How AFL-CIO & Democratic Party Have Helped Privatize Medicare & Retirees Fighting Back

How the AFL-CIO & the Democratic Party Have Helped Privatize Medicare and how Retirees are Fighting Back
By Steve Zeltzer

The political explosion generated by the murder of United Healthcare CEO Brian Thompson by Luigi Mangione has brought forth a national outpouring of anger, rage and class hatred by the American people against the major healthcare insurance companies like United Healthcare. There is a reason for their hatred. Since the passage of Obama Care, United Healthcare, Anthem, Humana, Blue Cross Blue Shield, Cigna, CVS and Emblem have captured over 50% of the entire Medicare program with their Medicare Advantage program and are profiting massively by denying and delaying benefits.The privatization of Medicare through Medicare Advantage is the intended outcome of the Affordable Care Act passed by the Obama Administration with the support of the entire AFL-CIO leadership.

Not only have these companies profited from taking over tens of billions of dollars of the Medicare system, but the AFL-CIO and many national unions have welcomed Medicare Advantage programs and have actually contributed to the privatization of Medicare. The unions have partnered with the insurance companies by offering financial incentives to their members if they drop Medicare and enroll in the privatized Medicare Advantage programs.

The AFL-CIO leadership and most national union leaderships welcomed the passage of the ACA in 2012, arguing that it would be a step toward healthcare for all and would require the health insurance industry exchanges to “operate with high standards of quality and cost-effectiveness and not become hostages of insurance companies.” Since the passage of the ACA, not only have they not fought the insurance industry take-over of Medicare by Medicare Advantage but they themselves are entering into financial partnerships with Emblem and other insurance companies and pushing their members to join the drive for privatization.
https://aflcio.org/about/leadership/statements/building-affordable-care-act

This betrayal by union leaderships has led to a bitter and growing labor dispute, which is now centered in New York City. In 2021, the city workers Municipal Labor Committee, which is made up of leaders of the municipal unions, made a secret deal with former Mayor Bill de Blasio that in return for $600 million in increased wages for city workers, 250,000 retirees would be forced into Medicare Advantage programs through Emblem and other private insurers.
https://www.nyc.gov/assets/olr/downloads/pdf/health/ma-faqs-01-21-2022.pdf
Workers leaving the city and retiring in other regions would be forced to enroll in Medicare Advantage programs with far higher costs and less benefits.

Rather than fighting the billionaires who really run and own New York City, top city union officials decided that they could throw the retirees off their healthcare programs to fund raises for their working members. It has now blown up in their faces and has national implications.

When retired workers in different unions found out about this scheme, they began to organize union by union to get the retiree chapters to oppose this change and they also filed lawsuits to stop it. They also began rallies and lobbying NYC politicians to oppose the change and stay with their full Medicare coverage.
The New York City charter has so far helped win their lawsuits in the courts but many of these union leaders have targeted politicians who have opposed the Municipal Union Labor deal. The Organization of Public Service Retirees has been a key organizer of the fight in all the public union organizations in the City.

They have also learned that most of their union leaders from the Teamsters, AFSCME, SEIU and TWU were doing everything in their power to keep this privatization deal with the city.

New York City’s AFSCME District Council 37 (DC 37) is the largest public employee union in the city, representing about 150,000 members and 89,000 retirees and is led by Executive Director Henry Garrido. When the retirees’ chapter organized to support and fund lawsuits against the Medicare Advantage deal, AFSCME President Lee Saunders and Executive Director Henry Garrido took control of the chapter on the pretense that it had financial problems, and dropped its position against the Medicare Advantage deal.

Garrido and Saunders continue to support the insurance industry’s Medicare Advantage scheme. Some of the officials are even denying that their members will be hurt from these programs. TWU Local 100 President Tony Utano, who took over from former President John Samuelsen (now president of the entire TWU), continues to claim that TWU members in these Medicare Advantage programs will have the same benefits as the New York City Medicare program.

Meanwhile, a growing rebellion in the United Federation of Teachers has forced UFT President Michael Mulgrew to oppose the Aetna Medicare Advantage program that he had pushed along with the rest of the MLU officials.

Mulgrew’s flip-flop came in June, after his election slate faced a complete collapse in support. Retirees, who are able to vote in the UFT elections, vented their anger on Mulgrew’s support for the Aetna Medicare Advantage programs. A retiree caucus called Retiree Advocate, backed by The Organization of Public Service Retirees, won 63% to Mulgrew’s Unity Caucus slate and Mulgrew and his other supporters could have lost their positions when top officials come up for election in 2025.
At this point, Mulgrew changed his position, sending a letter to MUL President Nespoli, in which he wrote: “It has become apparent that this administration is unwilling to continue this work in good faith. The city has delayed our current in-service and pre-Medicare retiree healthcare negotiations for months, and we no longer feel that it is in the interest of our members to be part of that process. This administration has proven to be more interested in cutting its costs than honestly working with us to provide high-quality healthcare costs to city workers.”

Mulgrew is a protege of AFT president Randi Weingarten, the former leader of the UFT. His support has been critical in keeping the MUL in support of this scheme to privatize healthcare plans for New York City workers. The position of the union leaders has also enabled a push by Mayor Adams to force all New York City workers to accept Medicare Advantage.

AFT president Randi Weingarten has been a major national opponent of Medicare For All. When it came up in 2016 at the National Democratic Party Convention, she voted to oppose a resolution for Medicare for All as a National Democratic Committee member.

The support for corporate insurance companies is directly connected to the MLC, who are pushing Medicare Advantage. The leadership of the MLC also lobbied in the New York legislature to prevent a vote on the New York Health Act, a piece of single-payer legislation. New York became the second large state with a Democratic legislative supermajority to block an up-or-down vote on single-payer healthcare.

MLC chair and Teamster Local 381 leader Harry Nespoli wrote to House Speaker Carl Heastie opposing the legislation: “For over 50 years, the MLC has bargained healthcare matters with the City and other NYC-based employers. We are proud of the programs we have developed—which provide quality care without any contribution to premium for either actives or retirees.” Gregory Floyd, who is president of Teamsters Local 237 and Secretary of the MLC, is also on the board of EmblemHealth, as are other officials in the AFL-CIO.
Today, Medicare Advantage is being pitched as a private alternative to traditional Medicare with the active support of the AFL-CIO. In 2023, nearly 31 million Medicare beneficiaries—or 51%, of the eligible Medicare population—are enrolled in a Medicare Advantage plan.

Nearly $5 trillion was spent on healthcare last year in the US—about 20% of US GDP. United Healthcare is the top employer of doctors in the US and the fourth largest company in the country by revenues. It has captured a significant part of the healthcare industry in a further monopolization through a vertical structure control from bottom to top. Medicare Advantage has been a key factor in the further privatization of the US healthcare system.

A recent strike by Unite Here Local 2 in San Francisco has focused on the attack on healthcare benefits. The hotel companies wanted to eliminate a union healthcare plan and turn this plan over to the Marriott, Hyatt and Hilton plans. The strike ended after 93 days when the union threatened to have a mass picket at the J.P. Morgan Healthcare Investors conference in San Francisco on January 13 at the Marriott owned St. Francisco hotel. Their fear was that a mass labor community protest at this investor’s conference could unite a massive campaign against the entire insurance industry, which is hated by millions. The conference, which is the largest in the world, is set to bring together over 8,000 investors and speculators in healthcare to San Francisco.
https://www.businesswire.com/news/home/20241209218007/en/UNITE-HERE-Hotel-Workers-Call-on-J.P.-Morgan-to-Cancel-2025-Healthcare-Conference-in-San-Francisco-as-Strikes-Affect-27.5-of-Citys-Hotel-Rooms

The conspicuous silence by Liz Schuler and the AFL-CIO about this recent development is a sign of their fear of the growing rage in the United States against this sick murderous system of privatized healthcare. They have reason to be fearful, as they are embedded in this very system themselves.


The allegiance of the AFL-CIO leadership to business unionism and to the insurance industry is a key obstacle in the United States to getting the insurance industry out of healthcare. Today, it takes 1.4 million workers employed by the insurance industry to deny healthcare to people in the United States in order to increase the profits of the insurance companies and investors.
In 2021, through the Union Plus program, Trumka and the AFL-CIO launched a new retiree healthcare program in partnership with Anthem and the AFL-CIO Mutual Benefit Trust. Trumpka wrote to unions that “Our goal is to make these plans simple and streamlined for your organization to implement, while delivering exceptional value and rich benefits to your retirees at the same time.” This collusion with the insurance industry has been continued by AFL-CIO president Liz Schuler with a partnership with Emblem insurance company and United Healthcare. https://aflciohealthandwelfarefund.org/wp-content/uploads/2023/09/SPRJ82306_2024PY-AFL-CIO-HW-Meeting-Schedule_FINAL-002_one-Page.pdf
While the AFL-CIO leadership talks about defending American working people, they are actually helping further the privatization of Medicare. Under the Trump administration and Project 2025, there will be a full press campaign to completely destroy and privatize Medicare and Medicaid and turn them over to United Healthcare and the rest of corporate profiteers.
Union officials in the United States are also embedded in the privatized workers compensation system, with some union officials sitting on insurance company boards that administer workers’ compensation. They also personally benefit from limiting the compensation of their injured members by colluding with the insurance industry in deciding what the benefits are. This corporate collusion is another example of how the ideology of business unionism has harmed workers in the US and around the world.
In California, the former SEIU 2015 president April Verritt, who is now the national president of the SEIU, opposed a single payer plan in the legislature. The California State SEIU Council, with more than 700,000 members, joined with Governor Gavin Newsom in dumping legislation that would have pushed a single payer program. Under Trump, their members will face a massive drive to privatize public healthcare alongside a drive to destroy all public unions in the United States.
The Democratic National Convention highlighted this corporatization of labor. Harris raised over $1 billion from many of the same capitalists and insurance companies who are privatizing the economy. Most of the trade union leadership of the AFL-CIO were on board with the program of Harris and the Democratic Party, which included continued privatization of the Medicare system through Medicare Advantage.
The United Electrical Workers Union is now urging trade unionists to begin steps to build a labor party that would have a program of public control of the healthcare system. This issue will grow as millions of trade unionists and workers see their healthcare and labor rights destroyed in front of their eyes. https://www.ueunion.org/ue-news/2024/general-executive-board-build-a-labor-party-to-unite-the-working-class
A Labor Party could also fight the privatization of public jobs and services in the United States, which the Democratic Party is part and parcel of. Notably, this call is being welcomed by the Democratic Socialist of America’s new leadership, which has called to finally end that organization’s decades of support for the Democrats.
Unlike the national unions in the US, some public unions in Canada have taken up a national political education campaign against privatization of public services. The Canadian Union of Public Employees (CUPE) has had a national education campaign for years to fight privatization and right-to-work laws pushed by Wal-Mart and other union-busting corporations. https://cupe.ca/privatization
Major public sector unions like AFSCME, SEIU, AFT, NEA, NALC, IFPTE and the Teamsters have ignored the drive for privatization, because opposing privatization and deregulation would mean a direct fight against the Democratic party.
Another major part of privatization has been the AFT and NEA’s national support for charter schools if they are “union.” This has led to a two-tier public education system. The privatization of public services throughout the US is also being pushed by the funding of nonprofits to take over the jobs of public workers throughout the US economy. These non-profits, like charters, undermine pay, pensions and benefits and help weaken the labor movement and destroy public services.
One of the goals laid out in the fascistic Project 2025 is to eliminate public unions, public services and public education. The SEIU, along with most other public unions, has refused to launch any national campaign against privatization and has failed to educate their members about the real agenda of Project 2025.
Millions of working people are rightly angry about the profiteering of the healthcare and insurance industry, which routinely denies needed medical treatments and is destroying what is left of public healthcare for the benefit of the billionaires. Workers now need to bring their union officials to account for their years of helping facilitate this pernicious destruction of our public healthcare system, public services and public education.

Steve Zeltzer is the producer of WorkWeek Radio and a member of Pacifica Media Workers Guild - CWA and with United Front Committee For A Labor Party