While endorsing the goals of President Barack Obama’s Affordable Care Act, delegates to the national AFL-CIO convention condemned provisions that threaten health coverage for 20 million Americans, including several hundred thousand in Minnesota.

AFL-CIO President Richard Trumka is in discussions with federal officials in a last-ditch attempt to fix the Act, which union leaders said has devastating consequences for multi-employer health care plans, also known as Taft-Hartley plans.

Workers as diverse as construction workers, seafarers, grocery clerks and railroad engineers get their health coverage through these plans. Unions developed the plans in part because commercial insurance companies weren’t interested in covering workers whose schedules were sporadic or whose jobs were mobile.

The non-profit plans are generally bargained by unions and employers and jointly administered by them.

Now insurance companies are poised to gain millions of new customers under the Affordable Care Act, while multi-employer plans face potentially crippling fees.

“The federal agencies that are administering the ACA seem to have forgotten the vital role the Taft-Hartley plans have for millions of workers,” said Loretta Johnson, secretary-treasurer for the American Federation of Teachers.

While exact figures aren’t available, there are at least 50 such plans covering 350,000 union workers and their families in Minnesota, Wisconsin, North Dakota and South Dakota, according to the Labor/Management Health Care Coalition of the Upper Midwest. The AFL-CIO said 20 million workers are covered through the plans nationally.

As currently written, the Affordable Care Act requires multi-employer plans to pay a fee of $63 per person into a fund to subsidize coverage for all workers.

The freight rail industry, for example, projects $27 million in fees on its health care plans next year because of the ACA, said Robert Scardelletti, president of the Transportation Communications Union/IAM. “They’ve already told me that’s coming out of our wages in the next round of bargaining.”

High fees will drive many multi-employer plans out of business, union leaders predicted. Those that continue to provide health care will find it hard to compete with companies that drop coverage and force workers onto the publicly administered health exchanges.

Rail workers won health care because of a 1955 walkout during which one striker was murdered, Scardelletti said. “I will never forget the sacrifices made by all of us who came before us so we could have the good health care we have today.”

That theme was echoed by other labor leaders, who were clearly angered that the Obama administration had given employers a one-year extension on the mandate to provide coverage, while failing to address the labor movement’s concerns.

“We fought. We laid down in the street to get health insurance,” said Terence O’Sullivan, president of the Laborers International Union. “We can’t afford to have a law that takes it away.

“The president said, ‘If you like your health insurance, you can keep it.’ We want him to keep that promise.”

Union leaders thanked Trumka for all the work he has done to try to resolve the problems with ACA and urged him to finish the job.

“The clock is ticking on us,” said Sean McGarvey, president of the AFL-CIO’s Building and Construction Trades Department.

O’Sullivan said that if the ACA cannot be fixed, it should be repealed.

Other speakers pointed out the goal of the Affordable Care Act – to extend health care coverage to all Americans – could be better achieved through a single payer system. Trumka noted that the AFL-CIO previously endorsed single payer and continues to support “the ultimate goal of health care for all through the single payer model.”