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The largest union representing long-term care workers in the United States has withdrawn from a coalition of healthcare reformers intent on issuing widespread recommendations for lowering costs, according to published reports.

The Service Employees International Union, as well as the American Federation of State, County and Municipal Employees, another large union, withdrew from The Health Reform Dialogue coalition. AFSCME officials refused to elaborate on why they withdrew, according to The New York Times.

The two unions, which each support a public insurance plan and mandates on employer contributions to healthcare costs, sought a more expansive reform package, the Times reports. One member of the coalition said the final recommendation likely would reflect the lowest common denominator of reform options.

The Health Reform Dialogue coalition consists of representatives from physician and nurse groups, hospital associations, businesses, pharmaceutical firms and union groups. The group is expected to issue a recommendation for controlling healthcare costs and revamping the healthcare system as a whole by the end of the month.