Sept. 7, 2009 -- 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 ABCNews.com's "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.
"It's expending a huge amount of political capital, and labor is not going to be well-positioned to achieve their other priorities," said Marick F. Masters, a labor expert who is director of the Center for Workplace at Wayne State University in Michigan.
"They will be yelling in a forest -- nobody can hear them," Masters said.
A Gallup Poll out last week found a drop in public support for labor unions, with a slight majority now saying they hurt the economy. Only 48 percent of respondents said they "approve" of labor unions -- down 11 points from a year ago.
Unions haven't been held in such low standing by the public since Gallup first started asking that question in 1936.
Labor unions have seen their membership decline for decades. About a third of voters were from union households in 1976; that number was down to 21 percent last year, according to exit polls. Union membership did, however, rise significantly in 2008, adding 428,000 members.
Labor leaders see the current debate in Washington as a chance to achieve vast health-care expansions that would help their members. They also sense an opportunity to crack down on health insurance companies that have tangled with unions over the years.
"We see this up-close and personal every day. Our workers see this on the front lines," said Anna Burger, secretary-treasurer of the Service Employees International Union, and the chairwoman of the Change to Win coalition.
"It's at the top of the agenda -- it needs to get done," Burger said. "It's important to the Obama administration, and it's important to the Democratic agenda."
Despite their differences, Change to Win and the AFL-CIO agree that, soon after health care is finished, Congress should take up the Employee Free Choice Act (EFCA), a controversial measure that would make it far easier for workers to unionize.
"I anticipate it being the next thing up," Burger said.
But EFCA -- called "card-check" by its opponents -- was facing uncertain legislative prospects even before the health-care debate got bogged down this summer. Quick passage of the measure seems unlikely, particularly as labor unions continue their focus on health-care reform.
"They're trying to bully and coerce, while most Americans are scared to death of putting us on a path to socialized medicine," said Katie Packer, executive director of the Workforce Fairness Institute, a business-backed group that's opposing EFCA.
Trumka and other labor leaders downplay talk of the health-care debate as a test of their political sway.
"Y'all always want to make this about a litmus test for us -- this isn't about us. This is about the American public," Trumka told reporters last week. "This is about the American people and what they want, and we're speaking up for what they've told us they want."
But labor has put itself on the line, as public anger bubbles up in the health care debate, said Masters, the labor expert.
"As a political diagnosis, both the Democrats and organized labor have paid a tremendous price for health care," he said. "They've boxed themselves in."