Confronting the Medicare Advantage Monster Lurking in New York City

Municipal retirees opposing amending Section 12-126 of the Administrative Code and paving the way for Medicare Advantage used some Halloween-themed street theater outside City Hall this week to drive the message home. Photos and video by Helen Klein.

By Helen Klein

The skeletons were fake, but the scare was real as municipal workers, past and present, gathered near City Hall on Thursday, Oct. 27, to protest the city’s efforts to substitute a Medicare Advantage plan for the health insurance retirees have counted on for years.

“Halloween is a spooky, scary, fun time of year but there’s nothing fun about losing your hard-earned Medicare health care that you were promised,” contend Gloria Brandman, a retired teacher, who dressed in a witch’s pointed hat, emceed the protest, as attendees, many in costume, swarmed the sidewalk at Broadway and Park Place, brandishing signs making their displeasure clear.

“We need to keep up the pressure on the mayor and the Municipal Labor Committee to make sure they don’t turn into monsters,” she added during the event, organized by the Cross-union Retirees Organizing Committee.

“We’re the voice of the voiceless,” noted Michelle Keller, president of the NYC Coalition of Labor Union Women.

The retirees currently enjoy traditional Medicare with supplemental insurance that they say allows them to receive the medical care they are entitled to, based on promises made to them for decades, and many oppose a change that would effectively force them into a Medicare Advantage plan, which is administered by private insurers who have a profit motive to deny or defer coverage of specific interventions.

While the city and union heads including the United Federation of Teachers’ Michael Mulgrew have said switching to the Medicare Advantage plan would bring with it huge cost savings without a diminution in quality of coverage, Dr. Oliver Fein, an internist who is chair of the board of the NY-Metro chapter of Physicians for a National Health Program, tells a different story.

He said that many doctors, and even hospitals, are refusing to accept Medicare Advantage patients because the private insurers administering the programs often “actively delay approval” of referrals for testing or specialists, or for costly medications.

“What happens,” Fein added, “is that patients suffer and may even die.”

The New York City Council — touted as most progressive and diverse in the city’s history — is under increasing pressure to oppose shifting present and future municipal retiree into Medicare Advantage. Above: Council Member Christopher Marte says stopping the plan is a “matter of life and death.”

In a letter urging City Council Speaker Adrienne Adams to oppose changing Section 12-126 of the Administrative Code, the NYC Managerial Employees Association said doing so “will seriously undermine and compromise the healthcare protections for all City workers.”

“It will allow the City to renegotiate the rate for everyone and place employees into different "classes" with reduced benefits eliminating the protections and equal treatment regarding health benefits that current and retired employees have now,” the October 17, letter warns.

The shift would have already taken effect this past April, but a lawsuit brought it to a grinding halt, thanks to a ruling (now being appealed) by Judge Lyle Franks, who focused on the fact that those retirees who wanted to opt out of the Medicare Advantage plan would have had to pay $191 monthly to stay in their old plan.

As a result, the city came up with a different approach, what opponents are calling an “end run” around Franks’ decision, and is looking to amend the city’s Administrative Code (specifically section 12-126) to allow it to move forward with the change, which would take the support of the City Council.

So far, only a handful of councilmembers are actively opposing the switch to Medicare Advantage, but none has come forward to sponsor a bill to change section 12-126, according to Neal Frumkin, vice president of inter-union relations for the DC 37 Retirees Association. “That’s a good thing,” he told the crowd.

One of the opponents of the change is Councilmember Christopher Marte, who represents portions of lower Manhattan. Calling the effort to prevent the city from implementing the change, “A matter of life and death,” Marte said that the switch to a Medicare Advantage program was “not an advantage to our employees and not Medicare as we know it. We’re organizing to make sure the City Council, aka the most progressive City Council, aka the most diverse City Council, isn’t hoodwinked.

“I tell my staffers now, if they’re coming for the retirees, they’re going to come for you,” he added.

“Nobody should be the sponsor of this,” agreed Councilmember Charles Barron, who represents East New York and other portions of southeastern Brooklyn, who pledged support to the crowd.

Councilmember Alexa Avilés, who represents Sunset Park and surrounding areas in Brooklyn, concurred. She said it was “unconscionable” for the city “to go back on the commitment” it made to retirees. “We must choose people over profit every day. Do we sell them out for a buck? Hell no, is what I say.”

Also strongly opposed to the change is Public Advocate Jumaane Williams, who asked the crowd, “Is this the way you treat retirees? People deserve to have quality health care, period, and especially if you were made promises, those promises must be kept.”

As the protest ended, Brandman urged attendees to keep up the pressure.

“I’m tired of doing this, but I’m not going to let up,” she said. “I know the city is not going to stop. Guess what – neither are we.”