Health Care for Farmworkers, or an infusion for an ailing union?

The Robert F. Kennedy health insurance plan illustrates two extremes of Cesar Chavez’s legacy for farmworkers. In the early 1970s, the UFW-sponsored plan provided much-needed health care for farmworkers and epitomized the audacious triumphs that grew from Chavez’s soaring vision. But within a decade, the insurance program came crashing to earth in a bureaucratic mess. Staffed by overwhelmed volunteers, RFK failed to pay bills in a timely fashion, jeopardized members’ credit ratings, and turned into a public liability that spurred internal dissension within the United Farm Workers union

Today the RFK health insurance plan, still operated by the UFW, is a very small shadow of its former self, but in the news once again: the California state budget just passed by the legislature includes a $3.2 million subsidy to bring the substandard plan into compliance with Obamacare. Lawmakers justified the unusual subsidy by saying it would cost more if the plan collapsed and farmworkers ended up on public assistance. (More about that assertion in a minute.)

In the end, sadly, very little of this is about farmworkers and their very real need for health care. Like the UFW today, the RFK plan has little relevance to the lives of the hundreds of thousands of California farmworkers struggling to eke out a livelihood. The real debate should have been about finding the best way to provide quality health care for farmworkers; instead, what took precedence was the need to prop up a failing institution that has far more clout in Sacramento than in the California fields.

The most recent federal filings show the RFK plan has fewer than 3,000 participants. And a good number of them aren’t farmworkers at all: They’re employees of the UFW and its related non-profit entities, under the umbrella of the Chavez Foundation.

In other words, beyond the precedent of bailing out one health insurance plan (while others that provide health insurance to farmworkers have borne the expense of upgrading to meet the federal standards), the state budget includes a subsidy that benefits UFW staff as well as those who work at the Chavez Foundation’s radio stations, housing projects, and educational endeavors. Judging from those entities’ tax returns, the total staff would be about 300, or roughly 10 percent of the RFK participants. Of the $14 million RFK reported receiving in its latest federal filing, more than $1.5 million came from the UFW and its related entities. But those staffs work year-round, unlike most farmworkers, so their coverage would be continuous and they would likely be the heaviest users of the health services.

Even leaving that aside, and assuming the number provided by the UFW – 10,700 people covered by the insurance plan – is an accurate estimate of family members included in the plan, we’re still talking about a very small fraction of the farmworker families in California.

That handful of farmworkers are enrolled in RFK because their employers are under contractual obligation to pay a certain amount per hour, per worker, into the plan (and it’s not an insignificant amount – close to $3-per-hour). If the plan collapsed, the contracts would have to be renegotiated and that money might be used to provide health coverage for the employees under alternative plans. Given economies of scale, and the fact that RFK is essentially a pass through that pays Anthem Blue Cross and other insurance companies, it’s certainly plausible that more comprehensive care could be obtained at more reasonable cost.

From a historian’s point of view, the current controversy over RFK has odd, sad echoes of the past. Chavez always envisioned his movement as being about far more than labor contracts, and that was part of the movement’s strength and appeal. From the start of his efforts to organize farmworkers in the early 1960s, he developed a credit union, a burial insurance plan, and a newspaper. A few years later, he started the National Farmworkers Service Center, which offered help on everything from tax returns to legal battles. Under the auspices of the Service Center, the first union-run health clinics opened, providing desperately needed health care for farmworkers at minimal cost.

When the UFW finally brought California table grape growers to the bargaining table in 1970, the contracts they signed included a provision to pay a certain amount per hour into a trust fund that became the RFK plan. The idea was to design health care that took into consideration the migratory and seasonal nature of farm labor, with a multi-employer plan that would keep workers covered as they moved from job to job. The plan therefore also envisioned a future where the industry would be largely unionized, so workers could keep their health insurance wherever they worked.

But that never happened. The union imploded under the weight of its own success, the clinics closed, the health plan, like the union, shrunk. And in the California fields, tens of thousands of farmworkers who have never heard of Cesar Chavez struggle to find health care.