When Laborers’ International Union President Terry O’Sullivan took the AFL-CIO convention podium in September, he voiced a majority view that, "If the Affordable Care Act is not fixed, and it destroys the health and welfare funds that we have all fought for and stand for, then I believe it needs to be repealed." White House meetings on the subject had not paid off, it seemed. According to Forbes magazine, the President had to intervene to forestall, barely, a convention resolution to repeal the ACA.
Generous, employer-paid health care coverage has been a chief attractant for low wage, non-union workers. Especially in the construction and transportation industries, much of that coverage has been provided through labor-management health and welfare trust funds, many of which are similar to self-insured, employer group health plans. Those funds are threatened by three ACA features: (1) beneficiary ineligibility for subsidies that would accompany their purchase of plans through the ACA Marketplace; (2) the coming “Cadillac plan” tax; and (3) other fees and taxes already imposed on insurance issuers and plan sponsors, most especially the annual reinsurance fee of $5.25 per month per covered life. So far, the Administration has not formally promised union funds any associated relief, despite heavy lobbying.