The tragedy surrounding UnitedHealthcare has brought renewed focus on cost barriers within the health care system.

A group of Minnesota unions said a nonconfrontational but organized front paid off in recent talks to limit cost hikes for members.

This fall, unionized state workers in northwest Minnesota, who receive care through Essentia, were notified the provider would increase out-of-pocket expenses Jan. 1. In a tiered system, they would move from Level Two to Level Three.

Amanda Stegmaier, information technologist at Minnesota State University-Moorhead, said she was caught off guard, noting the change could have boosted co-pays by roughly $30 per visit.

"I was personally looking at supplemental health insurance," Stegmaier explained. "What could I do to stay at a lower cost level, because being a single mom and one-income household, there's only so much money that goes around."

Stegmaier, a member of the Minnesota Association of Professional Employees, urged colleagues to contact Essentia about the situation. Regional members of other unions like the American Federation of State, County and Municipal Employees did too, and the coalition convinced the provider to keep the cost hike temporary. It goes back to Level Two March 1. Stegmaier acknowledged the issue will likely resurface a year from now but a strong unified message can have an effect.

State employees have the benefit of union negotiators but those involved said voices working together, no matter where their insurance comes from, and can reasonably articulate the plight of health consumers might be able to turn some heads.

Adam Kamp, business agent for the Minnesota Association of Professional Employees, feels it is a key strategy in the current landscape.

"Health care's becoming increasingly corporate, we're seeing more mergers, more buyouts," Kamp observed. "In that instance, it took peaceful, collective action in order to pressure the provider to do the right thing."

Stegmaier stressed keeping costs in check is important in her part of the state, because it allows members to keep going to the clinics that work best for them.

"Good health care in this area is hard to come by," Stegmaier emphasized. "When you find your care team that you're happy with, you wanna stick with them."

After five days of Oregon's largest health-care strike, including the state's first doctors' work stoppage, Providence Health announced it is ready to return to the bargaining table. The Oregon Nurses Association is calling for competitive wages and resolution of what it calls systemic, unsafe staffing issues.

Kathy Keane, a nurse at Providence St. Vincent Medical Center who has been on the picket line, said Providence needs to focus on recruiting and retaining skilled staff.

"I want to work with the best of the best. And when we are the lowest-paid caregivers in the Portland metro area, it's hard to argue why people should come here and stay here long-term," she explained.

Providence said it is ready to return to the bargaining table, thanks in part to what it calls an "unprecedented number" of union nurses who have chosen not to strike. Earlier this week, Providence filed an unfair-labor-practice complaint, saying the nurses' association unlawfully delayed bargaining by refusing to meet and not responding to proposals in a timely manner.

A recent poll conducted by the Oregon Nurses Association found more than 90% of patients reported a negative experience with Providence, and support the strike.

Laura Wadlin, a Providence patient since she was a kid, said has had many discouraging experiences with rushed providers.

"Every time I go back, my fears are only confirmed, so that really reinforces the inclination not to even try," she said.

Keane and other union members are also concerned about acuity, or the level of care that a patient needs based on how sick they are. Keane said she wants nursing assignments tailored more towards patient need, rather than focusing on a staff-to-patient ratio, and said this issue is not unique to St. Vincent.

"This is something that system-wide we've seen issues with, so we know that systemic issues need systemic change, and that's really what we're working towards," she continued.

Providence said it is committed to following Oregon's staffing law, and is taking acuity into account. The nurses' association says 305 unsafe staffing complaints were filed against Providence in 2024.

A fiscally conservative advocacy group is pushing for the renewal of President-elect Donald Trump's Tax Cuts and Jobs Act.

Americans for Prosperity launched a $20 million nationwide campaign earlier this week, urging Congress now is not the time for more taxes.

Andrea Moreno, executive director of Honest Arizona, said it comes at too high a price. She contends big corporations and the wealthy do not pay their fair share, which is why her organization is educating voters about the tax code's consequences.

Moreno stressed Trump's tax code would affect funding for such priorities as public education, access to health care and other safety net programs in Arizona and across the country.

"Cutting assistance like SNAP and WIC -- and as a mother, that is something that means a lot to me -- that would be detrimental for mothers and children as well," Moreno pointed out. "The ACA is another one, and making changes to Medicaid, which would definitely impact a lot of seniors."

Americans for Prosperity said if Congress isn't able to renew the measure, millions of Americans will have to pay an extra $1,500 or more in taxes next year. They project Arizonans could face an even steeper increase and face an extra $2,700 in 2026.

Moreno noted while Republicans have argued the plan will lead to economic growth, she disagrees and believes things like state and local public spending could be put in jeopardy.

Trump has proposed a number of tax policy changes, including cutting the maximum corporate income tax rate to 21%, redesigning international tax rules and providing a deduction for pass-through income. Such proposals would, on average, lead to a tax cut for the richest 5% of Americans and a tax increase for all other income groups, according to the Institute on Taxation and Economic Policy.

Moreno argued it does not make sense.

"It is disproportionately helpful for the wealthy and not for people who actually need it," Moreno stressed.

Moreno encouraged Arizonans to get educated on the possible changes and to reach out to their elected officials to express their opinions on the tax code. She added it is important for democracy for everyone to make their voice heard.

"Your local politicians are really instrumental in some of these things," Moreno emphasized.


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Michigan's tipped wage system is on the brink of extinction, with changes set to take effect next month after a state Supreme Court ruling last year mandated higher wages for tip-reliant workers.

The ruling will eliminate tipped wages below minimum wage and raise the state's minimum wage to more than $12 per hour.

Justin Winslow, president and CEO of the Michigan Restaurant and Lodging Association, said the almost 250% increase in the wages of tipped workers would be catastrophic and he said it is happening at the worst possible time, as inflation hits his industry more than others.

"You add that difficult environment to this new policy and you have the recipe for the loss of 60,000 restaurant jobs in Michigan and the closure of one in five full-service sit-down restaurants in Michigan," Winslow contended. "When I say catastrophic I think that's what we mean."

Supporters of the change argued it ensures fair pay and reduces income instability for tipped employees, who can face unpredictable earnings. Tipped wages are set to be phased out Feb. 21.

Winslow pointed out servers are currently earning around $30 an hour, with some making even more, all while enjoying flexible schedules. He emphasized roughly 80% of workers want to preserve the current system. On a positive note, Winslow noted bipartisan efforts are in motion, with similar bills from both parties set to be discussed in a hearing today, to protect tipped wages.

"The new House leadership seems to be making it a real priority to try to get something done in advance of February 21st, so we'll be front and center there making sure they understand and hear from the voices of impacted restaurant workers and restaurant owners."

The Michigan Restaurant and Lodging Association warned as many as 60,000 jobs could be in jeopardy if businesses are required to eliminate tipped wages.


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