Supporting Health Care Affordability While Strengthening Union Labor and Our Communities

An Educational ULA Network Policy & Public Affairs Blog

At the Union Labor Advisory Network (ULA Network), our mission is clear:
Support. Educate. Promote.

We support union members and their families.
We educate communities on policies that impact working people.
We promote solutions that strengthen union labor and long-term economic stability.

Today, one of the most urgent issues facing union households is health care affordability.

The Health Care Affordability Crisis

Premiums rise when care and medication costs climb — and both are higher than ever.

Recent data cited in the Blue Cross Blue Shield Association (BCBSA) 2025 Affordability Solutions for the Health of America report and supporting actuarial analysis from Harmonic Consulting, Dare Actuarial Consulting, and Helse Consulting Group (2025) outlines the scope of the challenge:

• Medical prices have grown 40% faster than inflation since 2000
• Drug spending increased 10% in 2024
• Hospital administrative costs have outpaced clinical cost growth
• Roughly 80% of hospital markets are highly consolidated
• Patients increasingly require more intensive and specialized care

The result?

• Higher premiums for union health plans
• Increased out-of-pocket costs
• Families delaying care
• Workers rationing medications
• Reduced discretionary household spending

For union benefit trustees, fund administrators, and collectively bargained health plans, this is not theoretical — it directly impacts contract negotiations, employer contributions, and long-term fund solvency.

A $1 Trillion Roadmap to Affordability

According to BCBSA’s 2025 policy framework, the proposed affordability solutions could deliver approximately $1 trillion in savings over time through structural reforms focused on:

• Competition
• Transparency
• Prescription drug reform
• Value-based care
• Telehealth modernization

The ULA Network shares this information as part of our educational mission to help union leaders, trustees, and members understand emerging policy discussions affecting benefit funds and working families.

1. Restoring Fairness in Hospital Pricing

The Challenge: Hospital Consolidation & Price Markups

Economic research cited in the BCBSA report indicates:

• Hospital consolidation can raise prices by approximately 20% on average
• Services billed as hospital outpatient departments (HOPDs) may cost up to 3x more than the same service delivered in a physician office
• Corporate hospital systems increasingly use “all-or-nothing” contracting and anti-tiering clauses

Proposed Policy Approaches (BCBSA 2025 Report)

• Expand site-neutral Medicare payment policies
• Increase billing transparency through separate National Provider Identifiers (NPIs)
• Strengthen FTC oversight of anticompetitive hospital consolidation
• Prohibit anti-competitive contracting practices

Projected 10-year savings from these reforms:
$484 billion + $10.8 billion + $78 billion (various reforms combined)

For union plans, these reforms could mean:

• Lower negotiated hospital reimbursement rates
• More predictable trend growth
• Protection against excessive cost shifting

2. Addressing Prescription Drug Costs

Prescription drug affordability remains one of the most pressing concerns for union members.

Identified Issues (BCBSA 2025 Report)

• Patent “thicketing” to extend monopolies
• “Pay-for-delay” settlements
• Product hopping to avoid generic competition
• 12-year exclusivity periods for biologics
• Tax deductions for direct-to-consumer drug advertising
• Oversight concerns within the 340B program

Proposed Legislative Concepts Cited

• Affordable Prescriptions for Patients Act
• Drug Competition Enhancement Act
• Preserve Access to Affordable Generics and Biosimilars Act
• Biosimilar Red Tape Elimination Act

Projected drug-related savings over 10 years:

• $53 billion (anti-competitive reforms)
• $134 billion (shortened biologic exclusivity)
• $137 billion (ending DTC ad tax deductions)

For collectively bargained plans, lower drug trend means:

• Greater ability to preserve benefits
• Reduced pressure during contract negotiations
• Increased sustainability of retiree health plans

3. Promoting Value-Based Care & Efficiency

Many providers are still reimbursed based on volume of services, not quality or outcomes.

The BCBSA framework promotes:

• Mandatory participation in two-sided value-based contracts (VBCs) for Medicare and Medicare Advantage providers
• Expansion of multi-payer CMMI models
• Greater transparency in hospital administrative costs
• Permanent removal of outdated telehealth restrictions

Projected savings:

• $54 billion (value-based care expansion)
• Additional efficiencies through administrative transparency and telehealth modernization

For union members, this aligns with:

• Better outcomes
• Improved preventive care access
• Reduced avoidable hospitalizations
• Expanded rural and underserved access via telehealth

Why This Matters to Union Labor

Union health and welfare funds are among the most comprehensive and well-managed benefit systems in the country. However, they are not immune to:

• Market consolidation
• Pharmaceutical pricing power
• Regulatory shifts
• Cost trend acceleration

When premiums rise, the impact is shared:

• Employers face higher contribution requirements
• Trustees must make difficult design decisions
• Members may face higher co-pays or deductibles
• Bargaining leverage can be strained

Health care affordability is therefore a labor issue, an economic issue, and a community issue.

ULA Network’s Role: Support • Educate • Promote

The ULA Network does not endorse specific legislation or lobby on behalf of policy proposals. Instead, we:

• Provide educational awareness on major health policy developments
• Highlight research from credible industry organizations
• Connect union leaders with healthcare stakeholders
• Promote transparency and informed dialogue

We work alongside healthcare organizations, including national carriers and regional plans, to help union members better understand available resources and cost-management strategies.

Through podcasts, educational media, policy summaries, and stakeholder roundtables, we aim to:

• Equip trustees with timely information
• Empower members with knowledge
• Encourage data-driven dialogue
• Strengthen community health outcomes

Aligning Healthy Members with Healthy Unions

Healthier members mean:

• Reduced absenteeism
• Lower long-term plan costs
• Stronger workforce participation
• More resilient communities

Affordable, transparent, high-quality care supports:

• Collective bargaining stability
• Multiemployer plan sustainability
• Economic development across union communities

When healthcare policy promotes competition, transparency, and value, union families benefit.

Educational Attribution & Sources

This blog references publicly available policy proposals and economic estimates from:

• Blue Cross Blue Shield Association (BCBSA)
  2025 Affordability Solutions for the Health of America
• Economic modeling and analysis prepared for BCBSA by:
  Harmonic Consulting
  Dare Actuarial Consulting
  Helse Consulting Group (2025 Report)
• Centers for Medicare & Medicaid Services (CMS) site-neutral policy updates (2025 Final Rule)

Readers are encouraged to review the full BCBSA report and related legislative materials for comprehensive details.

Final Thought

Health care affordability is not just a policy debate — it is a working family reality.

At the ULA Network, we remain committed to:

Supporting union members
Educating our communities
Promoting solutions that strengthen working people

Because strong health systems help build strong unions — and strong unions build strong communities.

The ULA Network is dedicated to honoring the strength and solidarity of union labor by educating, connecting, and empowering individuals through shared experiences, opportunities, and support. Our mission is to uplift families and communities by promoting the value of union careers, economic development, and workforce resilience. Through collaboration and storytelling, we aim to build a future where every person understands the power of unity, dignity in work, and the promise of a better tomorrow. http://www.ulanetwork.com  Subscribe to the ULA Network for more interviews, insights, and inspiration about union labor, skilled trades, and the opportunities waiting for you in the construction industry!

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