NYC MAP Attack: Powerbrokers Desperate to Break the Backs of Medicare Advantage Opponents

NYC municipal retirees and their supporters in labor have consistently gotten into the streets to prevent the privatization of their healthcare - to the frustration of the Adams administration and those pushing the plan at all costs. Photos by Joe Maniscalco.

By Bob Hennelly

Faced with the failure of the City Council to change the administrative code to permit the shifting of city civil service retirees to a privatized for-profit Medicare Advantage plan, the city is moving for the “immediate implementation of a Medicare Advantage plan with the elimination of all other plans that otherwise would have been offered to retirees.”

Both the Adams administration and the Municipal Labor Committee support the shift and have been pressing the City Council to make the necessary change to the city’s Administrative Code that would clear the way for the change.

In a broadcast email to its members, the United Federation of Teachers described the city letter as a “bombshell that puts our premium-free health care in jeopardy.” The advisory explained the City put the unions on notice “of its intent to enroll all Medicare eligible city retirees in a NYC Medicare Advantage plan and eliminate all other retiree health plans, including GHI SeniorCare. If the unions don’t go along with it, the city has threatened annual health care premiums of roughly $1,500 for all in service municipal employees.”

In that October 28 letter to Municipal Labor Committee chairman Harry Nespoli, Office of Labor Relations Commissioner Renee Campion said unless the Council passed the change to  Administrative Code 12-126 by Nov. 4, the Adams administration “would seek relief” from mediator Marty Scheinmen, to order the change that would also comply with a standing order from a state judge that the city continue to provide retirees premium a free health insurance option.

“The City continues to lose $50 million a month for every month this plan is delayed, putting our shared goals in significant jeopardy,” Campion wrote. “We must move forward with the MAP plan in any way that we can, as quickly as we can. 

The ratcheting up of pressure on the city’s public unions came a day after the city’s lawyers ran into tough questioning from Appellate Division First Department over its plan to convert its civil service retirees from traditional Medicare to a private Medicare Advantage.

Across the country, public employees, who were front line essential workers throughout the pandemic, are now being hit by double digit health insurance price hikes with New Jersey public workers being slammed with a 20 to 24 percent spike in rates. 

“This is a national crisis right now,” said UFT Michael Mulgrew, who has been pressing for the Administrative Code change and the shift to Medicare Advantage. “With my work at the AFT I help locals across the country and they are getting killed on healthcare. They are literally getting 3 percent raises and taking home less money because the insurance companies and hospitals are running amuck. They don’t know what to charge. How can you do actuarial tables when we have been in a pandemic for a year.”

Opposition to forcing municipal retirees into to a privatized for-profit Medicare Advantage Plan includes the Uniformed Fire Officers Association, Local 1 Plumbers, NYC Local 294 Laborers, Professional Staff Congress and others.

“Right now, the workers of New York City and their unions are dealing with a $450 million bill just from COVID testing alone,”Mulgrew said, adding that the only way to deal with the healthcare cost crisis was with significant federal intervention.

The ongoing controversy is an outgrowth of last year’s successful retiree revolt against then-Mayor Bill de Blasio and the Municipal Labor Committee’s proposal to shift retirees to a privatized Medicare Advantage program in hopes of realizing some savings.

City Hall and the MLC said the plan, branded as Retiree Health Alliance, which was going to be run by Anthem and Empire Blue Cross Blue Shield, would produce $600 million in savings with no loss in coverage. Retired civil servants and the NYC Organization of Public Service Retirees countered the move  threatened retirees’ continuity of care, would cost more, and would cover less as providers would squeeze more profits out of the conversion.

Tens of thousands of city retirees opted out. One key issue was a requirement that city retirees who opted out of the new offering would have to pay a $191 monthly premium for their old plan. Subsequently,  the two health insurance companies fronting the controversial plan withdrew. 

The New York City Organization of Public Service Retirees successfully challenged  the city in court bringing the implementation of the plan to a standstill at the start of the Adams’ administration. That litigation continues. 

While Judge Frank green-lighted much of the MLC’s plan that cleared the way for Medicare Advantage, he cited  the binding nature of the language of the city’s Administrative Code 12-126 which committed the city to provide premium-free healthcare for retirees.

Mulgrew said during an interview the city has made clear that he believes without the change to the city’s Administrative Code and “without Medicare Advantage active workers will be saddled with health insurance premiums for the first time.”

Mulgrew argues the change in the city’s Administrative Code is necessary to protect the unions’ rights to collectively bargain for healthcare benefits including to ensure that “our retirees not only have a premium free plan, but to have options because they have always had options.”

Retired city workers who have waged a successful legal battle and lobbying effort to resist the change to Medicare Advantage accused the MLC and the UFT of “pitting working members against retirees.” 

“We will not let that happen,” said UFT President Micheal Mulgrew, who supports the change in the Administrative Code and the shift to Medicare Advantage. “The only thing we need is the Administrative Code change which for some reason the City Council believes because 500 people contact them, they are having difficulty coming to that decision.”

The UFT leader said that over the last several years the unions and the city, working together to contain healthcare costs, had saved $3.4 billion from initiatives like charging participants a $500 co-pay for unnecessary Emergency Room visits.  But he said the ongoing litigation brought by retirees opposed to the Medicare Advantage “has put this kind of effort on hold.”

The issue of changing the city’s Administrative Code and the shift to Medicare Advantage has split the MLC, the umbrella group that represents over 300,000 public workers with over 100 city agencies. 

The leaders of the Professional Staff Congress, representing 30,000 workers at the City University of New York, along with DC 37 Local 2507, representing FDNY EMS, as well as the Uniformed Firefighters and Uniformed Fire Officers Association have gone on record opposing the changes which they contend could have serious unintended consequences. 

Retirees who oppose the shift to a Medicare Advantage plan point to a recent study by the Department of Health and Human Services Inspector General that found the plans run by for profit providers showed that the “plans  sometimes denied or delayed patients’ access to medically necessary services, even though the requests met Medicare coverage rules.”

Around the same time that the fire unions announced a very public lobbying campaign to push back against any changes to the city’s administrative code, the New York Times published a devastating expose on the nation’s leading Medicare Advantage plans.

“Medicare Advantage, a private-sector alternative to traditional Medicare, was designed by Congress two decades ago, to encourage health insurers to find innovative ways to provide better care at lower cost,” reported the Times. “If trends hold, by next year, more than half of Medicare recipients will be in a private plan.”

The newspaper reported that in “a survey of dozens of fraud lawsuits, inspector general audits and investigations by watchdogs” showed “how major health insurers exploited the program to inflate their profits by billions of dollars.”

In an information sheet to its members, DC 37, the city’s second biggest union with dozens of locals that represent 150,000 members and 89,000 retirees echoed Mulgrew’s warning that without amending the administrative code “active members and retirees could be forced to pay premiums for themselves and their dependents.”

“New York City is the only major municipality that provides this benefit for city workers, and the City needs every available tool to retain and recruit its workforce. If the administrative code is not amended, retirees will not keep their current healthcare as-is—the current plan is not financially sustainable,” according to the DC 37 fact sheet. 

Marianne Pizzitola, is a retired FDNY EMT represented by DC 37’s Local 2507 and the president of the New York City Organization of Public Service Retirees. 

“What you really mean is that the City refuses to continue paying for Medicare eligible retirees as is required by law and, by removing that obligation and placing it on the federal government, the  active and pre-Medicare retirees will be saved from being charged premiums,” wrote Pizzitola in a point by point rebuttal of the DC 37 handout. “How long will it be before the plan pegged for active and pre-Medicare retirees is also changed?”