On Thursday, in a packed conference room on the first floor of the statehouse, Trenton’s top Democrat and figure most associated with big labor in the state unveiled his latest legislative endeavor: a new concept to deliver more “patient-centered” healthcare to tens of thousands of New Jersey public sector workers. Clad in dark suit and yellow tie, Senate President Steve Sweeney (D-3) described the concept in his usual characteristically candid and plain-spoken way, calling it a more “personalized” approach to healthcare in the state, like the kind he “had as a young man.” It would “actually improve care, and reduce costs,” for workers and physicians alike, he said.
Most importantly, though, it would save the state a ton of money as it battles an unruly pension and benefit system. “We’re looking at a new concept to deliver healthcare, one that helps the workers with better health and a better life, and also helps the taxpayers. That’s the win-win,” Sweeney said.
There were others, too, in the room to help Sweeney push the issue. Behind him, to one side, stood a motley crew of practicing physicians who took turns at the mic describing how, under today’s fee-for-service healthcare model, they felt like victims on an endless “hamster wheel”, and how patient-centered care allowed them to return to affecting real change in the lives of patients (the “reason why I got into this business,” said one). To the other side stood a scrum of broad-shouldered labor leaders, figureheads of groups from the AFL-CIO to the New Jersey Education Association to the Communications Workers of America, who praised the program for promising to reduce out-of-pocket healthcare costs at a time when they sit at an all time high.
For political observers in the room that day, it was this group that stole much of the spotlight, despite the more passionate accounts offered by the doctors who’d actually need to take on the burden of the new program (burden, because the program’s cost-savings for the state comes through asking physicians to participate voluntarily). “The concept before you this afternoon really has the potentially to be a sea change,” said Eric Richards, a lobbyist for the AFL-CIO.
“We commend Senator Sweeney on this issue and support his cause as we continue to move forward,” added NJEA secretary-treasury Sean Spiller.
THE PICTURE OF Sweeney and public labor standing shoulder-to-shoulder to advance the same initiative last week was important, not solely because the latter’s support will likely be instrumental in bringing the plan to fruition. It was also, after all, the first time in nearly four years the two forces — Sweeney and the Senate Majority office and public labor unions like the NJEA — had partnered on such a big-ticket item.
Political observers will recall well the falling-out Sweeney, a one-time iron worker and darling of public and private sector labor alike, had with organizations on this side of the labor fence. In 2011, swept up in feelings of partisanship-busting and productivity the then-newly-minted Republican governor had brought to Trenton, the top Democrat joined forces with Chris Christie on a plan to reform the state’s sizable and chronically underfunded pension and benefit system, bringing to heel runaway costs and neglected payments by governors going back over a decade. Under the new agreement, workers would have to contribute more to the system, but the state would finally pay its fair share.
Of course, that’s not how it ultimately played out. Christie rescinded on the agreement, opting instead to cut $2.4 billion in scheduled pension payments in favor of plugging a gaping state budget shortfall. The washout put the state back in the predicament it was before, and is now, drawing the outrage of millions of public sector workers and union bosses who saw their livelihoods jeopardized as a result. Much of that outrage found its target in Sweeney, in their eyes a labor champion-turned-Trenton insider who had bought in to Christie’s false promises and got little to nothing to show for it.
Since then, the need for Sweeney to find his way back into the good graces of these public labor unions has been great. It’s also likely never been greater, as the prospective gubernatorial candidate prepares for life post-Christie. “The big battle in 2017 is going to be for the Democratic base,” said Patrick Murray, director of the Monmouth University Polling Institute. “Sweeney has a ways to go to repair relationships with state public workers unions, and he knows it.”
Indeed, Sweeney himself seemed to implicitly note the significance of Thursday’s meeting, and stressed repeatedly the importance of having labor at the bargaining table. “That’s a big statement,” Sweeney said, pointing over his right shoulder to the group in the corner. “And hopefully the administration will not demonize labor, but will actually be willing to come to the table also.”
At least one bystander threw out the word “reunion”, referring to Sweeney and the public labor heads gathered in attendance. Others, however, speaking to PolitickerNJ in the days following the presser, rejected the characterization.
“This is all through the lens of there’s going to be some reuniting with Sweeney,” said one source present in the room Thursday who requested anonymity. “No, it’s not.”
Those on the public labor side involved in the deliberations over the new healthcare concept’s roll out in particular — as well as sorting out the pension and benefit mess in general — suggested that this latest partnership is one born out of convenience. As the state struggles to meet its pension liabilities, Christie’s answer has been continued cuts or more contributions from workers, forcing public labor unions and those in the legislature looking to curry their favor to search for their own solution. “For too long, negotiations over healthcare benefits have boiled down to who would pay for what,” said Spiller Thursday, later echoed by Richards: “This concept isn’t about cost-shifting, it’s about cost saving, and that’s why I think organized labor is excited about this program.”
Thus, labor leaders said this new patient-centered healthcare concept is a way to preserve some semblance of benefits in the face of state budget cuts and rising costs under the ACA. But it’s also a way to circumvent Christie, who they say has “stonewalled every step of the way” their efforts toward making healthcare reforms. “We finally realized that the governor’s side of the pension and benefit design committee will continually stonewall us on making any changes or even getting correct information,” said Patrick Colligan, president of the state Policeman’s Benevolent Association, referring to the evenly-split 12-member board created in 2011 to handle pension and benefit planning. “So we started thinking outside the box.”
Colligan said public unions’ meeting with Sweeney on the issue was almost coincidental — both had been working on parallel courses for “over two years” two come up with a new concept to offer more affordable healthcare to state workers. And with Christie’s pension and benefit commission report due out the end of this week, which many expect to conform to the cost-shifting rhetoric the Republican presidential hopeful has already employed in his dealings with the unions, they realized they needed to get ahead of the game. “It was really just a healthcare issue,” Colligan said, noting that “you can’t not have a relationship with the senate president.”
Colligan added that the initiative will likely require Christie’s stamp of approval — or at least the approval of a handful of the governor’s appointees on the 12-member design committee — to begin it’s roll out. He said he “hopes that somebody on that committee has the guts to see we really are trying to save costs.”
“[The administration] is only going to be interested in making us pay more and get less,” he said. “And we know that there are some options out there, and thankfully Senator Sweeney did too.”
“I would not read anything into this other than what it is,” said the other source, referring to the implication that the old tensions have been laid to rest with this new initiative.
But for Sweeney, it is, at the very least, a political opportunity. “He’s jumping in where there’s a lot of fear and uncertainty,” Murray said, “so it gives him the opening to mend some fences.”
IF THE NEW patient-centered healthcare plan is a play by Sweeney to win back public labor’s affections, not all are persuaded, however. Sweeney will have to do more, critics say, than that to earn their support — and even then, it’s unclear whether he’ll ever be able to fully rectify the past.
“It doesn’t replace that,” Lionel Leach, president on CWA Local 1039, said of the new healthcare initiative. “You can’t screw people over with their pensions and benefits and then try to put something in place that was only going to help 60,000 people. I don’t think this exactly makes up for that.”
While Leach said figuring out an alternative to rising healthcare costs is important, he’s skeptical of how much the program would actually accomplish, given the relatively sparse details offered so far. During the press conference Thursday, Sweeney and Mark Blum, Executive Director of America’s Agenda, said pilot programs will be rolled out in five different parts of the state, catering to at least $60,000 participating workers. It would encourage doctors to put quality over quantity of care by limiting the number of patients they see and paying them monthly rather than per visit. It would also reduce or do away with all together the pesky out-of-pocket costs that make regular doctor visits so off-putting for patients.
But for Leach, that still only makes up for a fraction of what they were promised — and never given — in 2011. “We were told that the [2011 reforms] would cure the pension situation,” Leach said. “Needless to say, it hasn’t.”
Political experts note that securing the support of figures like Leach and Local CWA 1039’s dozens of members will be essential for gubernatorial aspirants like Sweeney and Jersey City Mayor Steve Fulop in 2017, when a fierce Democratic primary is expected to take place after four years of Republican leadership. Those candidates are already making calculated moves to position themselves for that battle, Sweeney with initiatives like this one in Trenton and Fulop by building strategic alliances with North Jersey power brokers. Anyone who can more convincingly approach that base – including former Germany Ambassador Phil Murphy, who launched his own organization, New Start New Jersey, geared toward capturing the progressive vote — will bolster their chances two years for now.
In a sense, Leach is an early litmus test. And right now, he said, neither Sweeney nor Fulop nor Murphy is passing muster.
“Lionel Leach is looking for a candidate that has pure Democratic values. And the members of Local 1039 will be looking for a gubernatorial candidate with those principals,” he said. “And the party right now has Democrats that are not really Democrats at times. They waver on real Democratic issues and policies. And I don’t think people are going to be fooled with just ‘this is what I want to do.’ Your actions have to show more.”
In the end, Leach isn’t sure Sweeney’s latest act — or any, for that matter — can repair the bridges burned over the last few years.
“You work with the governor to try and do this. You work with public employees and say this is going to fix it, and it doesn’t fix it,” Leach said. “I don’t know how you overcome that.”