Health Care Reform Articles - July 3, 2015

Medicare and Medicaid at 50

by The New York Times Editorial Board

Medicare and Medicaid, the two mainstays of government health insurance, turn 50 this month, having made it possible for most Americans in poverty and old age to get medical care. While the Affordable Care Act fills the gap for people who don’t qualify for help from those two programs, there are important improvements still needed in both Medicare and Medicaid.

At the time the two programs were enacted in July 1965, advocates of Medicare, which today covers 46 million Americans over the age of 65 and nine million younger disabled people, expected that it would expand to cover virtually all Americans. Although polls between 1999 and 2009 showed consistent majorities in favor of expanding Medicare to people between the ages of 55 and 64 to cover more of the uninsured, it never happened.

Still, its achievement in improving life expectancy and reducing poverty among the elderly has been enormous. Before Medicare, almost half of all Americans 65 and older had no health insurance. Today that number is 2 percent. Analysts say that between 1970 and 2010, Medicare contributed to a five-year increase in life expectancy at age 65, by providing early access to needed medical care. Even compared with people under age 65 who have insurance, those on Medicare are less likely to miss needed care or have unmanageable medical bills.

While Medicare, which covers hospital care, doctors’ services and prescription drugs, is comprehensive, many people are still left struggling to pay premiums, cost-sharing for various services and the full cost of items not covered by Medicare, like dental care and extended stays in nursing homes. Roughly half of all Medicare recipients live on incomes of less than $24,000 per person, and while the poorest of them get additional help from Medicaid, many do not. Medicare still lacks a cap on the amount a beneficiary has to pay out of pocket, the most basic function of insurance. By contrast, the Affordable Care Act puts limits on beneficiary spending per year and over a lifetime.

The Affordable Care Act has helped Medicare beneficiaries by eliminating co-payments and deductibles for preventive care like mammograms and colonoscopies, and by providing discounts for very heavy users of prescription drugs. It will strengthen Medicare as a system through demonstration projects to find new ways to deliver care that will improve its quality and lower its cost. The challenge will be to identify and spread the most promising innovations so that they benefit not just Medicare, but the entire health care system.

Medicaid, the other part of the medical safety net, is a joint state-federal program for the poor. For the past five decades, it has been critical in reducing childhood deaths and infant mortality. It has saved the lives of patients with chronic conditions like heart disease, diabetes and asthma. Last year it covered some 64 million people in a typical month and 80 million people at some point during the year. If Medicaid did not exist, life expectancy in America would be much lower.

The problem with Medicaid is that federal rules give states great leeway in deciding whom the program helps. Many states are so cheap that only extremely poor parents qualify for Medicaid coverage and childless adults are excluded entirely. Texas, for example, only covers parents who earn up to 15 percent of the federal poverty level, or less than $4,000 a year for a family of four, and does not cover other non-disabled adults at all, while other states, including New York and California, offer far better coverage. The result is huge differences across the country for assistance to poor, sick people.

The Affordable Care Act was intended to reduce this disparity by offering additional federal funding for states to expand their Medicaid programs to cover all adults up to 138 percent of the federal poverty level, or $32,913 for a family of four. Yet 21 states, the vast majority run by Republican governors, have chosen not to expand.

Medicaid could be improved by raising its payments to doctors, who often refuse to take Medicaid patients because the rates are so low compared to private insurance and Medicare. Medicaid should also cover legal immigrants, who currently have to wait five years to be eligible, and illegal immigrants, who are currently denied coverage entirely.

Despite the perennial fear that the costs of these two programs will grow uncontrolled, spending in both has been growing at a relatively modest rate in recent years. Medicare and Medicaid have changed and grown over the decades, through Republican and Democratic administrations, to meet new challenges. Their performance and popular support has allowed them to withstand ideologically-driven attacks on their continuance as government entitlements. These programs succeed, in fact, because they entitle all eligible Americans to receive the health care they need.

http://www.nytimes.com/2015/07/03/opinion/medicare-and-medicaid-at-50.html?action=click&pgtype=Homepage&module=opinion-c-col-left-region&region=opinion-c-col-left-region&WT.nav=opinion-c-col-left-region&_r=0

Opinion: Need more than Obamacare ruling

Kate Kanelstein

Last week the U.S. Supreme Court upheld subsidies for buying private health insurance in states with federally-run marketplaces or exchanges.

The court's decision has been an enormous relief for the millions of people who stood to lose access to coverage had the subsidies been revoked, and is seen as a vindication of Obamacare. However, many people with health care issues are asking whether it's time to move beyond Obamacare's market-based insurance system — in which subsidies ultimately flow to the big private insurance companies — and instead ensure that our public dollars go towards meeting the needs of our families and communities.

As in many other states, here in Vermont the rollout of the Affordable Care Act's health care exchange has only increased — rather than resolved — our continuing health care crisis, with the failure of private contractors to make the Vermont Health Connect website work resulting in health care uncertainty and unaffordable costs for tens of thousands of people in Vermont.

Our frustrations should be directed at CGI and Optum, the private, for-profit contractors hired by the state to roll out the VHC website, as well as the Shumlin administration for failing to hold these contractors accountable.

But we risk missing the forest for the trees if we don't acknowledge that the roots of the flawed VHC rollout lie in fact in the market-based approach of the Affordable Care Act, with its insurance industry-guided design, complete with tiers of coverage and eligibility restrictions. Rather than ushering in a new era of treating health care as a right and a public good for all, the ACA has enshrined a fundamentally unjust market-based system with different and unequal insurance products, different and unequal prices for health services, and different and unequal access to care.

If we are serious about universal health care, providing public subsidies for the purchase of private insurance products is just not going to cut it. The inequitable financing of health care contributes directly to the largest concentration of wealth in our country since the 1930s and the biggest income inequality gap since the late 1970s. Even with subsidies, low-income people pay proportionally much more for health care than the wealthy, for insurance plans that rarely meet all of our needs. One in three people in the U.S. struggle with medical bills, while insurance executives are raking in billion-dollar compensation packages.

In Vermont, many of us are bracing for another round of rate hikes, with Blue Cross/Blue Shield requesting an 8.4 percent rate increase for its 2016 Vermont Health Connect plans. Meanwhile, BCBS is paying its CEO, Don George, many times the average Vermont resident's salary, putting him (and many of their other executives) at the top of the state's 1 percent.

It's no big news to say that the healthcare system fails to meet our needs. But the long and short of it is that addressing the health care crisis is going to take more than fine-tuning the VHC website, or switching to Connecticut's exchange or the federal exchange. Thankfully, unlike other states struggling with the fiasco of implementing Obamacare, Vermont already has a clear path forward towards an equitably-financed, no-nonsense, universal healthcare system: Green Mountain Care. It is time for our state to start walking that path.

As the 2016 election season approaches, we can count on politicians to make all sorts of promises about how they'll address the issues impacting our communities. But for those of us with health care horror stories, or who've lost family members because they were denied the care they needed, we know that we can't afford to sit back and rely on politicians to do what's right. It's up to us to organize and ensure that decision-makers follow through with Act 48 and pass equitable financing for a universal, publicly-financed healthcare system that treats health care as a public good and a human right.

Kate Kanelstein of Burlington is lead organizer for the Vermont Workers' Center.

http://www.burlingtonfreepress.com/story/opinion/my-turn/2015/07/01/opinion-need-obamacare-ruling/29572101/?from=global&sessionKey=&autologin=

How to Talk About Dying

By ELLEN GOODMAN

 JULY 1, 2015 6:45 AM

I was 25 when I flew home for my father’s last birthday. His cancer had returned and he would die three months later at the age of 57. What I remember most about that weekend was the large rectangular gift box he opened. My mother had bought him a new suitcase.

I don’t know if that suitcase qualifies my family for the Denial Hall of Fame. There are so many contenders for that honor. But I’ve carried the psychic baggage over the years. I have never forgotten that image and how we lost a chance to say goodbye. I still wonder if my father was lonely in the silence that surrounded our inability to talk about what we all knew.

Decades later my mother began a long slow decline. By then, I was a newspaper columnist, a job that I often described as “telling people what you think.” I was professionally outspoken. But little had changed since my father’s death.

Yes, my mother and I talked about everything — but we didn’t talk about how she wanted to live toward the end. The closest we ever came to discussing her wishes was when she would see someone in dire straits and say, “If I’m ever like that, pull the plug.” But most of the time there is no plug to pull.

Gradually and painfully, my mother lost what the doctors call “executive function,” as if she were a C.E.O. fumbling with Excel spreadsheets, not a 92-year-old who couldn’t turn on the television or make a phone call. Eventually, she couldn’t decide what she wanted for lunch, let alone for medical care.

In some recess of my mind, I still assumed that death came in the way we used to think of as “natural.” I thought that doctors were the ones who would tell us what needed to be done. I was strangely unprepared, blindsided by the cascading number of decisions that fell to me in her last years.

http://opinionator.blogs.nytimes.com/2015/07/01/how-to-talk-about-dying/?action=click&pgtype=Homepage&module=opinion-c-col-right-region&region=opinion-c-col-right-region&WT.nav=opinion-c-col-right-region

What’s next for Obama and the Affordable Care Act now that the Supreme Court has ruled?

U.S. President Barack Obama (L) and Vice President Joe Biden walk back to the Oval Office after speaking about the Supreme Court ruling to uphold the nationwide availability of tax subsidies that are crucial to the implementation of the Affordable Care Act, at the White House in Washington June 25, 2015. 

By Moneytips.com, 

Posted July 01, 2015, at 7:49 a.m.
Last modified July 01, 2015, at 10:19 a.m.

Foes of Obamacare were dealt a major blow on Thursday. In a closely watched 6-3 decision, the Supreme Court concluded in King v. Burwell that the wording of the Affordable Care Act (ACA or Obamacare if you prefer) allows those signing up through the federal healthcare exchange access to subsidies. This had been called into question by plaintiffs in the suit and their supporters — which included Republican governors in Alabama, Georgia, Indiana, Nebraska, Oklahoma, South Carolina, and West Virginia — who held that wording in one section of the law could be interpreted as making subsidies available only through state exchanges. A ruling against subsidies through the federal exchange Healthcare.gov would have made insurance unaffordable again for approximately 6 million Americans, and almost certainly would have sent Obamacare into an unsustainable death spiral.

Worse for Obamacare foes, the ruling makes repeal more difficult in another way. Chief Justice John Roberts, writing for the majority, suggested that the so-called “Chevron Deference” did not apply to this case. Named for a 1984 Supreme Court case, the Chevron deference states that ambiguous wording in a law should be a matter for the regulating agency to work out in the implementation. Roberts argued that the tax credits are of such central importance to the law that the issue was not one for the IRS to interpret but for the courts to decide.

By removing the ambiguity issue, the Court has made it more difficult for a Republican president to thwart Obamacare through the use of executive powers on regulation and enforcement. Repeal now requires signed legislation passing both houses of Congress, and the longer Obamacare is in place, the more difficult it will be for any fully Republican government to replace it with an alternative.

There will still be plenty of media blather and political posturing, but like it or not, Obamacare is here to stay. Now what happens? One likely result is the relatively rapid demise of the state exchanges in favor of the federal exchange.

Supremacy of the Federal Exchange

After an undeniably difficult start, Healthcare.gov managed to get its footing and is now operating with far less problems. That is not the case for state exchanges. Even the success stories are having difficulties — Washington’s and Minnesota’s exchange are experiencing “substantial information technology problems” according to the New York Times — and the Washington Post reports that almost half the states are dealing with financial difficulties.

As more of the financial burden falls on state exchanges, and by extension state governments, most states are likely to say, “Why bother?” Now that the Supreme Court has opened subsidies to all qualifying US residents regardless of where they live, expect the state exchange to be a rare sight down the road.

Hospitals, insurers benefit from the decision

We can also turn our attention to how well the law is working on both the care level and the financial level. The major intent of Obamacare was to increase health coverage for all by partially subsidizing insurance for poorer and sicker Americans, and spreading the risk throughout the healthy in a controllable form. Recall that a pivotal point of the initial Supreme Court decision was that Obamacare is effectively a tax, via the mandated coverage with penalties for failure to comply.

Certainly, it has succeeded in increasing the rolls of the insured. According to the National Center for Health Statistics, 8.8 million Americans that were previously without insurance acquired coverage in 2014, representing a 20 percent drop in the uninsured. This shouldn’t be a surprise to anyone, given that the law is a mandate for health coverage.

On the financial front, the Obamacare news seems to be positive as well. Investors sent health care stocks soaring after the ruling, particularly those of insurance companies and hospitals. Among the winners of the day immediately after the ruling were Tenet Healthcare (NYSE:THC) up 9.23 percent, Hospital Corporations of America (NYSE:HCA), up 8.34 percent, and Universal Health Services (NYSE:UHS), up 8.51 percent. Insurance companies rose but to a lesser extent, with Cigna (NYSE:CI) up 0.37 percent and Aetna (NYSE:AET) up 2.04 percent.

These reactions of the market are not surprising. With an adverse decision, hospitals would likely have been deluged with emergency room visits from the previously insured that had lost their subsidies, causing massive unrecoverable expense. As for insurance companies, they now have a greater degree of certainty on the healthcare rules.

With respect to costs, the situation is mixed. Healthcare costs continue to rise. They had been doing so at a lower rate than in the past, but the most recent data from the Census Bureau’s Quarterly Services Survey shows health care spending increasing 7.3 percent year over year in Q1 2015 with a 9.2 percent increase in hospital spending. Spending is up because the services are being used more often, exactly as planned.

Meanwhile, the recent CBO report on the costs of repealing Obamacare showed that the deficit would increase by $137 billion over the next ten years using dynamic scoring to predict the overall economic effects (estimating the ripple effect throughout the economy), and an increase of $353 billion using the old scoring rules. Progressives are touting this as showing Obamacare’s effectiveness, but more likely, it just reflects the potential chaos of yet another huge shift in healthcare policy. The report states clearly that the uncertainty with the assumptions means that the actual deficit could vary in either direction, high or low, beyond the estimate. Like many long-term projections, the CBO report is basically in dartboard territory.

The takeaway

Health care stocks rightly rose on the King v. Burwelldecision and they are likely to stay strong for some time, even given a bit of positive overreaction. Revenues of companies in this sector have stabilized, and most have already adapted to the new realm of Obamacare through mergers and acquisitions, as well as other cost-cutting measures. As an investor, you want to look for relative over/underpricing within the healthcare market, and that will have more to do with their management than with Obamacare.

Meanwhile, as a second year of Obamacare works toward a close, we should have more solid data about how well it’s working in other meaningful ways. Will more affluent consumers be fed up with higher premiums and revolt (the ACA certainly didn’t make their insurance affordable)? Will the uninsured ranks continue to fall or will the numbers level out, and will the quality of care increase, stay flat, or decrease? And finally, will the downward bending of the cost curve finally materialize? Thanks to the Supreme Court ruling, it’s time to focus on these other questions instead of the potential non-existence of Obamacare.

http://bangordailynews.com/2015/07/01/the-point/whats-next-for-obama-and-the-affordable-care-act-now-that-the-supreme-court-has-ruled/?ref=The%20PointBox

Undocumented immigrants help keep Medicare solvent, according to new study

By George Lauer
California Healthline, June 29, 2015
Undocumented immigrants pay billions more into Medicare every year than they use in health benefits, and in fact they subsidize care for other Americans, according to researchers.
A study published in the Journal of General Internal Medicine contends that undocumented immigrants generated surplus Medicare contributions of $35.1 billion from 2000 to 2011, extending Medicare's estimated life span by one full year. The study appeared earlier this month as an "online first" article in the Journal of General Internal Medicine and will appear in a forthcoming print edition of the journal.
Researchers from Harvard Medical School, the Institute for Community Health and City University of New York's School of Public Health at Hunter College found that in one year alone -- 2011 -- undocumented immigrants generated an average surplus of $316 apiece for Medicare. Other Americans generated an average deficit of $106 apiece. Undocumented immigrants contributed $3.5 billion more than they received in care in 2011, according to the study.
Researchers concluded that restricting immigration would be bad for Medicare's financial health. They estimated that contributions from undocumented immigrants during the first decade of the century prolonged Medicare's trust fund solvency by one year. The trust fund is predicted to be insolvent in 15 years.
Background and study methodology
Undocumented immigrants are not eligible to participate in government health programs, including Medicare and the Affordable Care Act, but they do contribute by paying taxes. Payroll taxes are the major revenue source for Medicare's trust fund, used primarily to pay hospital bills. Using an Individual Tax Identification Number or an unauthorized Social Security number, most undocumented immigrants -- the estimate in California is 90% -- pay payroll taxes.
Researchers examined Medicare trust fund contributions and expenditures from 2000 through 2011, comparing data from the Census Bureau's Current Population Survey to calculate tax contributions. They used the HHS Medical Expenditure Panel Survey to determine medical expenses paid by Medicare.
"For years I have seen my unauthorized immigrant patients be blamed for driving up health care costs," lead author Leah Zallman, a faculty member at Harvard Medical School and researcher at the Institute for Community Health said in a prepared statement. "Yet few acknowledge their contributions. Our study demonstrates that in one large sector of the U.S. health care economy, unauthorized immigrants actually subsidize the care of other Americans."
CMS officials declined to comment on the research, citing a standing policy against commenting on "outside studies."
Implications for Medi-Cal
Although the research dealt exclusively with Medicare -- the federal health coverage program for seniors and those with disabilities -- the findings have implications for Medicaid -- the state-federal partnership providing health care for those with low incomes -- according to California Insurance Commissioner Dave Jones (D).
"While these are two different programs with different funding sources, I think there's no question that this study lends support to the efforts to extend Medi-Cal coverage to undocumented immigrants. I think many of the same points in this research -- that undocumented immigrants contribute tax money to support government programs -- applies to Medicaid and California's Medicaid program, Medi-Cal," Jones said.
Zallman said the study's underlying message -- that undocumented immigrants' contributions should be recognized and appreciated -- applies to Medicaid, as well.
"I think our study should cause us to re-examine our assumptions about the impacts of unauthorized immigrants in other sectors such as Medicaid," Zallman said.
Daniel Zingale, senior vice president at the California Endowment, said the Medicare research showed similar results to the Endowment's own efforts to secure health coverage for undocumented Californians.
"These findings mirror what we found in California -- that undocumented people contribute far more than they take out," Zingale said.
As part of its Health4All campaign, the California Endowment did similar research in California and found undocumented Californians paid $3.2 billion in state and local taxes in 2012.
The Endowment's statistics are included in a You Tube video, California's Hidden Truth.
Research may affect immigration reform
Jones and Zingale predicted the Medicare research would help advance immigration reform efforts.
"I believe this may be the first study to analyze the impact of unauthorized immigrants on the national Medicare program," Jones said. "The information is well researched and well documented and clearly shows they have had a very positive impact."
Jones said the study goes one step further and predicts that immigrants will continue to bolster Medicare's trust fund under President Obama's immigration reforms.
"This study also analyzes the potential impact of the president's efforts if the courts allow him to move forward with immigration reform to enable some portion of the unauthorized population to stabilize their status and move forward on a path to citizenship. The net contributions persist even if there's a path to citizenship," Jones said.
Zingale said Medicare's national status will help broaden the immigration arguments his organization has been making in California.
"This is another installment in a mounting number of facts that show how undocumented people are good for the health of our country," Zingale said. "Because Medicare is a big deal, it will advance that progress toward a greater understanding."
Zingale and Jones both pointed to California's budget agreement last week that includes health coverage for undocumented children.
"Clearing the way for children of unauthorized immigrants to join Medi-Cal is a good first step," Jones said.
"We're calling that the first ever health for all kids budget," Zingale said. "That shows you how far we've come. That budget received Republican votes. Indeed, we are in a very different place than we were just a few years ago. Remember Proposition 187?"
In 1994, California voters approved Prop. 187, a controversial ballot measure denying public services -- including health care and education -- to undocumented immigrants. Courts declared much of the initiative unconstitutional and last year, Gov. Jerry Brown (D) signed legislation repealing unenforceable provisions of the proposition.
Ties to national physicians group
Physicians for a National Health Program, a national advocacy organization, is helping spread the word about the Medicare research.
Although the group "had no role in conducting, financing or otherwise supporting the research, it decided to help publicize the study and its findings because they are consistent with PNHP's mission statement," Zallman said.
The organization's mission statement, in part, says:
"PNHP believes that access to high-quality health care is a right of all people and should be provided equitably as a public service rather than bought and sold as a commodity."
Two of the Medicare study authors -- Steffie Woolhandler and David Himmelstein, both professors of public health at City University of New York and lecturers in medicine at Harvard Medical School, are co-founders of PNHP.
http://www.pnhp.org/print/news/2015/june/undocumented-immigrants-help-keep-medicare-solvent-according-to-new-study

Aetna Agrees to Acquire Humana for $37 Billion in Cash and Stock

By CHAD BRAYJULY 3, 2015

The health insurer Aetna said on Friday that it had agreed to acquire its smaller rival Humana for $37 billion in cash and stock, signaling the start of what may become a flurry of consolidation in the sector.

The deal would bring together two of the United States’ biggest health insurers. The combined company would have estimated operating revenue of $115 billion this year and more than 33 million consumers.

The merger could be the first in a series of deals as the health insurance industry in the United States grapples with rising medical costs and seeks growth to create better pricing power in negotiations with health care providers and pharmaceutical companies.

That push for mergers received a jump-start last week after the Supreme Court upheld a central part of the Obama administration’s health care overhaul, which has delivered a lift to the insurance industry. Insurers also are feeling pressure as consumers, who are being asked to shoulder more of the burden of health care costs, are becoming more price conscious.

Under the deal, Humana shareholders would receive the equivalent of $230 a share, which is almost 29 percent higher than before news reports emerged that it was considering a sale.

“The acquisition of Humana aligns two great companies and will significantly advance our strategy of more effectively serving members in a rapidly changing health care industry,” Mark T. Bertolini, the Aetna chairman and chief executive, said in a news release. “This combination will allow us to continue to invest in excellent service for our members and strengthen our partnerships with providers to deliver high quality care at an affordable price.”

News that a deal was close emerged late Thursday.

The transaction is subject to shareholder and regulatory approval and is expected to close in the second half of 2016.

Under the terms of the offer, Humana stockholders would receive $125 in cash and 0.8375 Aetna shares for each share they hold in Humana.

After the transaction, Aetna shareholders would own about 74 percent of the combined company, while Humana shareholders would own the remaining 26 percent.

Aetna previously received a preliminary takeover approach from UnitedHealth, the largest health insurer in the United States, and Anthem is pursuing a merger with Cigna.

On Thursday, Centene Corporation, a provider of managed-care health benefits, agreed to acquire Health Net in a cash-and-stock deal valued at $6.8 billion, including the assumption of debt. The deal would bulk up Centene’s business in California and several Western states.

It is possible that regulators in the United States could block some mergers: Antitrust officials at the Justice Department and the Federal Trade Commission have shown an increasing willingness to do so if they believe the alliances could hurt consumers.

http://www.nytimes.com/2015/07/04/business/dealbook/aetna-agrees-to-acquire-humana-for-37-billion-in-cash-and-stock.html?hpw&rref=business&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-well

Obama Takes Health Care Momentum Into G.O.P. Territory 

By GARDINER HARRIS and ABBY GOODNOUGHJULY 1, 2015

NASHVILLE — Days after the Supreme Court delivered a victory for his health care law for the second time, President Obama flew into mostly Republican territory on Wednesday and began an aggressive push to get states that have resisted parts of the law to expand care to more of their poor residents.

“With the Supreme Court case now behind us, I’m hoping what we can do is focus on how to make it even better,” Mr. Obama said to an audience here that included health care administrators and people who got health insurance under the Affordable Care Act.

The authors of the law had envisioned that each state would expand its Medicaid program to cover many more low-income residents. But the Supreme Court ruled in 2012 that states could opt not to expand Medicaidcoverage.

Even though the federal government would cover at least 90 percent of the costs of any such expansion, 21 states — all but three of which are led by Republican governors — have so far decided against expansion.

Gov. Bill Haslam of Tennessee, a Republican, came up with an alternative to a straight Medicaid expansion, and he called a special legislative session in February to push it through. But it quickly died when a Senate committee rejected it.

Similar battles are underway in Utah and Alaska. And with billions of federal dollars at stake and hospital executives in the holdout states complaining about strained budgets, such battles are almost certain to continue in other states.

http://www.nytimes.com/2015/07/02/us/politics/obama-takes-health-care-momentum-into-gop-territory.html?mabReward=CTM&action=click&pgtype=Homepage&region=CColumn&module=Recommendation&src=rechp&WT.nav=RecEngine

Eastern Maine Medical Center preparing for nurses strike

By Ryan McLaughlin, BDN Staff

BANGOR, Maine — Eastern Maine Medical Center is preparing for its nurses to go on strike July 13 and 14, the hospital’s management announced in a statement Thursday. 

At the start of bargaining on Thursday, the hospital received a notice from the Maine State Nurses Association, National Nurses Organizing Committee and National Nurses United that its members plan to strike at EMMC’s State Street campus, the Union Street health care mall and the Lafayette Family Cancer Center in Brewer. 

In June, bargaining teams representing EMMC and the nurses were unable to reach a new contact, and the current deal was extended through July 2, the second extension since the nurses’ original contract ended on May 30. 

The union represents about 858 EMMC nurses. 

EMMC officials remain hopeful an agreement can be reached but are preparing for a strike.

“EMMC is prepared to continue providing care and services for our patients,” EMMC President and CEO Deborah Carey Johnson said in the statement. “We will have highly qualified replacement nurses working alongside EMMC staff to provide the high level of care our patients expect.”

Deb Sanford, EMMC’s vice president and chief nursing officer, said later Thursday about 250 nurses from Autumn Staffing will arrive in town for the start of the 7 a.m. shift on July 13. 

Sanford said Autumn Staffing is the same staffing agency hospital officials used during a one-day strike in 2010. 

“We’re really confident that the nurses that will be coming to Maine will be delivering high-quality care,” Sanford said.

Union members eventually ratified a one-year contract in May 2011, after eight months of often contentious negotiations that included a strike, work stoppage and lockout, with threats of a second strike and lockout. Even after ratifying the last contract, nurses said staffing remained a problem.

According to a statement from the National Nurses Union, negotiations have been ongoing since April over the issue of safe staffing and little movement has occurred. 

On Thursday morning, registered nurses delivered a 10-day notice to hospital officials of their intent to strike. 

http://bangordailynews.com/2015/07/02/business/eastern-maine-medical-center-preparing-for-nurses-strike/print/