‘Protocols and ‘Processes’ are Robbing NYC Retirees of Their Healthcare
New York City municipal retirees rally against Medicare Advantage at last September’s Labor Day Parade. Photos/Joe Maniscalco
By Joe Maniscalco
“Protocols” and “Processes.”
Having already reported on the “protocol” within the New York City Council that gives one person—the Speaker—sole power to determine what the rest of the 50 other members get to vote on, we couldn’t help but also take note recently of another colossally-undemocratic and grossly authoritarian “process” governing the lives of everyday working class people in this town.
And just so we’re clear, we’re specifically referring to working class people in this town who’ve spent their working lives making it possible for New York City to survive all the calamities and catastrophes it’s been subjected to over the last 25 awful years—at least.
Hizzoner, Mayor Eric Adams, inadvertently revealed this anti-democratic and authoritarian “process” last week in the Bronx while addressing a room full of older New Yorkers who refuse to be pushed into the profit-driven Medicare Advantage health insurance scheme the mayor has planned for them.
He probably doesn’t realize that’s what he did because up until that point in the Bronx meeting the mayor appeared to be on cruise control, successfully managing the electorate the way practiced politicos like himself know how to do so well in these kinds of very controlled settings.
But then he had to shift gears and try very hard to justify why, if he is indeed “the best person to be at the helm right now,” city attorneys are still in court trying to push a profit-driven Medicare Advantage health insurance plan on retirees that “everyone else is running away from.”
Despite nine consecutive losses in court, Mayor Adams continues to bet the New York State Court of Appeals will ultimately override a lower court’s decision blocking his administration’s attempts to herd municipal retirees into a profit-driven Medicare Advantage plan they reject.
He signed a five-plus year contract with Aetna back on March 30, 2023, saying that its profit-driven Medicare Advantage plan “improves upon retirees’ current plans” and is “in the best interests of both our city’s retirees and its taxpayers.”
Retirees challenged him in court on that score and won—over and over again.
Last week in the Bronx, however, the mayor said, “The lawyers for the city are responsible for protecting the city interest. While they’re out there going to court—I’m in the room with the MLC [Municipal Labor Committee]. I’m in the room with the unions. I’m in the room and saying, ‘Listen…what are the other ways we can do this…and try to figure this out…that’s how this process goes.”
“That’s how this process goes.”
Set aside the premise of city attorneys returning to court again and again trying to force city retirees into a Medicare Advantage plan they do not want, while Hizzoner is supposedly “in the room” with labor trying to find “other ways we can do this,” and how laughably ludicrous that all sounds—and just concentrate on that statement.
“That’s how this process goes.”
And what about all those older people out there who’ve helped pull New York City through some of the darkest days it’s ever experienced? Yeah, well…they are not part of “this process.” In fact, “this process” ignores them entirely. On purpose. By design. None of those esteemed organizations the mayor has previously cited being involved in “this process”—not the MLC, OMB, OLR—none of them represents municipal retirees. The municipal retirees represent the municipal retirees.
“Maybe [the mayor] doesn’t want me in the room because he doesn’t want to say he’s okay with killing off retirees and diminishing their healthcare because OMB & OLR said it saves money. I’m not going to tell him what he wants to hear—I’m gonna tell him what he needs to hear—and I’m probably the only one willing to do it.” —NYCOPSR President Marianne Pizzitola
They’re formed into easily recognizable and definable groups including the New York City Organizaiton of Public Service Retires [NYCOPSR], Cross-Union Retirees Organizing Committee [CROC], Council of Municipal Retiree Organizations [COMRO], District Council 37 Retirees Association, and Retiree Advocate/UFT.
Mayor Adams could have talked to some of them directly last summer outside Sunset Park High School in Brooklyn, but Hizzoner chose instead to walk right past them and pet somebody’s dog on the sidewalk before continuing on his merry way again.
Retired NYPD Lieutenant and 9/11-related cancer survivor Jack LaTorre rode his bike over from Bay Ridge that day to urge the mayor to stop trying to push retirees into a profit-driven Medicare Advantage plan they do not want because the prior authorizations required for care and narrow pool of doctors and hospitals make it trash—whether it’s “premium-free” or not.
Mayor Adams could have talked to Jack and learned a lot about Medicare Advantage’s real world impact on retirees. But he didn’t.
That’s not how “this process” goes.
In March, the JAMA Health Forum published a piece highlighting that in 2022, “one-third of [Medicare Advantage] beneficiaries experienced a denial for 1 or more services each year, with annual denials increasing by 15% over a 5-year period.”
Notably, the article continued, “nearly 15% of the 5.6 million denials—a full $150 million in denied spending—was attributed to [Medicare Advantage] policies that were more restrictive than traditional Medicare’s coverage rules. These data suggest that [Medicare Advantage] plans sometimes deny care that would have been approved by traditional Medicare.”
The mayor tried to score a couple of points during last week’s meeting with retirees in the Bronx by tossing out a quick reference to an earlier conversation he had with a person vaguely described as being part of “the coalition.” In addition to “being in the room” with the MLC and the unions, the mayor said this person was able to give him a “few ideas,” too.
Retired NYPD SBA Sergeant Robert “Bob” Ganley became vice-president of NYCOPSR in February. The 45-minute conversation he had with the mayor—the one Hizzoner referenced during the Bronx meeting with retirees—took place more than a month ago. Sergeant Ganley still hasn’t heard back from Mayor Adams since then.
“We had a serious discussion,” Ganley told Work-Bites this week. “He listened to my thoughts and concerns. I’m disappointed he hasn’t gotten back to me.”
Ganley, like many other municipal retirees fighting to keep the traditional, non-privatized Medicare coverage they were promised when they agreed to work for New York City, was on the job during the 9/11 terrorist attack on the World Trade Center.
Members of the Cross-Union Retirees Organizing Committee [CROC] and Retiree Advocate/UFT rally outside the Manhattan offices of the Centers for Medicare and Medicaid Services in April.
“I think it is reprehensible what they’re doing to force people into a managed care plan that is not as good as traditional Medicare,” Ganley continued. “Medical procedures should between you and your doctor—not a medical company. I never thought in 2001 we would be in this fight for our traditional Medicare.”
See what’s going on here? The mayor claims he wants to “fix” this problem, but he is purposefully going through all kinds of confused contortions doing everything but those things that would actually solve the problem.
It’s not hard. COMRO President Stu Eber provided the solution when he spoke to Work-Bites last week.
"The Mayor should instruct his Law Department to drop all four cases and then call Speaker Adams to prioritize the passage of the bill that died in committee earlier this year,” Eber said. “He should then meet with the representatives of the major retiree advocacy groups, including COMRO, CROC and NYCOPSR, to work on a health care plan that provides real savings to the taxpayers while protecting retirees' health care from the avaricious for-profit insurance giants.”
Done. Problem solved.
“The Mayor is being lied to and I have stood ready to speak with him from the heart and bring facts to the table,” retired EMS worker and NYCOPSR President Marianne Pizzitola told Work-Bites this week. “No one wants me in the room because they don’t want the truth exposed. If the mayor believes he is best suited to fix this, he will invite me to his office to hear the whole truth, details not being shared so people don’t lose their jobs and it doesn’t get exposed what got us here, and it wasn’t just Michael Mulgrew of the UFT.”
Why, Pizzitola wonders, if you’re the incumbent mayor you keep appealing nine unfavorable decisions in court?
“You once said the buck stops with you—you are the mayor,” Pizzitola said. “Maybe he doesn’t want me in the room because he doesn’t want to say he’s okay with killing off retirees and diminishing their healthcare because OMB & OLR said it saves money. I’m not going to tell him what he wants to hear—I’m gonna tell him what he needs to hear—and I’m probably the only one willing to do it.”
The battle over retiree healthcare, Pizzitloa promises, will be the “number one” election issue in New York City.
“And every candidate will have to answer—whether the incumbent or primary candidate—what they are doing, and what would they do to protect the healthcare promise made to retirees in protecting their Medicare benefits they earned and paid for, she said.
Until then, however, there are “Protocols” and “Processes” in New York City.