For too much of American history, workers risked their health and safety just by stepping onto the jobsite. It was a given they would be subject to injury, illness and harassment, and have to pay for their own health care—simply because the bosses didn’t want to pay. But the labor movement changed all that. Workers organized unions and collectively bargained for contracts that protected their health and safety on the job, guaranteed comprehensive health insurance, and provided for workers’ and their families’ fundamental needs. Today, corporations, billionaires and their political allies are threatening to erase that progress and once again sacrifice working people’s health and lives to grow their bottom line. Our federation refuses to give up these rights and protections workers fought and died for. Public policy and medical research rooted in science, not misinformation, is the backbone of advocating for safe workplaces and the health of our communities. We resolve to not just defend these rights but to expand them.
Healthy Lives—Making Health Care a Basic Right
For more than a century, the labor movement has fought to make health care a basic right. Everyone has a right to receive quality health care without fear of financial hardship, regardless of their race, gender, identity or immigration status. Year after year, our unions negotiate comprehensive health coverage for their members, benefits that serve as a benchmark for the coverage we seek for all, under employment-based plans, the Affordable Care Act (ACA), Medicare, Medicaid or a single-payer system.
Our first task in securing health care as a human right is to reverse the devastating policies enacted by President Trump and congressional Republicans that will leave 15 million Americans uninsured. The Republicans’ “Big Ugly Bill” slashed funding for health coverage under Medicaid, ACA and the Children’s Health Insurance Program (CHIP) by more than $1 trillion. These massive cuts will increase premiums and out-of-pocket costs for everyone with private and public insurance, as hospitals and doctors are pushed to charge higher rates to make up for uncompensated care costs and patients who forgo care.
We must also reverse the great harms that President Trump and Health and Human Services Secretary Robert F. Kennedy Jr. have inflicted on science, medicine and our public health infrastructure. We will fight to restore funding and staffing for our public health and medical research agencies that keep Americans healthy. We will work to ensure the current administration will restore access to life-saving vaccines and recommit to evidence-based policies. A robust public health infrastructure is needed at the national, state and local levels to guarantee capacity to meet future public health emergencies and climate change-related disasters.
We are further resolved to advance policies that strengthen employment-based coverage, through stronger enforcement of the original ACA statute to limit costs for families, expand access to care and restore the family glitch fix. We will protect high-quality coverage by opposing taxation of health benefits, efforts to undermine the uniform administration of our plans through the erosion of ERISA and regulations that impose unnecessary costs on jointly administered Taft-Hartley health plans. We will ensure any health care reforms build on existing care that is working and address what is not working. We will improve public programs by requiring coverage of comprehensive services and reducing premiums, deductibles and copays. We will build a comprehensive financing system that enables older Americans and people with disabilities to get long-term services and supports (LTSS) when and where they need them. We will advocate for improved mental health and substance use disorder treatment access. We believe that all individuals have a right to quality health care and the right to control their own bodies, including equal access to contraception and reproductive health care.
Our goal is to move toward a single-payer system, like Medicare for All, that provides universal coverage using a social insurance model, while retaining the critical role of workers’ health plans. Any such system must guarantee everyone can get the health services they need without exclusions or financial barriers to care, and with access to high-quality doctors, hospitals and other health care providers; not diminish the hard-fought benefits union members have won for themselves and all working people; include long-term care for all; retain the Department of Veterans Affairs health care system as the primary direct provider of fully integrated care to veterans; provide multiemployer and other worker health plans the opportunity to administer core health benefits and to provide supplemental benefits, each on a fully tax-advantaged basis; and keep a strong federal role without shifting costs to states. We will support legislation, like Medicare for All, that guarantees health care as a human right through a single-payer system, which we will judge according to the above core values.
Intrinsic to whether people have access to affordable, quality care is how the health care system treats its workforce. Poor wages, overwork, unsafe workplaces, systematic employment discrimination and deskilling have yielded a decadeslong staffing crisis that continues to grow. Hospitals and nursing homes are chronically and intentionally understaffed to cut down on labor costs for the employer. Patients continue to suffer poor outcomes and higher mortality as understaffing undermines patient care.
To build a robust health care workforce, we must make health care jobs good jobs—by making them safe; providing good pay and benefits; ensuring scheduling regularity; fully and safely staffing shifts; and guaranteeing a voice on the job. We will restore the minimum staffing levels for nursing homes torn down in 2025 by President Trump and the Republicans in Congress, and we will pursue legislation that would require minimum nurse-to-patient staffing ratios for hospitals. We will bolster the staffing pipeline by overturning the administration’s effort to deprofessionalize nursing and other health care occupations by slashing access to student loans, and we will advance policies that further expand the grants and loans available.
We are resolved to address the violence that continues to be on the rise in clinical settings—endangering both patients and staff. We will enact workplace violence prevention legislation requiring employers to protect health care and social services workers. We will fight to end the violent disruptions to patient care that occur when Immigration and Customs Enforcement agents force their way into emergency rooms and hospital units to detain suspected undocumented workers.
Workers in long-term services and settings face particular challenges. This workforce is largely composed of women of color, and there are historical patterns of wage and employment discrimination that must be reversed. We will oppose the Trump administration’s efforts to compound this discrimination by moving to rescind federal minimum wage and overtime protections that apply to all other workers. Beyond this fight, we will enact policies to tie funding from public programs to better wages, training and workforce standards.
The ability of health care workers to fulfill their professional and moral obligations to patients is threatened by the rapid implementation of artificial intelligence (AI) in clinical settings without worker input. We will secure protocols for AI that ensure licensed health care professionals retain the right to override any clinical decision made by AI algorithms without fear of employer retribution. Workers must have a voice in the development and deployment of AI systems to ensure they support patient care and do not contribute to the deskilling of clinical jobs.
Guaranteeing workers a voice on the job is the top priority in addressing all of these concerns. When health care workers join together in a union, they can bargain for higher wages, push for safety measures in clinical settings, negotiate and enforce requirements that shifts are safely staffed, and ensure that administrative tasks do not rob time from direct patient care. We will advocate for stronger legal protections for workers who wish to join a union and enact laws to bar providers from public programs if they have a pattern of labor violations. We will also advocate for repeal of the “Big Ugly Bill”’s ban on dues deduction for home care workers employed in the law’s newly created Medicaid waiver program.
At the heart of our desire to live healthy lives is affordable access to care and nutrition. A healthy, well-fed and supportive society is a productive one. Our movement must advocate not just for a health care system that expands access for all, but also for nutrition assistance for families in need. Food and nutrition assistance programs kept millions of adults and children from malnutrition and helped lift families out of poverty. Yet the “Big Ugly Bill” imposed $186 billion in cuts to the Supplemental Nutrition Assistance Program (SNAP), shifting program burdens to states. With 42 million SNAP participants as of 2024, 25% are Black adults and children, and 80% of all families in the program have a family member who is either a child, an elderly adult or a person with a disability. As the bill’s provisions are implemented, it will increase poverty, food insecurity and hunger. The labor movement must fight to repeal these dangerous cuts and commit to holding elected officials accountable who vote to put our lives at risk.
Health and Safety on the Job
The reality of a safe job is a fundamental worker right and a core principle of the labor movement. Worker power is the driving force to winning and sustaining meaningful safety and health protections, from the shop floor to the halls of government. For generations, workers and their unions have led the fight for safe and healthful working conditions to protect ourselves from injury, illness and death; demanding not only safer workplaces, but the dignity of returning home to our loved ones safely at the end of each shift. Workplace hazards are preventable, and protecting workers from job hazards also makes spaces safer for consumers and the public. We have made real progress, winning strong comprehensive laws and protections that have made workers and the public safer, saved lives and improved livelihoods.
Elevating workplace safety and health issues is more important than ever. Our fight for safer workplaces has become more challenging as employers’ opposition to workers’ rights and protections has grown, and attacks on unions have intensified. Big corporations have launched an aggressive assault on worker protections, attempting to shift the responsibility for safe jobs from employers onto workers themselves. Instead of making working environments safer, corporations are rewriting the rules to make it safer for them to avoid accountability, allowing scores of employers to violate the law without consequence. These efforts undermine the core responsibilities that workplace safety agencies such as the Occupational Safety and Health Administration (OSHA), the Mine Safety and Health Administration (MSHA) and the National Institute for Occupational Safety and Health (NIOSH) have had over the past 55 years.
Workers’ lives are at stake. Each day in this country, more than 380 workers die due to job injuries and illnesses. Each year, millions more workers suffer serious workplace injuries. Long-recognized hazards, including most toxic chemical exposures and musculoskeletal disorders, remain unaddressed. Workers are exposed to infectious diseases, heat, workplace violence and silica dust in mines. Many workers of color, including Black and Latino workers, hold some of the most dangerous jobs and face higher fatality rates than their white counterparts. Immigration status and lack of union representation makes immigrant workers especially vulnerable to unsafe working conditions, which inevitably lowers the floor for all workers. Employers’ growing reliance on temporary workers, independent contractors and misclassification of employees as contractors denies workers basic protections and has made it easier for employers to deflect accountability for meeting their obligation of providing a safe workplace.
We are fighting back and pushing forward to defend the fundamental right of every worker to a safe job. Workers, unions and our allies stand united to defend our hard-won gains and secure stronger protections and rights for all workers.
Our job is never finished. We must protect the rights we have won and keep fighting for safer working conditions. At a time of deep division, the fundamental need for a safe and healthy workplace unites all working people, and is important for our bargaining, education, organizing, mobilization and advocacy.
We resolve to:
- Remember every worker who has died on the job, or who has been seriously injured or made ill because of their work.
- Champion fully staffed and funded job safety agencies with the expertise to issue strong regulations and conduct critical research to reduce injury, illness and death from work.
- Defend against corporate attacks on protections from all chemical, biological, ergonomic, radiation, other energy, safety and other hazards, including worker-related provisions in OSHA, MSHA, the Environmental Protection Agency, Chemical Safety and Hazard Investigation Board and other laws; safety and health standards; workers’ compensation; and workers’ rights.
- Win new safeguards to protect workers from exposure to legacy asbestos, silica dust and other toxic chemicals, heat illness, workplace violence, infectious diseases, musculoskeletal disorders, combustible dust, hazards that result from climate disruption events, and other workplace emergencies and other hazards through whatever means possible—including federal and state legislation, regulations, enforcement, organizing and collective bargaining.
- Institute safety and health guardrails against the use of artificial intelligence that undermines risk assessments and hazard identifications; promotes continuous surveillance and monitoring of workers instead of hazards; permits automation, technology and machine learning of safety procedures that require human expertise; replaces workers’ right to exercise professional judgment and places the burden and the liability of verifying the accuracy and efficacy of AI on the workers rather than the employer or AI company; and relies on algorithmic management for unsafe scheduling, work pace and retaliation.
- Protect food manufacturing workers and consumer safety by advocating for appropriately regulated line speeds, mitigation of ergonomic stressors, safe staffing, and allowing workers to exercise their rights to report injuries and receive proper medical care.
- Strengthen job safety and health laws to cover public sector, temporary and contract workers; increase penalties; and strengthen whistleblower protections under the Occupational Safety and Health Act, the weakest of 25 federal whistleblower statutes.
- Build state resources to strengthen state OSHA plan capacity, standard setting and enforcement, and strengthen federal oversight of state OSHA plans.
- Increase union capacity to mobilize and organize workers using safety and health issues and tools that are worker-driven.
- Educate working people and the public about the attacks on worker protections and rights while confronting misinformation, disinformation and the misuse of science that weaken worker protections.
- Strengthen enforcement and penalty programs against severe violators and repeat offenders, and prohibit bad actors from agency safety recognition.
- Strengthen workers’ right to refuse unsafe work and strike over unsafe working conditions in the private and public sectors.
- Expand efforts to address the growing concern of violence against teachers, school leaders and other education workers by advocating for comprehensive policies that address school safety and protect workers in public schools.
- Expand efforts to protect the safety and health of women who are disproportionately exposed to workplace violence, face particular challenges with ill-fitting protective equipment and suffer unique consequences of workplace chemical exposures and lack of bathroom access.
- Win safer staffing levels and mental health support that prevent and address workplace injury, illness, fatigue and the risk to the public.
- Push for stronger anti-retaliation protections and worker participation rights, and ensure health and safety committees are used meaningfully and effectively to help workers address safety issues in their own workplaces.
- Demand that women are safe at work: Ensuring women are safe at work is a fundamental right, requiring a proactive, zero-tolerance commitment to end gender-based violence and harassment. This involves implementing strict, clear policies, providing secure, confidential reporting mechanisms, conducting regular training to shift culture and fostering an environment where all workers are supported without fear of retaliation. The AFL-CIO will continue to support the U.S. ratification of International Labor Organization Convention 190, the first global binding treaty on ending violence and harassment in the world of work.
[SUBMITTED BY THE AFL-CIO EXECUTIVE COUNCIL]