A Health Care Union's Succession Battle

[MUSIC]

Brian Lehrer: Brian Lehrer on WNYC. The country's largest health care union, 1199SEIU, is in the middle of an internal fight that could shape, not only the future of its members, but also its role in national labor politics. Maya Kaufman's recent POLITICO story lays out the stakes, the first contested leadership election at 1199SEIU in decades. I know we have 1199 members in our audience, and we're going to open up the phones for you in a minute, but how the union should adapt in a second Trump presidency is one of the issues.

This is happening as organized labor is trying to flex its muscles across industries, from the Teamsters' recent moves, to high-profile strikes in Hollywood that you know about, and beyond. Maybe you saw the news from Philadelphia just today that for the first time, an Amazon subsidiary, Whole Foods, has a successful unionization process that has culminated at Philadelphia Whole Foods. What does this mean for 1199's members, this leadership battle, hundreds of thousands of health care workers, and for the labor movement at large?

Maya Kaufman, health care reporter for POLITICO New York, does join us now to explain. Hey, Maya, welcome back to WNYC. Do we have Maya?

Maya Kaufman: Hello?

Brian Lehrer: I think we can hear you. Ah, now we got you. Can you hear me, Maya?

Maya Kaufman: I can hear you. Can you hear me?

Brian Lehrer: Now I can hear you. Sorry about that. Listeners, we want to hear from you. You can help Maya Kaufman from POLITICO report this story. Are you a member of 1199? What are your thoughts on your union's leadership battle and direction? How do internal union dynamics impact your work and your representation, as well as what other larger implications for the country you think are at stake here? 212-433-WNYC. We're opening up the phones for 1199 members who work in health care. 212-433-9692, call or text.

Maya, for listeners unfamiliar with 1199, what makes this union so important in health care and general labor politics?

Maya Kaufman: Sure. 1199 is truly a force to be reckoned with, both in health care and in politics and labor. It has about 450,000 members across multiple states. It's headquartered in New York, but it also represents members all the way down to Florida, all the way up to the most northern tip of New York, almost at the Canadian border. It's incredibly influential as far as geographic reach but also politically.

Especially in New York, they have a really strong alliance with the Greater New York Hospital Association here. They have always had a strong voice in state politics as well in determining some of the biggest budget fights and some of the biggest policy fights here in New York.

Brian Lehrer: What is this internal conflict about, and why is it happening now?

Maya Kaufman: What's happening right now is there's going to be an election in the spring for 1199's leadership. Their president, George Gresham, has been at the helm of 1199 for nearly two decades. He inherited the position from a truly renowned leader, Dennis Rivera, who really made 1199 into the political force that it is today. What we're seeing right now is quite unusual. George Gresham has never been challenged for his leadership. Actually, two of his top lieutenants right now have launched a opposition slate to challenge him for the presidency.

It's unusual that he's being challenged, but also, he's seeing it actually come from the top, from two of the most well-known people inside 1199 and two of his top lieutenants, their senior executive vice presidents. Yvonne Armstrong is running for president. Veronica Turner-Biggs would be secretary-treasurer, basically, the second top position.

Brian Lehrer: Are there issues, or is this just, "I want power. No, I want power"?

Maya Kaufman: The way that it's being framed by George Gresham and his allies is certainly that it's a power struggle and that these folks also at the top want to oust him and have power for themselves, but the opposition slate is very firm that there's a number of issues in the union that need to be addressed. Namely, they talk about transparency and accountability.

Even though they're right at the top of 1199, they say, "We're not actually in the room when key decisions are being made by George Gresham, and so we need to involve our leadership, our membership more in these decisions in determining the future of the union and also take a firmer stand on key political fights, have a key multi-state strategy that unionizes all of our members across states," so that they're all together fighting as one organization in big political fights as the union gears up to challenge things like the potential Medicaid cuts that could be coming under the Trump administration, which would be a huge blow for 1199's workers since Medicaid funds so many of the institutions that employ them.

Brian Lehrer: Let's take a phone call. William in Astoria, you're on WNYC. Hi, William.

William: Yes, I appreciate this issue. I'm a longtime union activist and organizer. I've been doing it for many years. I'm stepping back and doing community work. I'm curious of the writer's perspective. One thing I've seen in movement work, I'm 56, I've done the work [unintelligible 00:06:16], is we haven't created helpful organizations where unions and other progressive organizations respect the health of their own members and organizers, and we end up with organizations that constantly burn people out. I've had that experience in my life.

I think if we're to build progressive organizations at the national, local level, whether it's unions or other groups, we need organizations where there's change in leadership. We need organizations where there's democratic participation, and we need organizations that are built to last and are sustainable, that have turnover in leadership. I'd be curious of your experience. I do have friends working at 1199. I've worked for many unions, and I know they can be terrible places that burn people out, and then you end up with leaders that are old and staff that's constantly turned over because there's not a focus on health. I'd be curious.

You probably dug in deeper on this issue, but I've had my own experience. What do you think are the issues at stake here in terms of promoting healthful organizations that defend the health of their staff, that are built to last, have young leaders, and your take on the unhealthful Trump regime, which is obviously, in my opinion, out to make America very unhealthy?

Brian Lehrer: Yes. Great, great question. Before we get Maya's answer, you just mentioned something about generational change, but I think you maybe had emphasized it even more to our screeners. Is part of this, from your perspective, that it would be healthy for 1199 to have younger leaders now at the top for some particular reason?

William: Absolutely. Every movement in every country and every-- If you look at our political system, Trump probably, arguably has dementia. We need youth. I'm 56, and I feel like I'm old. I think healthfulness is recommending that healthy organizations have a turnover of staff, they have young leaders in, they have young energy, new ideas, creative ideas. It's another dimension of health that you're drawing out of my question that is so important. We need young people with healthy ideas and some of the resilience that those of us in our 50s, 60s, and 70s do not have. I can say I'm 56 and I get more tired easily than my kid who's 18. [chuckles]

Brian Lehrer: William, thank you very much for your call. Maya, what are you thinking as you listen to William?

Maya Kaufman: Yes, it's a great question. There definitely is an aspect of that argument that it's time for new leadership, for George Gresham to pass the torch along in the Members First Unity Slate, as they're calling themselves. Even some others who I spoke to, union alums told me that the organization really just doesn't have the political oomph that it once had. It doesn't even have a permanent political director, to give you a sense.

As far as the membership part, the health of the membership, it's also important to note that the in-house staff of 1199, as I've also previously reported, actually unionized themselves and they have been now fighting for a contract against the top leadership at 1199, trying to get a lot of those benefits that the caller I think alluded to, so having more of a work-life balance, having job security, they have just cause protections, they can't just be fired for any reason, and to address a kind of culture of fear, as it was described to me within the organization.

There is definitely a push for change in, not only how the organization operates externally, thinking about how it operates politically and might assert itself on the federal stage, but also how it operates internally, how it treats its staff, how it does that day-to-day organizing work, helping new shops organize, helping old shops negotiate new contracts. We really are seeing something quite remarkable happening in 1199 at multiple levels.

Brian Lehrer: Any other 1199ers out there who want to chime in? 212-433-WNYC, 212-433-9692. Call or text for Maya Kaufman from POLITICO New York, who's reporting on the internal leadership battle at the big health care union and its implications for public health and for the power of labor nationally. You know, on the New York side of that, Maya, isn't 1199, for whatever lethargy, if that's the right word you and the caller are attributing to it at the national level, isn't 1199 incredibly powerful in the state of New York, like over any kind of health policy that comes out of the New York State legislature?

Maya Kaufman: Yes, it absolutely is, and a lot of that owes to an alliance that they've had historically with the Greater New York Hospital Association, which in and of itself is incredibly powerful. The two have been aligned for decades now. They often advocate Medicaid rate increases on the state level, it's one of the big political issues, and they certainly do see continual political success and policy success, but certainly, their political oomph, as I said before and as it was termed to me, has faded a little bit.

If you think about some of the local races, 1199 endorsed Maya Wiley for mayor in the last race and Eric Adams vested her. To me, that's one example of seeing that it's not quite the force that it once was in that sense. We have seen recent wins on the state level for the likes of 1199 with Medicaid rate increases under Governor Kathy Hochul, but there certainly, I don't think, is the same sense that they get everything that they want and that they've asked for.

Brian Lehrer: Let's take another caller. Paula in White Plains, you're on WNYC. Hi, Paula.

Paula: Hi. Terrific. I am a refugee from a major hospital, alleged nonprofit hospital in the Bronx. 1199 represents us. They are a dinosaur. They need to change. They are unbelievably bureaucratic. Then the people who are committed to making change, they're really bureaucratic. It needs a facelift badly.

Brian Lehrer: What would you like to see come of that, primarily, Paula?

Paula: Primarily, I would like to see better representation for the staff, especially the professional staff, doctors. Nurses, of course, have their own union. The professional staff of psychologists and social workers, we're not well represented, and the patients are not getting good care. They're not getting good care because there's not enough of us.

Brian Lehrer: Because there's not enough of you. Paula, thank you very much. In fact, Maya, I don't know if this is on your beat, but that's the point of the doctor strike at public hospitals that was threatened recently. Just yesterday, even after the union, that's a different union, came to a tentative agreement for doctors at several big New York City public hospitals, the rank-and-file doctors rejected it and they're back to the bargaining table, and with the doctors just like the nurses. There was a big nurses' settlement not that long ago. The issue was even more than pay, though pay is always an issue. It was staffing levels, right?

Maya Kaufman: Yes, that's exactly right. I remember the nurses' strike. I was out there on the front lines covering that as well several years ago. What happened with Doctors Council, which actually is also a local of SEIU like 1199 is, although it's a different union from 1199, is doctors at three hospitals voted "no" to ratifying their tentative contract agreement. What we could see is potentially a historic doctor strike still coming from that because two of those three facilities actually had previously voted to authorize a strike.

To me, that really signals a willingness to resort to that kind of action to get more staffing protections, basically provisions that could recruit and retain more staff. There's a lot of shortages and key specialties and subspecialties across the system that can result in delays and people getting care or they have to go to different hospitals in the New York City health and hospital system to get an appointment with the kind of provider who they need to see.

Brian Lehrer: On the quality of employment, ironically, working for a union, one listener texts, "I work closely with the Paid Family Leave program for 1199 members, and 1199 makes it very hard for members to be approved for Paid Family Leave to the point that they temporarily lose their health insurance until it's approved. They require paperwork that's not required per the New York Paid Family Leave government guidelines to be approved initially, such as the payroll form and HIPAA form. They also don't allow direct deposit, and checks often get lost or are severely delayed in the mail."

I don't know if those are all things you can confirm. That's one listener's comment. I also know that there was an effort last year, and maybe this has already culminated, you tell me, looking at a NewsGuild CWA union release from last June headlined, Employees at America's Largest Healthcare Union 1199SEIU-UHWE Vote to Unionize Themselves: A labor History Milestone. On either of those things?

Maya Kaufman: Yes, exactly. That's referenced to the in-house unionization effort that I referenced earlier that happened last summer, and they're now negotiating their first contract with 1199 leadership. On the listener's point, I can't confirm that, although I certainly hope that person reaches out to me and tells me more about what they've been experiencing since I would love to hear about that and anything else that listeners would like to share. I do know though that there have been complaints historically about access to the benefits funds that 1199 runs.

1199, like a lot of unions, has really generous benefits package, health insurance, and other benefits, but there certainly are issues that people have raised in accessing those, although I hear those most often with home care workers.

Brian Lehrer: Right. 1199 has historically been very successful at organizing, and they're currently in the process of organizing home health care workers as New York State tries to consolidate that program under one company, right?

Maya Kaufman: Yes, that's exactly right. This is at the beginning stages, so it's not really clear exactly how that is going to play out, but it's certainly something that the union is eyeing. They have seen a lot of growth in their home care sector. It's notable that Yvonne Armstrong, the person who's running to oust George Gresham as president, oversees the long-term care division for 1199. She's incredibly well-connected in that area, which has been the area of the most growth.

1199 really started as more of a hospital workers and pharmacists union, and as they basically tapped out on the membership that they could gain in that industry, they moved a lot to home health care, especially as that has increased in popularity in recent years. We are seeing a lot of movement in that space. We're seeing a unionization push with Summit Health as well. Think about some of those urgent care centers as well. There certainly is a push for growth. That's one of the things the opposition slate has highlighted is the need for the union to keep growing.

Brian Lehrer: Now the complaints are really rolling in, in text messages. I think some of the people who called in kind of gave people permission in their heads to start piling on. Listener writes, "I'm a staff person at 1199, and I've seen firsthand how out of touch our current president is." Another one says, "It's not surprising that 1199 Head George Gresham is being challenged from inside and that other key leadership staff are absent because of the many years of internal dysfunction stemming from Gresham's abusive, bullying, belittling, and controlling management style." That's an allegation.

Another one says, "I was an 1199 delegate in the early '80s and went through the strike, and then the rise of Dennis Rivera, who used to head that union, the union going into the strike was very divided. Organizers had been purged and the union president was not equipped to handle things." Then it went on. Also, Maya, 1199 has a workforce that's largely women of color. Are there racial or gender dynamics playing into this internal conflict?

Maya Kaufman: Yes, there absolutely is. There has been, especially as of late, there's always talk of Black leadership versus Latino leadership at the top. There's talk of there should be a woman president at the top of 1199. All of those dynamics definitely are playing out as well, racial and gender dynamics, and who should head this union, who should be the public face of this union at this time.

Especially as we're seeing the Trump administration talk about mass deportation efforts, this is something that 1199 really wants to fight with full force. They have a workforce as well that's a lot of immigrants, people who have come here from other places for generations. They're first-generation, second-generation, third-generation people whose family members were in 1199 and now they're in 1199. A lot of that is really bubbling up and coming to the forefront now. I hope some of those listeners who have specific gripes reach out to me too. [chuckles]

Brian Lehrer: You can give your email address if you want. Do you?

Maya Kaufman: Yes, absolutely. My name is Maya Kaufman, mkaufman@politico.com. Please reach out to me. I can keep you anonymous, if need be, if you want to talk about something sensitive. I keep reporting on health care, so let me know what I should do next.

Brian Lehrer: Last question just to cycle back to the first segment of our show today, which was about the RFK Jr. nomination to be Health and Human Services Secretary. Does this intersect with that at all? 1199 is, after all, a health care workers union.

Maya Kaufman: Yes, absolutely. The clearest intersection is if RFK is confirmed to lead HHS. Within HHS, you see CMS, the Center for Medicare and Medicaid Services, which is the agency that oversees Medicare and Medicaid basically to massive payers of health care services in our country, and especially Medicaid, which is for lower-income Americans in New York, is a massive payer in exactly the sectors where 1199 has workers.

If you think about nursing homes, home health care, and even a lot of safety net hospitals, they depend on Medicaid. If there are cuts to Medicaid, if there's changes in how federal funding to Medicaid, which depends on federal funding as well as state funding, those are all things that really could impact 1199 workers, especially in things like nursing homes and home health care that really depend on those Medicaid rates, those Medicaid payments.

Brian Lehrer: There we leave it with Maya Kaufman from POLITICO. Maya, thank you for all this.

Maya Kaufman: Thanks so much for having me.

 

Copyright © 2025 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.