How to make health care affordable for more Rhode Islanders?

Look for the union label.

By Patrick Crowley and Karen Hazard, Rhode Island Current

The Rhode Island health care system faces a number of significant threats to its viability. In Washington, D.C., Congressional Republicans are proposing significant cuts to Medicaid spending, while locally, for-profit hospital owners are filing for bankruptcy protection and state leaders grapple with the fallout. As labor leaders, we share the concerns of many Rhode Islanders about the condition of our health care system. 

In our small state of just over 1 million people, over 50% of us are insured through either Medicare or Medicaid. In our hospitals, over 70% of patients are covered by public health care plans. That leaves only 25% of hospital patients covered by commercial insurance, well below our neighboring states of Massachusetts (30%) and Connecticut (29%).

What most Rhode Islanders might not know: The next largest group of insured Rhode Islanders get their health care from a union-negotiated health insurance plan, whether they are a union member or not. Even though there are about 9,000 unionized state employees, approximately 33,000 people are insured through union plans. It’s not only because of the dependents we cover, but also because our plan also covers non-union workers like managers and supervisors, as well as their families.

In the Ocean State, there are close to 15,000 unionized health care workers; so, not only are our members consumers of health care services, but we are also providers of health care. We have a vested interest in making sure our health care system is as strong as possible. That is why we believe all Rhode Islanders who are concerned about the state of our health care system should encourage more workers to join labor unions where they work. 

To us, increased unionization is a key component to a strategy ensuring every Rhode Islander has access to affordable health care services while simultaneously addressing a health care funding crisis that seems to get more precarious by the day. 

As a recent poll commissioned by the Rhode Island AFL-CIO found, there is strong public support for unions in the Ocean State, with more than eight in 10 Rhode Islanders agreeing that unions “are necessary to protect the working person.”

There are just over 500,000 Rhode Island based non-farm jobs in the state according to the Rhode Island Department of Labor and Training. About 80,000 of these jobs are protected by collective bargaining agreements. We know from sources like the U.S. Department of Treasury that not only do unions raise the wages of their members by 10 to 15%compared to similar non-union jobs, but that all workers in markets with a heavy union presence see economic improvements. On top of that, 96% of union members have employer- provided health insurance compared to just 69% of non-union workers. 

Now imagine there were 10,000 more union members in Rhode Island by the end of 2025. If the average wage paid to a Rhode Island worker averages $65,000 per year, and these workers, through collective bargaining, could increase their wages by 10%, that would mean the individual worker would see a salary increase of $6,500. In a state with just over 1 million people, that means an additional $65 million in economic activity, leading to increased tax revenues from income and sales taxes. 

It would also mean these 10,000 workers, and their dependents, would be much more likely to have commercial health insurance. This could equate to as many as 25,000 fewer people on Medicare, meaning our hospitals would receive adequate payments for the services they provide, instead of relying on low reimbursement rates from public health insurance plans.

Please don’t misunderstand our point of view. As trade unionists, we believe that in a perfect world, there would be some form of national health care system where every American’s health care would be provided for without concern for the cost to the patient and their family. But we don’t live in a perfect world, and Rhode Island is confronting a crisis today.

According to Rhode Island General Laws § 28-7-2, “…it is declared to be the public policy of the state to encourage the practice and procedure of collective bargaining.” This section of law refers not only to the public sector workers, but to those in the private sector as well. 

It is why the AFL-CIO refers to Rhode Island as a “labor state” and why, we think, we can use the power of organized labor to help address Rhode Island’s health care crisis. That is why we are calling on the collective leadership of the state — elected officials, business, community, and other civic leaders — to join with us during the next few months as the General Assembly debates next year’s state budget and encourage as many Rhode Islanders as possible to join with their coworkers and negotiate for better wages and benefits. The entire state of Rhode Island would be better off if more of our proudly working-class state were part of organized labor.

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Rhode Island Current is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Rhode Island Current maintains editorial independence. Contact Editor Janine L. Weisman for questions: info@rhodeislandcurrent.com.