While the nation waits for an overdue Supreme Court decision that will decide the fate of President Obama's Affordable Care Act, another health care drama with wide implications for universal health care is just starting in Vermont.
Prodded by a strong grassroots movement, the Vermont legislature voted last year for a single-payer state health care system (Act 48) where every citizen will eventually be eligible for publicly funded health care.
The new system would take five or six years to fund and implement, however, between phasing out existing insurance arrangements, overcoming legal obstacles, dealing with provisions of the ACA and finding the money to pay for it all.
Meanwhile, the local business community, private insurance companies, and right-wing PACs have regrouped and counterattacked, with non-stop advertising. They're doing their well-funded best to make sure that single payer never happens in this state or any other. They know that a lot can change, politically and in the state budget, between now and the Act 48's final implementation in 2017, particularly in a state with two-year gubernatorial terms.
Last year's overhaul was backed by Governor Peter Shumlin, a multimillionaire businessman, who faces re-election this year after narrowly winning office in 2010.
Single payer continues to poll well, despite its lack of concrete benefits for any Vermonter so far--a weakness that conservative opponents are exploiting in their campaign of disinformation and fear-mongering. A recent poll conducted by several Vermont media found nearly 48 percent of those surveyed still favor single payer; 36 percent are opposed; and the rest remain undecided.
Shumlin is likely to defeat GOP candidate Randy Brock, whose top adviser is Darcie Johnston, founder of Vermonters for Health Care Freedom, a key conduit for anti-single-payer propaganda, financed by business.
But even if Brock and fellow Shumlin critic Wendy Wilton, who is running for state treasurer, lose this fall, progressives fear they will spread doubt about reform. As a centerpiece of her campaign, Wilton predicts that Vermont will be running budget deficits above $2 billion by 2018 if "Green Mountain Care" becomes a reality. Right-wingers also warn about the new taxes everyone will be required to pay.
'Air War' for Single Payer?
To counter this right-wing assault, Shumlin and others are holding a June 28 press conference to unveil "Vermont Leads: Single Payer Now!," their own vehicle for advertising and door-to-door canvassing in favor of Green Mountain Care. This new entity will spend more than $100,000 on a six-month drive "to engage and activate Vermonters through media and grassroots organizing." According to political operative Peter Sterling, who was just named director of the group, "more is expected in 2013 for TV ads," when the legislators reconvene to decide Act 48 financing questions.
Unfortunately, Vermont Leads doesn't draw on the formidable grassroots network created since 2008 by the Vermont Workers' Center (VWC)--and seems designed to bypass the state's most influential single payer advocate. The VWC's much-admired "Health Care Is a Human Right" campaign has been widely credited, both locally and nationally, with spearheading the multi-year community-labor mobilization needed to pass Act 48 last year.
While working closely with Shumlin and key Democratic legislators to achieve that goal, the Workers' Center has also been willing to sound the alarm and swarm the statehouse when things got off track. Last May, for example, VWC organizers brought more than 1,500 Vermonters to the Capitol to thwart a bid by legislative insiders to exclude undocumented workers from the scope of the law.
The VWC has long received strong backing from unions with members who live and work in Vermont--like the United Electrical Workers, Communications Workers, and the AFT-affiliated Vermont Federation of Nurses and Health Professionals, which bargains for most unionized health care workers in the state. In contrast, Vermont Leads is being entirely funded by just one union--the 1.9 million-member Service Employees International Union. SEIU has no members working in the state and failed to affiliate the still-independent Vermont State Employees Association more than a decade ago.
'Working with People Who Have Money!'
For individual activists tapped, so far, to serve on Vermont Lead's small board of directors, SEIU's arrival on the Vermont scene, with a wad of cash large by local standards, is cause for some rejoicing. As Jill Charboneau, a postal worker and former state AFL-CIO president, noted in an email to friends, "I am not used to working with people who have money!"
Another Vermont Leads enthusiast is Middlebury College anthropology professor Ellen Oxfeld, who regards SEIU funding as "a gift from heaven." According to Oxfeld, "We want to combat the lies, keep up the momentum for single payer, and organize around the financing package" to be adopted by legislators next year.
Deb Richter, leader of Physicians for a National Health Program in Vermont, gave similar reasons for joining Shumlin at the June 28 press event. "We've got six more years of fighting to do to keep this on track," she said. "We now have the ability to spend more for ad campaigns and literature drops. Instead of using existing groups, it made sense to have this one be a separate entity."
As for SEIU, "they've always been single-payer supporters," Richter asserted. "That's what I've been told."
Looking a Gift Horse in the Mouth?
Others in single-payer circles wonder whether this particular gift horse could become a Trojan horse that will weaken Vermont's movement for health care as a human right.
SEIU's sudden appearance in Montpelier is worrisome to union friends and political allies of the VWC, now in the middle of its own fundraising drive to support an energetic staff of eight who coordinate the work of scores of volunteers around the state.
The VWC is enlisting nationally known figures, like Bernie Sanders, Noam Chomsky, Dr. Paul Farmer, Chris Hedges, and Cornel West on a public statement of support titled, "Vermont Can Lead the Way." In a VWC letter soliciting 1,000 such endorsers, its leaders argue that "we will never be able to outspend giant healthcare profiteers and other big money groups in an 'air war.' But we can out-organize them on the ground!"
SEIU's lack of any members on the ground, plus its unhelpful role nationally in health care reform from the Clinton to the Obama eras, has led some labor activists to question its motivation for becoming a single-payer sugar daddy, virtually overnight.
One explanation involves SEIU's competition with AFSCME to represent personal care attendants in Vermont. Neither union can gain 5,000 new members in that workforce without Shumlin and the legislature agreeing to create a new home care bargaining unit, along with some sort of card check or election mechanism for union recognition by the state. If Shumlin, in the meantime, ever needs to do some back-peddling on single-payer--under pressure from business interests--SEIU could provide useful political cover for him. And the quid pro quo, local activists suspect, would be the governor favoring SEIU over AFSCME in home care.
Bad Record Elsewhere
Elsewhere in the U.S. and at the federal level, SEIU has repeatedly undercut single-payer efforts by other labor organizations (even though its own local unions have passed many pro-single payer resolutions over the years).
When the California Nurses Association (CNA) was campaigning for single-payer legislation in California four years ago, then-SEIU President Andy Stern cooked up a plan with Governor Arnold Schwarzenegger that would have required all Californians to buy private insurance but didn't control the cost of that insurance and set no minimum standards for coverage. Included in the bill was a fund for homecare workers' health benefits--to be administered by SEIU.
"SEIU played the leading advocacy role and ultimately the lead compromise role on that bill," California Nurses Association staffer Michael Lighty recalled. "Stern went behind the back of the California State Fed to cut the deal. But it didn't even pass in the state senate. It lost the backing of labor. It could not withstand the scrutiny." (For more on a similar SEIU-CNA controversy that just occurred, threatening already enacted nurse-patient staffing ratios in the same state, click here.)
In Massachusetts, SEIU affiliates have historically done little or nothing to build Mass-Care, the main single-payer advocacy group. Instead, the union worked with Ted Kennedy, then-Governor Mitt Romney, and the coalition known as Health Care for All to enact the state system of mandated private insurance that became the model for the ACA. As one labor friend of Mass-Care notes, "SEIU has been completely absorbed with 'Romneycare.' For them, it's all about hospital financing, never about changing the system itself."
Similarly, SEIU helped run interference for the Obama administration when it was working to keep single payer--and ultimately, any public option--off the table in 2009-2010.
Working with liberal foundations and other labor groups, SEIU helped raise $40 million for a group called Health Care for America Now. As David Moberg from In These Times reported, HCAN's spending swamped that of single-payer groups, while "promoting a strategy closer to Obama's proposal that would include employer-provided or individually purchased private insurance."
In 2009, SEIU operatives even tried to prevent local PNHP supporters from distributing single-payer pamphlets at community forums held to discuss health care reform in neighboring New Hampshire.
SEIU's Man With A Plan
Further fueling suspicions about SEIU's intentions in Vermont are the multiple hats worn by recently arrived national staffer Matt McDonald. His past assignments have included trying to keep 45,000 Kaiser Permanente hospital workers from fleeing SEIU in California and joining the National Union of Healthcare Workers. In 2010, McDonald was part of an organizing team that engaged in so much misconduct that the National Labor Relations Board overturned the results of that election.
McDonald set up Vermont Leads from scratch, made himself a board member, and hired Sterling as its director. Meanwhile, he is also masterminding SEIU's attempt to create the new statewide bargaining unit for personal care attendants, an effort that wisely includes wooing advocates for the elderly and disabled who receive such services in their own homes. For details on AFSCME's home care worker organizing in Vermont, which started before SEIU intervened, click here.
In response to an email seeking details on SEIU's home care unionization plans and the about-to-be-unveiled Vermont Leads, McDonald offered to talk off the record but, in the meantime, replied, unpromisingly: "The questions below don't deserve a response as far as I'm concerned. I think they even threaten the dual goals of creating a single payer system here in Vt., and the eventual unionization of thousands of workers."
The Scramble For New Members
A slugfest between SEIU and AFSCME in Vermont would be a throwback to the frenzied spending contests waged by the same two unions over home-based workers in 2004-2005. In the process of obtaining "organizing rights" deals in Illinois for both childcare and homecare workers--and prevailing over AFSCME there--SEIU became labor's biggest funder of Rod Blagojevich, the Democratic governor whose illegal "pay to play" schemes landed him in jail for 14 years.
As similar homecare or childcare units unravel elsewhere in the mid-west under hostile GOP governors, SEIU is now increasingly desperate for new members. A union that was growing by 100,000 annually in 2006-2008 has hit the wall, due to external enemies and the internal dysfunction that I described in "The Civil Wars in U.S. Labor" (Haymarket Books, 2011).
In 2011, SEIU registered a net gain of only 7,000 members and agency fee-payers, as compared to 59,000 the previous year. So 5,000 new dues payers in Vermont have become a more tempting prize than before, even if they require a costly brawl with an AFL-CIO union that already represents other public workers in the state.
For budgetary reasons, Vermont's Democratic-controlled legislature balked at creating a new statewide bargaining unit for publicly-funded day care providers earlier this year. This was a major, but hopefully not permanent, setback for the Teachers (AFT), the state's largest AFL-CIO union. But Shumlin's passive role and the opposition of key Democratic legislators doesn't bode well for AFSCME or SEIU doing much better in home care, as long as the two unions remain divided.
Price of a Relationship
The prospect of a homecare union war is not appealing to others in Vermont labor, for multiple reasons.
"In my opinion, SEIU seems to be cultivating a direct relationship with our governor by loyally supporting his health care plan--including all the expected compromises and retreats that may lie ahead," says Traven Leyshon, secretary-treasurer of the Vermont AFL-CIO. "This will create real problems for any of us pushing for a stronger, more progressively financed single-payer system than Shumlin favors."
Ellen David-Friedman, a founder of the Vermont Progressive Party and past organizer for the National Education Association in the state, agrees. "SEIU makes very short-term and opportunistic calculations," David-Friedman said. "They will help Shumlin get re-elected in exchange for legislation authorizing homecare unionization. My guess is that his position on single payer really doesn't matter much to them, since they've never really fought for it anywhere else."
State Senator Anthony Pollina, a Progressive Party leader, worries that the wrong kind of pro-single payer "air war," funded and directed from out of state, may "encourage right-wing groups to come in and spend even more money."
According to Pollina, "things could escalate into a media campaign that leaves citizens on the sidelines, just like past single-payer referendum campaigns that were lost in Oregon or California." Like the Workers' Center, he believes that "progressive grassroots activists can 'out-organize' the opposition on the ground but SEIU's invasion could end up undermining this good work."
Richter and Oxfeld both insisted they would never let this happen while they served as Vermont Leads board members. "Vermont is a small place," Richter said. "If it turns out SEIU is trying to push us in a different direction, they won't have the ground troops to pull it off." According to Oxfeld, "if they really try to get in the way, I don't see anyone on the board going along with it."
Health Care History Repeats?
Three years ago, Michael Lighty from the CNA predicted that creation of a publicly funded model plan, providing universal coverage in an American state, would "move us closer to a single-payer solution" than the "public option" that labor wanted in the Affordable Care Act until President Obama nixed it.
But Lighty warned that "if you pass a plan that's watered down and bad, you've squandered the political moment. You're going to fuel the cynicism and distrust so many people already have in what can be accomplished in Washington."
Health care reformers in Vermont have good reason to fear that SEIU will eventually play the same role locally that it did nationally in 2009-2010. If that results in another squandered political moment--this time leaving Vermonters cynical and distrustful about what can be accomplished in Montpelier--the repercussions will be felt in every other state capital where progressives still hope to improve on the ACA.
Steve Early is a labor journalist who started writing about Vermont politics when he was a Middlebury College student in 1968. He spent three decades as a New England representative for the Communications Workers, assisting members in Vermont and other states with strikes, contract negotiations, organizing, and health care reform activity. He is the author, most recently, of The Civil Wars in U.S. Labor, from Haymarket Books, and a longtime supporter of the Vermont Workers' Center.