By Mark Gruenberg
PAI Staff Writer

WASHINGTON (PAI) – Union leaders cheered the U.S. Supreme Court’s decision on June 29 upholding the comprehensive national health care law.  But the National Nurses United, which sent a visible contingent to join the crowd outside the court, said the justices’ 5-4 ruling would not stop NNU’s drive for universal government-run single-payer national health insurance, also known as Medicare for all.

And, deep in his statement praising the court, AFL-CIO President Richard Trumka advocated that, too.

The court majority upheld the key section of the law, which Democratic President Barack Obama maneuvered through the then-Democratic Congress on party-line votes in 2010.  After much bargaining and some Obama arm-twisting, labor swallowed its opposition to taxing so-called high-value health insurance, starting in 2018.

The key section the court upheld is the law’s order to buy health insurance, or, if people refuse, to pay an extra tax, via the IRS, to cover the uninsured.  The law does not flatly force people to buy insurance, Chief Justice John Roberts wrote for the court majority.  But the practical effect of the law and the court’s decision, experts said, is given the choice between buying insurance or paying extra to the IRS, a majority will buy insurance.  One expert estimated only 4 million people would decline to buy.

Union leaders hailed that either-or choice, and the court’s reaffirmation of the law, as the way to expand health insurance coverage for millions, though not everyone.

The ruling “means we can continue moving full speed ahead to implement and build upon” the law, said AFL-CIO President Richard Trumka.  “We have no illusion the destination has been reached, and we are more committed than ever to the hard work necessary to achieve our dream of quality health care for all.”

He particularly praised the court for letting 105 million people benefit from the law’s elimination of lifetime limits on insurance coverage, its elimination of the “doughnut hole” in seniors’ prescription drug coverage and its decision that “insurance companies will not be able to deny coverage due to pre-existing conditions, charge women more or drop coverage for those who get sick.”

But he also warned states must establish exchanges, as the law requires, to help cover the uninsured.

Then he suggested something better: “A simple indisputably constitutional solution is to allow Americans of all ages to buy into an improved Medicare program.  We believe every baby in America – whether rich or poor – deserves the same standard of quality care, and we will keep moving forward until we make this a reality.”

IBEW General President Edwin Hill said “the Supreme Court’s 5-4 decision to uphold Affordable Care Act is an historic victory for all those committed to achieving affordable and comprehensive health care coverage for every American.

“While we may not agree with every aspect of the Affordable Care Act, it is a substantial reform that is already benefiting millions of Americans by expanding health care coverage, reducing costs and protecting the American consumer from insurance industry abuse.

“President Obama’s health care plan, while far from perfect, has already made real progress in reducing medical inflation and guaranteeing more Americans access to quality health care. By upholding the law, the Court has made a vital step toward solving our health care crisis and bringing some balance back to the economy.

I hope this ruling brings to an end the Republicans’ quixotic quest to turn back the clock and undo health care reform, and focus Capitol Hill’s attention on job creation and reviving an economy that works for everyone.”

Several union leaders, including Trumka, Steelworkers President Leo Gerard and Service Employees President Mary Kay Henry, not only praised the court but also said the GOP, including presumed presidential nominee Mitt Romney, wants to go backwards and make it harder and more expensive for workers to get health care.

“For more than two years, Republicans like (House) Speaker John Boehner, Rep. Paul Ryan and Romney have put their political careers ahead of working Americans struggling to afford and keep their health care,” Henry said.  “Insurance companies and corporate insiders spent millions to take away the benefits of the law.  The court rejected their cynical approach and working people won a resounding victory.”

National Nurses United, however, vowed to continue its campaign for single-payer government-run health care.  That came from both its official statement from co-president Jean Ross and in interviews with activists holding their big “Medicare For All” banner in front of the court.  NNU was the sole visible group of unionists among the thousand-plus people jamming the plaza, though several SEIU staffers were there, too.

The Affordable Care Act, aka ObamaCare, offers a number of new elements of new health care coverage. Many of the individual elements are more popular than the entire law:

• Expanded coverage for preventive care and screenings;
• New options for people with pre-existing conditions;
• Lowered costs for people in the Medicare Part D “Doughnut Hole”;
• Greater consumer protections against insurance cancellations;
• An end to lifetime limits on health insurance coverage;
• Expanded coverage for adult children up to age 26.