Las Vegas Sun

March 29, 2024

Nevada unions split on presidential health plans, Medicare for All

Bernie Sanders at Culinary Union Town Hall

Krystal Ramirez / Special to the Sun

Democratic presidential candidate Sen. Bernie Sanders, I-Vt., greets attendees in December 2019 during a town hall at the Culinary Union Local 226.

With the Nevada Democratic presidential caucuses just days away, two Nevada labor unions representing tens of thousands of workers have publicly split on one of the Democratic Party’s cornerstone issues.

Leadership at Nevada’s influential Culinary Union last week announced opposition to a single-payer health care proposal being pitched by some Democratic presidential hopefuls, stating that the union’s 60,000 members here do not want to replace their hard-earned, popular health insurance with a universal, government-sponsored program.

“We have already enacted a vision for what working people need — and it exists now. Workers should have the right to choose to keep the health care Culinary Union members have built, sacrificed for, and went on strike for six years, four months and 10 days to protect,” union secretary-treasurer Geoconda Argüello-Kline said in a statement.

Although the Culinary Union says it will not endorse a candidate ahead of Nevada’s presidential caucuses on Saturday, some saw the union’s statement as an indictment against Vermont Sen. Bernie Sanders, whose presidential campaign is championing a universal, single-payer “Medicare for All” plan. Fellow presidential candidate Sen. Elizabeth Warren of Massachusetts also supports Medicare for All, but her proposal calls for a gradual phase-in of the single-payer system.

Sponsored by the union and its casino employers, the Culinary Health Fund provides its members and their families with coverage as well as access to the fund’s 24-hour health center and two pharmacies.

“We don’t want it to change,” said member Donna Kelly-Yu, a dispatcher, order-taker and cashier at Caesars Palace. “I will fight today, fight tomorrow and fight every day to keep it.”

If the union’s statement was an indictment of Medicare for All, then a counterstatement released less than a week later by another prominent progressive union in Nevada appears to be an endorsement of a Sanders or Warren-type proposal.

Representing 19,000 health care and public service employees in the state, Service Employees International Union’s Nevada Local 1107 offered a different message Monday: Whether a member of a union or not, everyone deserves access to quality health care. SEIU’s statement did not name the Culinary Union explicitly but called the recent “debate” about universal, single-payer health care and union-negotiated health benefits “a false choice.”

“SEIU members support all proposals that will expand health care to millions more working people and their families, as Medicare for All will,” several union officers said in the joint statement.

Nevada has the sixth highest uninsured rate at 14% of the state’s population, according to the Nevada-based think tank Guinn Center for Policy Priorities. Nationally, health care has consistently ranked as one of voters’ top concerns in the 2020 election. Nonetheless, the disagreement between two of the state’s major unions going into the presidential caucuses reflects the fact that organized labor in Nevada has not coalesced behind a single health care platform.

Only one major union in Nevada — the Clark County Education Association, Nevada’s largest teachers’ union representing 11,000 public school teachers — endorsed Sanders in January after a poll of members revealed more supported the self-described democratic socialist over any other candidate in the race.

Sanders’ Medicare for All plan would benefit organized labor because union organizers would not need to negotiate for better health insurance benefits if the government guaranteed coverage, CCEA executive board member Kenny Belknap said. It would also save employers money, which, in the case of the Clark County School District, could free up additional funds for classrooms and students, said Belknap, who teaches U.S. government.

While he appreciates the health insurance that he currently gets through the school district, Belknap says he would not mind switching to a single-payer system.

“When it comes to labor and Medicare for All, I look at it as a net positive, because no longer are you working with an employer who has to worry about setting funds aside for health care. It’s already taken care of,” he said.

That’s not to say that all members of the CCEA necessarily support Medicare for All. Nor do all members of the Culinary Union vehemently oppose it. Although Culinary Union member Marcie Wells enjoys the health insurance plan provided by the union, she said she would be willing to switch to a single-payer system.

“Based on the existence of out-of-pocket costs and other barriers that keep sick working-class people on the margins, I know for a fact that universal health care is the best health care model for America,” said Wells, who works at a bar on the Strip. “I don’t care what your job title is, unless you’re afforded the privilege of being wealthy, if you get sick, you will suffer financially at the same time.”

Given that the Culinary Union fought hard for its current plan, longtime casino dealer and union leader with United Auto Workers Local 3555 Kanie Kastroll said she understood some members’ skepticism about giving it up.

“It’s not (that) you don’t want everyone to have health care, but as a union, you want to take care of your own members,” said Kastroll, who currently receives health insurance through her employer. “You want to be able to provide for your members, and when somebody comes and says you can’t, you’re like, ‘Well, that’s what unions service their members for.’”

Internationally, UAW advocates for a single-payer health care system, maintaining that this would benefit unionized members who already have health insurance as well as the 27.5 million uninsured Americans. Kastroll’s personal opinion, however, is that expanding health care coverage under the current system without eliminating private insurance is the best path forward.

“I supported Obamacare, and I’m probably leaning, if I had to go away from that, more toward a Pete Buttigieg-type plan: Medicare for All Who Want It,” said Kastroll.

Buttigieg, the former South Bend, Ind., mayor, proposed his “Medicare for All Who Want It” plan that would allow all Americans to opt into a government-funded public option. Uninsured Americans would be automatically enrolled in the public option, while those who could afford it or received it through their employer could keep their private insurance.

Even though Las Vegas-based SEIU member and union leader Abraham Garcia says he enjoys his private union-negotiated health care, he would prefer a Medicare for All system, which would eliminate copayments, deductibles and premiums. No one should go bankrupt due to an unexpected illness or medical expenses, whether they are part of a union or not, he said.

“This is a positive step into the future,” Garcia said. “At the end of the day, just in my personal opinion as a union leader, I think the majority of my co-workers would support Medicare for All.”