Union workers at HCMC are frustrated over health insurance changes they say will result in higher costs for less comprehensive coverage — and drive caregivers away to other hospitals.

Members of unions representing nurses, emergency care providers and other staff members held a news conference Tuesday morning to urge the Hennepin County Board to reject Hennepin Healthcare's annual budget plan. The County Board oversees the nonprofit, which operates HCMC and several clinics with a proposed 2024 budget of $1.48 billion.

The health system's budget was up for consideration at the board's regular Tuesday afternoon meeting, but commissioners decided to wait until Dec. 12 to take a final vote. Commissioner Angela Conley, who leads the board's health committee, and Commissioner Jeffrey Lunde said they still have questions that need to be answered before they feel comfortable voting.

"People are generally concerned about the process, about their benefits," Conley said. "I want to be sure that my constituents and the employees of the hospital are taken care of before I vote on it."

The delay was a welcome development for Janelle Johnson Thiele, an HCMC nurse and a leader with the Minnesota Nurses Association. She is one of several employees who have spoken out against the proposed changes. Johnson Thiele said HCMC is already short staffed and can be a tough place to work, even for the most dedicated caregivers.

"I'm thankful they are going to take the time to go back and get the information they need," Johnson Thiele said. "We have to do something to keep people here (at HCMC)."

Jennifer DeCubellis, Hennepin Healthcare CEO, acknowledged it is a "tough budget" when she presented it to the board Nov. 14. She noted that the hospital system faced a $127 million budget gap and had to make modest changes to worker benefits rather than cut elsewhere.

Hospital officials say the changes are not as bad as union leaders make them out to be. They say most of the 4,000 union staffers affected should see stable or reduced premiums, and they say benefits will remain among the best in the region.

Sam Erickson, vice president of the Hennepin County Association of Paramedics and EMTs, disputed that claim during Tuesday's news conference at the Hennepin County Government Center. He said premium adjustments might have been modest, but other modifications are troubling to members, including the decision to no longer cover weight loss drugs like semaglutide, which is sold under the name Wegovy.

"The coverage is significantly worse," Erickson said. "They are pulling the rug out from under folks."

Union leaders also noted that the health plan changes are coming after DeCubellis received a pay raise of more than 15%, and that the CEO will earn roughly $1 million in 2023. In a statement, the health system's board said DeCubellis' pay was competitive and it was important HCMC could attract and retain top leaders.

Caregivers also worry rising health care costs could mean more workers turn to HCMC where the cost they pay for care is cheaper. They argue that caregivers already struggle to handle the high volume of patients at the county's primary safety-net hospital.

"It already takes months to get appointments," said Johnson Thiele. "Our patients are going to go to the ER when they can't get appointments."

Hennepin Healthcare leaders say the number of workers who get care at HCMC is expected to be slightly lower in 2024, and that they continue to work to improve access for all patients.

Finally, staffers are frustrated that an $8 million supplemental appropriation from the County Board was not entirely used to keep health care costs low and maintain existing coverage. They say hospital leaders used about $4.5 million to help with benefit costs and the rest is being used for other expenses, such as improving safety and employee wellness.

This year, Hennepin County contributed about $27 million to HCMC to help with uncompensated care.

HCMC workers are not the only ones to express frustration to the County Board over rising health care costs. In September, county human services workers who belong to the American Federation of State, County and Municipal Employees Local 34 protested benefit changes and higher costs.

The County Board agreed to put $500 in worker health spending accounts to offset some of those increases. County leaders said pay increases should help further offset rising insurance costs.

The County Board is working to finalize its 2024 budget for approval Dec. 12.