By STEVEN GREENHOUSE
WASHINGTON — For more than a decade, Dennis Rivera was New York’s mightiest labor leader, running a union of 300,000 health care workers that often bent Albany to its will as it scared — and angered — governors, Democratic and Republican, with its hard-hitting ads.
Two summers ago, Mr. Rivera stepped down from that post and largely disappeared. But now, as President Obama’s health care push has run into trouble, Mr. Rivera has emerged as a central player in the effort to save Mr. Obama’s effort.
Mr. Rivera is the point man on health reform for the nation’s most politically powerful union, the Service Employees International Union, which is doing more than any other union to push for health legislation. In many ways, the White House is looking to the S.E.I.U. to lead labor in doing the blocking and tackling necessary for Mr. Obama to carry the ball forward.
At the same time, Washington insiders are impressed and surprised that it was a union leader — Mr. Rivera — who forged a coalition including giant drug makers, the health insurers, the American Hospital Association and the American Medical Association that helped secure their pledges to cut hundreds of billions of dollars in costs.
This summer, as high-decibel opponents have crowded into town hall meetings to denounce Mr. Obama’s reform effort, Mr. Rivera, working with other unions, has sent hundreds of labor activists to such meetings to counter opponents.
“We’re running this campaign like this was a presidential campaign, and our candidate is health care reform,” said Mr. Rivera, whose union is hugely resented by Republicans for doing so much to elect Mr. Obama.
In recent days, Mr. Rivera has rushed to shore up support for reform by meeting with conservative Democrats and one of the few Republicans who may still back reform.
“Dennis has been one of the few key players on health care,” said Senator Charles E. Schumer, Democrat of New York.
Many liberals adore the S.E.I.U. — and many conservatives detest it — because it relentlessly pushed to make universal coverage a major issue in last year’s presidential campaign and more recently championed a government-run health plan aimed at pressuring private insurers to reduce costs and premiums.
Many conservative skeptics ask why a union that represents one million hospital and nursing home workers is suddenly pushing for cost containment after decades of championing higher health spending, in part to ensure members’ jobs and raises. On the other side, many in the union fear that cost containment will translate into layoffs.
After years of battling efforts by New York governors to cut health costs, Mr. Rivera now says a nationwide cost containment effort is necessary to help enact universal health coverage. Such coverage — and the greater spending it would entail — could help increase job security for many of his union’s members.
Many other unions are wondering about the service employees’ strange bedfellows, including the pharmaceutical companies and Wal-Mart Stores, which the union helped persuade to back reform.
“If the business community, the pharmaceutical industry and Wal-Mart all opposed health care reform, this bill would be dead,” said Andrew Stern, the S.E.I.U.’s president. “What keeps it alive is that conservatives are isolated from their traditional business base. The business community appreciates that our country needs to do something about health care.”
Mr. Stern said his union picked Mr. Rivera to oversee its health care campaign because “we needed our General Petraeus to win this war.”
Mr. Rivera commands a much smaller army: 400 union staff members working full time for health care reform, an unusually large lobbying force that is part of the tens of millions of dollars the union has devoted to the campaign. In Maine, Montana, North Dakota and a dozen other states, the union’s activists have held news conferences and written op-ed articles decrying America’s health care system, all to push lawmakers to back reform.
After 18 years running the giant New York local, 1199/S.E.I.U. United Healthcare Workers East, Mr. Rivera has grown comfortable in Washington. He now wears suits, after years of wearing a $5 navy blazer he bought at a thrift shop. Soft-spoken, thin and 59 years old, he talks with hints of his native Puerto Rico, where his father was a factory manager.
“There is no peace of mind about health care for anyone in America unless you’re a zillionaire,” he said. “Anyone who doesn’t have insurance knows how hellish it is to have a health problem.”
The coalition he formed with business helped lead the pharmaceutical industry to pledge $80 billion in cuts and the hospital industry $150 billion. Though nonbinding, these pledges have buttressed Mr. Obama’s assertions that reform will not bust the budget, although the Congressional Budget Office says his plan does too little to curb runaway health spending.
Karen Ignagni, president of America’s Health Insurance Plans, an insurers’ group, opposes a public plan but cooperates with Mr. Rivera on reform.
“By force of personality,” she said, “he has been a very important part of the stakeholder community in sounding the theme of cost containment and the importance of teeing up this issue.”
His cost-cutting crusade has not spared him conservative opprobrium. Glenn Beck singled him out for attack on Fox News, while Eric Cantor, the House Republican whip, said Mr. Rivera’s support for a public plan was sabotaging cost containment.
“S.E.I.U. is the money and the muscle behind any momentum there is left for a public plan,” Mr. Cantor said. “If they think the only way to bring down costs is for the government to be involved, that’s counterintuitive to what we’ve seen in this country.”
In June, Mr. Rivera took his friend Mayor Michael Bloomberg to meet with Senator Olympia J. Snowe, Republican of Maine, to urge her to support health reform. Mr. Rivera has urged her to back a public plan, hoping she might be the 60th Senate vote needed to overcome a filibuster. To win her over, he is considering her proposal for a trigger mechanism that would create a public plan, perhaps when one health insurer dominates a state or when premiums are unusually high, as is the case in Maine.
Ms. Snowe praised his “very constructive outreach” and lauded his union for “helping get the facts out.” The union has sent a rented ambulance around Maine to publicize horror stories about the uninsured. Such efforts make it easier for Ms. Snowe and conservative Democrats to back reform.
Mr. Rivera acknowledged that some union members could lose their jobs if health care was overhauled — for instance, hospital workers who file patients’ charts could be laid off if electronic medical files became popular. Eager to reassure workers, he said those laid off should be retrained, with the promise of another health care job — as called for in 1199’s contract in New York.
In the end, Mr. Rivera says reform and universal coverage are the best options — for his union’s members and for the country. “The amount we spend on health coverage is unsustainable,” he said. Health costs have risen so fast that many union members cannot afford health insurance.
“We’re not only providers of health care, but we’re consumers of health care.”
http://www.nytimes.com/2009/08/27/business/27union.html?_r=1&ref=nyregion
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