A Win for ‘Every American Across This Country Being Lied to About So-Called Medicare Advantage’
“[Judge Frank] has joined the chorus of judges noting that corporations making hundreds of billions of dollars by delaying, denying, and restricting access to care are bad for people’s health.” - Alex Lawson, Social Security Works.
By Bob Hennelly
Within hours of a New York State Court decision “permanently” enjoining Mayor Eric Adams from forcing 250,000 retired civil servants into the for-profit Aetna Medicare Advantage Plan, one of the New York City Council’s most powerful members announced his support of legislation [Intro-1099] that would further protect retirees’ traditional Medicare coverage.
In his August 11 order, Hon. Lyle E. Frank relied on the “doctrine of promissory estoppel” as well as existing “provisions of New York City’s administrative code” to bar Mayor Eric Adams and his administration from making the move.
The Adams administration is appealing the decision. New York City Organization of Public Service Retirees, the plaintiffs in the case, maintain municipal retirees forced into the Aetna plan could lose access to their current health care providers and be subject to prior authorizations.
Last year, the New York Times and Kaiser Health News published extensive investigative pieces which raised alarming questions about the practices of the nation’s largest Medicare Advantage insurers including Aetna, which is currently under investigations by the Department of Justice.
“Now that the court has once again ruled that the city must continue providing retirees with traditional Medicare, in solidarity with the hundreds of thousands of impacted retired city workers, I am signing on as a co-sponsor to Intro 1099,” wrote Council Member Justin Brannan, (D-Brooklyn-43 Dist.), chair of the City Council’s Finance Chair.
Brannan’s statement continued, “As Chair of the City Council’s Finance Committee, it is my responsibility to negotiate and oversee a budget that protects the fiscal health of our City and the essential services that nearly 9 million New Yorkers rely on. To that end, I have serious concerns over the rapid rise in healthcare costs and its impacts on our city’s bottom-line. However, revoking promised benefits from vulnerable retirees in the middle of the game to save the city money is completely unfair and wrong. And, today, a judge agreed.”
Council Member Chair Barron (D-Brooklyn-42 Dist.), the lead sponsor of Intro. 1099, welcomed Judge Lyle’s ruling as an important validation of his belief “that we have a solemn obligation to keep the commitment it made to all of our essential workers who dedicated their lives to serving and protecting us.”
“Now, we need the City Council to step up and do its part to complete this peoples’ victory, and see to it we are on the right side of history, standing with our retirees,” Barron said.
The controversial drive to Medicare Advantage, which was initiated by Mayor de Blasio, has the support of the city’s Municipal Labor Committee, which is dominated by the heads of District Council 37, the United Federation of Teachers and Teamsters Local 237.
The boosters of the proposal said that the city could pocket $600 million in savings with no diminishment of city retirees’ coverage.
Several unions, including the Professional Staff Congress, which represents 30,000 CUNY workers, and DC Local 2507, which represents FDNY EMS — oppose the plan.
Earlier this year, the City Council, under the leadership of Speaker Adrienne Adams rebuffed a bid by the Adams administration and the MLC to change the existing language in the city’s Administrative Code that was cited by Judge Lyle in his ruling. However, Speaker Adams would not endorse legislation supported by the New York City Organization of Public Service Retirees [NYCOPSR] to strengthen those existing protections.
Speaker Adams’ press office did not respond to a request for comment on Judge Lyle’s ruling.
“This is now the third time in the last two years that courts have had to step in and stop the City from violating retirees’ healthcare rights,” wrote Marianne Pizzitola, president of the New York City Organization of Public Service Retirees. “We once again call on the City and the Municipal Labor Committee to end their ruthless and unlawful campaign to deprive retired municipal workers of the healthcare benefits they earned.”
Pizzitola continued, “Knowing after every win, the City has found a way to go around the Judge’s decision, the City Council should support Intro 1099 sponsored by Councilman Charles Barron and stop this administration from wasting taxpayer dollars appealing righteous decisions by the Court. NYC Retirees earned their right to Federal Medicare, and we relied on the promise we would have this benefit through our lifetime.”
She concluded by saying, “We hope this decision will help retirees nationwide stop their former unions and employer from privatizing the Federal Public Health Benefit of Medicare so we can live the rest of our lives in peace.”
So far, 17 members of the City Council have pledged to support Intro. 1099, including Council Member Joann Ariola (R- Queens Dist. 32), chair of the Committee on Fire and Emergency Management.
“I feel completely validated, and I am so happy we stood with the retirees from day one because we knew this [forcing retirees onto Medicare Advantage] was the wrong thing to do and this was an instance where the supporters of this maneuver were going to be on the wrong side of history — now that’s been proven by the courts,” Ariola told Work-Bites during a phone interview.
“This decision is great,” Council Member Chris Marte (D-Manhattan Dist. 1) said. “We knew all along the retirees were on the right side in the court room were time after time they got favorable rulings. That’s why we urgently have to move forward with Council Member Barron’s legislation to defend the healthcare rights of our retirees.”
Council Member Tiffany Caban (D-Queens Dist. 22) tweeted, “This is the right decision. Making our healthcare system financially sustainable requires passing universal public health insurance — not reneging on our city’s promises to retirees. Let’s get the New York Health Act and Medicare for all done.”
Council Member Gale Brewer (Democrat-Manhattan-Dist. 6) sent a text saying, “I believe that the current municipal retirees should be able to keep their health care. And I am pleased with the judge’s decision today regarding the lawsuit.”
The City Council’s Common Sense Caucus also hailed Judge Lyle’s ruling.
“While the City is expected to appeal, we are confident Judge Frank’s decision will withstand further legal challenges because New York City Administrative Code 12-126 is unambiguous in protecting this essential benefit,” the Common Sense Caucus wrote in a statement. “We were proud to lead the charge to preserve the current administrative code when the Mayor tried to change it and to file an amicus brief to support this successful lawsuit.”
The statement continued, “Once again, we hope this court order compels union leadership and the administration to come back to the negotiating table to find health insurance savings without diminishing the benefits our retirees have earned.”
Most of the City Council’s 51 members have yet to weigh in on Intro. 1099. But Council Member James F. Gennaro (D-Queens Dist. 24), weighing in before the latest court ruling, expressed opposition saying the legislative body had “no authority whatsoever to prohibit the mayor from asserting that Medicare Advantage met the standard of care he is required to provide under past collective bargaining agreements.”
Gennaro accurately predicted that the retirees would prevail in court “and have the retirees’ current superior healthcare plan continue” and that Medicare Advantage would just “go away.” He further stated, “Although the mayor can appeal that decision, the conventional wisdom (for what that is worth) is that the mayor will not appeal.”
Joshua Freeman, noted labor historian and author, is a distinguished professor emeritus of history at Queens College, the Graduate Center, and the School of Labor and Urban Affairs, City University of New York. He said Judge Lyle’s ruling “reflects the power NYC retirees have been able to assert by banding together and refusing to defer to the powers-that-be."
In a previous interview with Work-Bites, Freeman said it was “shameful that New York City union leaders are contributing to the privatization of Medicare, one of the greatest historic accomplishments that the union movement helped achieve, and to undermine it by pushing for the privatization of it when the whole thing is being looked at again — I just don’t get it. Even if there are short term advantages, as a policy, I just don’t get it.”
Last month, a delegation of 70 members of NYCOPSR, led by Pizzitola, were given a hero’s welcome at a ‘Save Medicare’ rally in front of the U.S. Capitol on July 27. The New York City retirees shared the spotlight with Sen. Elizabeth Warren (D-MA), and several other members of the House of Representatives who blasted for-profit Medicare Advantage insurance companies for delaying and denying health care treatment to seniors which they said resulted in an estimated 10,000 deaths a year.
“This year, for the first time more than half of all beneficiaries are enrolled in Medicare Advantage instead of traditional Medicare,” Sen. Warren told the large crowd in front of the Capitol. “Medicare Advantage substitutes private insurance companies for traditional Medicare and that private coverage is failing with Medicare beneficiaries and taxpayers. It’s all about the money. Private insurers are in Medicare Advantage to play games to extract more money from the government. Experts estimate the Medicare Advantage insurers will receive more than $75 billion in over payments this year alone.”
Dr. Steven B. Auerbach, with Physicians for a National Health Program, welcomed the retirees win in court.
“So-called Medicare ‘advantage’ is neither Medicare nor an advantage,” wrote Auerbach. “It is a deliberately dishonest label, a corporate marketing scam.
Real original public Medicare offers the broadest and best care. When you stop to think about it, the claim that somehow adding an additional for-profit corporate layer of middlemen and bureaucracy between Medicare and the Patient it is meant to serve will somehow both save money and improve healthcare — is obviously absurd nonsense.”
Alex Lawson, executive director of Social Security Works, said the NYC retirees’ victory has national significance.
“This is a win not only for New York public employees, but for every American across this country being lied to about so-called Medicare Advantage,” wrote Lawson in response to a query from Work-Bites. “This judge has joined the chorus of judges noting that corporations making hundreds of billions of dollars by delaying, denying, and restricting access to care are bad for people’s health. We are going to take the momentum from this win to every corner of this country where people are being forced onto corporate insurance against their will. We will not stop until we have completely eliminated non-medically necessary delays and denials.”
For a number of years, the insurance companies successfully lobbied individual members of Congress to sign a letter of support for their Medicare Advantage Plans which coincided with their national advertising blitz that proved hugely successful.
“But this year, progressive advocates led by Social Security Works organized a decline-to-sign campaign,” wrote Ady Barkan, a co-founder of Be a Hero, a non-profit that endorses universal healthcare. “Representative Earl Blumenauer (D-Ore.), who had once been a lead author of the letter, started educating his colleagues about the problems with Medicare Advantage. As a result, the insurance industry did not even circulate the letter in the House, because it knew it would get far fewer signatures.”
Barkan continued, “As more and more people speak out about the denials and delays of care and the abuse and fraud in the system, our elected leaders are taking notice and beginning to talk about protecting Medicare from the corporate greed that is trying to devour it.”