,” Seward said. If the federal government insured fewer services than New York’s broadly mandated services, the state could be liable for the cost, he said.

But that question was settled just hours after the forum, when the U.S. Department of Health and Human Services issued guidelines outlining essential benefits. The state could have its already mandated services covered under the federal plan, which would alleviate concerns about potential hidden costs.

The HHS guidelines set up a system whereby each state could determine its own essential benefits package, avoiding the possibility the federal government could be seen as imposing costly mandates on the states. In New York, it means people will continue to receive the same services they’ve always had, no more and no less, said Ben Geyerhahn, a Hudson TG who studies health care for the Small Business Majority.

“I think it will disappoint some consumer advocates who had hoped for more standards,” he said. “I don’t think, from a policy perspective there’s going to be a lot of change.”

Even if a bill to set up the exchange should pass in the next budget cycle, other key stakeholders voiced concerns about how it would work.

Separate exchanges that only cover small businesses, or ones that cover both small businesses and individuals could be considered under the state’s plan. And what the governor ultimately decides could have enormous financial consequences, because of the expense of covering individuals, said Margaret Moree, director of federal affairs at the Business Council of New York State.

“Everyone understands that the individual market in New York is under incredible stress,” Moree said.

Those considerations offered even more reasons for New York to authorize the exchange sooner rather than later, said Peter Newell, Health Insurance Director at the United Hospital Fund.

“I think my sense of urgency for not having legislation in place yet comes from the fact that you reach a point where … you need to have an exchange that can go out to the health plans and say, what kind of products are you going to offer? Are you going to play or not? What sort of network choices do you have?” Newell said.

“The exchange needs to get a sense of what kind of hand it’s going to be dealing to businesses and individuals who come and shop there,” Newell said, “because at the end of the day, they’re going to have a product to sell, and unless it’s a good product, people won’t buy there.”

Nurses at Mt. Sinai and Montefiore vote to strike

Vote sets the stage for a possible strike by 7,000 NYC nurses

MANHATTAN & BRONX, Dec. 9, 2011 – Registered nurses at Montefiore Medical Center and Mt. Sinai Medical Center have voted to authorize a strike if hospital management does not settle contracts that provide the best possible patient care, affordable health care for nurses and their families, and decent wages. The nurses at Montefiore and Mt. Sinai now join their colleagues at St. Luke’s-Roosevelt Hospital Center, who voted last month to authorize a strike.

The 7,000 registered nurses at the three hospitals, members of the New York State Nurses Association, are working together to win fair contracts at a time when hospital management at some of the city’s most prestigious and most profitable hospitals are using the difficult economic climate as an excuse not to reasonably compensate nurses for their extraordinary, daily contributions to the well-being of their patients and to the success of the hospital.

“Many New York nurses are working with long-expired contracts. A strike is our last resort,” said Judy Sheridan-Gonzalez, bargaining unit president of Montefiore’s Moses division.

“In 2010, 5 NYC hospital CEOs made almost $18 million!” Sheridan-Gonzalez said, quoting numbers from a Nov. 27, 2011 New York Post article. “We are demanding that we be able to protect our patients with safe staffing ratios. We are also standing up to the corporate agenda that has been squeezing workers across the country to pay more for benefits in order to fix years of their own mismanagement.”

Nurses have been at the negotiating table for months with the three hospitals and management has consistently refused to adequately address the nurses’ concerns about affordable health care premiums, reasonable wages and patient care issues.

The nurses at New York-Presbyterian Hospital had also authorized a strike in late October, but have now reached a tentative agreement that addresses key staffing concerns and would not increase the nurses’ health insurance benefit costs. A ratification vote for the proposed contract is underway.

“The nurses at Mt. Sinai stand together with our colleagues at St. Luke’s-Roosevelt, Presbyterian and Montefiore,” said Jacklynn Price, bargaining unit president at Mt. Sinai. “Our members give patients excellent care, and they need and deserve quality health benefits for themselves and their families, just as we provide care for all of our patients.”
In addition to preparing for a possible strike, the Nurses Association has launched a new 60-second radio ad on several New York-area stations, in which Karine Raymond, a working nurse from Montefiore, seeks support for the middle-class nurses in their contract fight against the millionaire hospital executives.

The nurses will decide in coming days when they will begin the strike notification process with hospital management.

The New York State Nurses Association is the voice for nursing in the Empire State. With more than 37,000 members, it is New York’s largest professional association and union for registered nurses. The association represents registered nurses, and some all-professional bargaining units, in New York and New Jersey. It supports nurses and nursing practice through education, research, legislative advocacy, and collective bargaining.

Nurses Association contact: Robin Wood (518) 782-9400, ext. 223