Labor on Line in Health Care Debate

As he makes the case for health care reform, Richard Trumka, the incoming president of the AFL-CIO, talks about the nation at a "crossroads," with decisions looming in Washington that will affect workers and the economy for decades.

That same metaphor applies to Trumka's union, and the labor movement more broadly, as debate rages over health care.

National labor leaders are front-and-center in a fight that's pitting them against some elements of the Democratic Party -- and might leave them choosing whether to oppose the White House itself.

Top union leaders have mounted an aggressive push to include a "public option" as part of health care reform. They're keeping up that pressure, despite hints from top Obama aides that the concept may get dropped in negotiations.

"If it's the status quo or it's the promise of eight, 10 years down the road or something like that, our answer's going to be, 'We need the health care reform now,'" Trumka, the AFL-CIO's secretary-treasurer and president-designate, said Thursday on's "Top Line."

Video of ABC News Top Line

"We need the public option to force [insurers] to become more efficient, more innovative and to break that stranglehold that they have on healthcare in this country," he said. "We need insurance reform right now. That's what people ask for, that's what they're demanding and we're going to fight to make sure that's what they get."

With the nation's largest unions coordinating Labor Day rallies nationwide, and with President Obama scheduled to speak at one such rally in Cincinnati today and address the AFL-CIO convention later this month, Big Labor is at a defining moment.

The AFL-CIO's insistence on a public option -- coupled with not-so-subtle threats to campaign against Democrats who stand in the way of health care reform -- is raising new questions about labor's political sway.

It's also highlighting a years-long rift inside the labor movement. Teamsters President James Hoffa said last week that he doesn't consider a public option critical to health care reform -- putting him at odds with the AFL-CIO.

"We've got to find out what's doable," Hoffa told Bloomberg Television. "I think it's important to get something done this time and declare a victory."

The Teamsters are one of seven national unions that split from the AFL-CIO four years ago to form a separate coalition, Change to Win. Talks are ongoing to reunify the rival factions, though Hoffa said he doesn't expect those discussions to heal the rift over strategy.

The dynamics combine to pose a challenge to a labor movement that had high hopes for its agenda with a Democratic president and Democratic majorities in Congress.

If health-care reform passes without a public option, that will mean Congress and the president chose to buck labor organizers despite their threats of an electoral backlash.

And even if Big Labor gets its wishes, the political battles are straining relationships inside the Democratic Party. Labor officials may find far less appetite in Congress for other big legislative priorities, including a major rewrite of labor organizing laws.

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