State’s Highest Court Delivers Another ‘Monumental Victory’ for New York City Retirees!

New York State’s highest court has ruled the City of New York must pay for Retirees’ Medicare coverage. Photo by Joe Maniscalco

By Steve Wishnia 

New York State’s highest court on Dec. 17 unanimously ruled that the city must pay for traditional Medicare for its retired employees and can’t offer them only a private Medicare Advantage plan.

The 7-0 decision in NYC Organization of Public Service Retirees v. Campion, written by Court of Appeals Chief Judge Rowan D. Wilson, revolved around the meaning of Section 12-126 of the city Administrative Code. That 1967 law requires the city to pay, for active employees, retirees, and their dependents, “the entire cost of health insurance coverage,” defined as a “program of hospital-surgical-medical benefits,” up to a statutory cap amount.

The petitioners, the New York City Organization of Public Service Retirees, argued that the law required the city to pay for any plan it offers, up to the cap. The city argued that it only had to pay for the one plan it offered, in this case Medicare Advantage.

“We hold that section 12-126 requires the City to pay up to the statutory cap for any plan it offers to employees and retirees,” the court concluded, upholding both a July 2023 ruling by the trial court and a later appeals-court decision.

“The court said what we’ve been arguing for the last three years,” Jacob Gardener, a lawyer for the retirees group, told a press conference outside City Hall. “We’re incredibly grateful for that decision.”

He warned, however, that “the fight isn’t over. Every time we achieve a victory, the city finds a way to double down on its unlawful plan to force retirees into a private Medicare Advantage plan that denies access to their doctors and limits medical care.”

The Court of Appeals decision closes this particular case, Gardener said, but there are two others still pending. One, Bentkowski v. City of New York, was filed on behalf of Robert Bentkowski and several other retirees. It involves what Organization of Public Service Retirees head Marianne Pizzitola calls “the nuclear option,” the Adams administration’s 2023 decision to offer the about 250,000 retirees only an Aetna Medicare Advantage plan.

Bentkowski, a former emergency medical technician, argued that that denied him medical care, because the Florida hospital where he was scheduled to undergo a second kidney transplant did not take Medicare Advantage plans. The state Appellate Division’s First Department ruled in his favor last May.

The city has appealed that decision, and the Court of Appeals will hear arguments on it sometime next year, Gardener said. Another pending case involves copays, he added.

He urged Mayor Eric Adams and the Municipal Labor Committee, the group of public-sector unions that agreed to move retirees into Medicare Advantage in exchange for raises for current workers, to “back down.”

“Every single judge has ruled in our favor, and the city refuses to take the hint,” he said.

Marianne Pizzitola, president of the New York City Organization of Public Service Retirees issued a statement following the Court of Appeals ruling urging the City of New York to finally abandon is relentless Medicare Advantage push.

“The City’s plan to defund retiree healthcare has now been analyzed by 13 different judges across all three levels of the state judiciary,” she said.  “Every single judge—all 13 of them—have concluded that the City’s plan is unlawful.  We once again call on the City and the Municipal Labor Committee, with the leadership of DC37, UFT, Sanitation, CWA Local 1180 and Teamsters Local 237 to end their ruthless and unlawful campaign to deprive retired municipal workers of the healthcare benefits they earned. The constant suppression of the HiP rate, and passing of copays on unionists MUST END. Constantly putting the elderly, disabled, line of duty widows/widowers and 9/11 responders through this is cruel and inhuman.”

The Adams administration wasted no time issuing a statement saying it will continue to pursue its privatization scheme.  

“While we are disappointed in the court’s decision today, we will continue to pursue the Medicare Advantage plan — which would improve upon retirees’ current health plan and save hundreds of millions of dollars annually — and await the court’s next decision in the coming year,” Liz Garcia, Adams’ deputy press secretary, said in a statement.

The city will argue that while the Court of Appeals decision says it must pay for any health-insurance plan it offers retirees, it doesn’t say it has to provide a particular type of plan.

“Today’s ruling is the final win for the 250,000-some retirees fighting to keep the health care they worked for and were promised,” City Comptroller Brad Lander said in a statement. “New York’s highest court decided seniors will continue to have access to all providers who accept Medicare, a victory for our public-sector retirees.”

He added that the city’s Medicare Advantage plan “would have constrained our retirees to a smaller network with more restrictive requirements on care,” and that he was “was seriously concerned about the privatization of Medicare plans, overbilling by insurance companies, and barriers to care under Medicare Advantage.”

Still, he warned, “there are real cost questions facing the city when it comes to health care.”

Councilmember Chris Marte [D-Manhattan], sponsor of Intro. 1096—the bill aimed at further protecting existing retiree healthcare from the onslaught of Medicare Advantage—called today’s ruling “a monumental victory for the 250,000 retirees who dedicated their lives to serving New York City.”

“The Court of Appeals has made it clear: the City cannot break its promises to those who built this city and safeguarded its future,” he said following the Dec. 17 ruling. “Retirees deserve access to the healthcare they were guaranteed—care that is vital to their well-being and dignity. This decision is a resounding rejection of efforts to defund retiree healthcare, and it underscores the need for us, as elected officials, to prioritize people over profits. I stand proudly with the retirees and will continue to fight to ensure their healthcare choices are protected. As such, we must pass Intro-1096 to enshrine retiree healthcare once and for all.”

Robert Hennelly and Joe Maniscalco contributed reporting to this article.

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