Hillary Clinton's Nevada union foes eye repeal of PPACA 'Cadillac tax'

When Clinton and her further-left rivals Martin O'Malley and Bernie Sanders address the Nevada AFL-CIO (each will deliver a speech, closed to media, without taking questions), Cancela wants to hear it discussed. "It seems to me like it would be foolish to not address it with this crowd," she says.

The excise tax is a long-time sticking point for organized labor, which pushed hard for President Obama's election and for passage of PPACA. Like the Trans-Pacific Partnership and the Keystone pipeline – two other issues where unions are trying to pin Clinton down—it's divisive among Democrats.

"After decades of fighting for it, we're finally moving towards a more rational, efficient health care system," Jared Bernstein, a former chief economist to Vice President Biden and current senior fellow at the liberal Center on Budget and Policy Priorities, wrote last month in a Washington Post essay defending the tax, which he said would help control costs, and keep the bill from increasing the deficit, all while initially hitting few employees. "Let's not screw that up."

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That plea didn't persuade UNITE HERE president D. Taylor. "Shifting costs to families that already can't pay their bills is not the same thing as holding down costs, and certainly doesn't control them responsibly," Taylor, who helmed the Culinary during the 2008 caucus, wrote in a rejoinder at the Huffington Post.

So far, the Democratic field is echoing unions' concerns, but not embracing any specific solution. In a questionnaire submitted to the American Federation of Teachers before winning its endorsement, Clinton said she was "examining" the tax, and that, "As currently structured, I worry that it may create an incentive to substantially lower the value of the benefits package and shift more and more costs to consumers."

In a Monday e-mail, Clinton spokesman Jesse Ferguson told Bloomberg that the Democratic front-runner "continues to seek ways to strengthen and improve PPACA, including examining concerns that many workers have with the so-called 'Cadillac' tax." He said she "supports the intention of trying to get health care costs under control" but also "believes we shouldn't put cost containment on the backs of consumers and workers."

In an answer a questionnaire for the Laborers International Union of North America, Sanders cited his proposal during the PPACA debate to use a surtax on millionaires instead of a "Cadillac tax," and said he's working on a solution in the Senate. "The challenge will be narrowly crafting legislation that provides relief to union members, while not giving another tax break to high-earning corporate executives," he wrote.

In an AFL-CIO questionnaire submitted July 2, O'Malley said it was necessary to "consider necessary changes" because the tax "may affect far more people than expected and make it more difficult for individuals to get important, comprehensive medical coverage."

Clinton, who's been endorsed by two national unions so far, is expected to land several more over the next few months, though the AFL-CIO itself could hold off until the primary is effectively over. Cancela predicts that the fortunes of Congressman Courtney's bill will affect when her union decides to endorse. (As in 2008, a formal endorsement would originate with the national union, but as representative of about a fifth of UNITE HERE's members, the home local of its current president, and a top player in an early caucus state, the Culinary has substantial sway.) UNITE HERE affiliates have sometimes frustrated allies by backing front-runners, like Chicago's Rahm Emanuel, against more liberal challengers.

For now, says Cancela, there's "a lack of urgency" from Culinary members about getting behind a candidate. "There's so much time before election day."