NEW YORK, N.Y. — More than 200 retired city workers and supporters marched through lower Manhattan June 30, protesting a possible deal to switch their health-care coverage from traditional Medicare to a private Medicare Advantage plan — which they say would cost them much more money and put a bog of stingy bureaucracy between them and their doctors.
“I worked 34 years. I was promised Medicare and supplements paid for by the city,” says Gloria Brandman, a retired special-education teacher and United Federation of Teachers member. If the proposed deal between the city and municipal workers unions goes through, she says, it would cost her $8,000 a year to keep her current health coverage.
“We don’t want Groupon coupons for silver sneakers,” longtime middle-school teacher Daniel Alicea told the marchers as they stopped outside UFT headquarters on Broadway. “We want our Medicare. We paid into it. It’s rightfully ours.”
The proposal grows out of a 2018 contract agreement between the city and the Municipal Labor Committee, the coalition that represents the more than 300,000 union city employees. The unions, including the UFT, District Council 37, and the Uniformed Sanitationmen’s Association, had agreed to find a way to reduce health-care costs by $600 million a year by the 2021 fiscal year.
To do that, the city is now soliciting bids from insurance companies to administer a Medicare Advantage plan for the estimated 245,000 retirees and their dependents, according to the Cross Union Retirees Organizing Group, which organized the protest.
Medicare Advantage plans typically offer some benefits, such as vision and dental care, that traditional Medicare doesn’t. The problem, Cross Union Retirees says, is that they also typically have higher copayments, require referrals and pre-approvals for many medical procedures, and have a narrow network, in which patients have to pay drastically more for treatment from doctors, hospitals, and other providers who are not included. Many retirees, the group says, are concerned that they will not be able to see their current doctors, “with whom they have established deep personal relationships,” or get coverage elsewhere in the country.
That would effectively create a two-tier health-care system for city retirees, says UFT member Roberta Pikser, a retired English-as-a-foreign-language teacher.
The UFT says those concerns are exaggerated. The retirees, the union said in a message to LaborPress, are now covered by traditional Medicare, which pays 80% of medical costs, with a private supplemental plan, EmblemHealth’s GHI Senior Care, to cover the other 20% without the retirees having to pay premiums. The proposed Medicare Advantage plan, it said, would replace only the supplemental coverage, and would be “a unique custom-made large group Medicare Advantage plan that would provide the same — or ideally increase — member benefits.” It would also “allow the city and the MLC to tap into additional federal subsidies” and “be designed to ensure that all Medicare-accepting doctors and other services would be covered.”
“A new supplemental plan would not be any more privatized than the current one,” the UFT said.
“That’s not really true,” Cross Union Retirees spokesperson Bennett Fischer told LaborPress the day after the rally. “The payments and the paperwork are all going through a private company.”
“I hope they’re right,” he continued, but he’s skeptical. While the MLC might have the leverage to negotiate a better deal than the usual private insurance, he said, “we haven’t seen the actual plan.”
There are three problems with Medicare Advantage plans, says Stu Eber, former president of the New York City Managerial Employees Association. First, “no Medicare Advantage that currently exists guarantees that your doctor will accept the plan.” Second, “no hospital is obligated to accept any Medicare Advantage group plan.” And third, “all Medicare Advantage group plans have gatekeepers,” which “sticks a clerk between you and your doctor.”
“If a new plan is put in place, it would provide access to all doctors and health services that take Medicare, which includes the doctors members are already using,” a UFT spokesperson told LaborPress.
“They say it will be just as good, but we know better,” says DC 37 Retirees Association President Ed Hysyk. “These for-profit companies make money by restrictions on health-care options.”
“When you give up traditional Medicare, you lose a lot of options, especially for rehab,” says UFT member Kathleen Manning, a physical therapist who works in Staten Island. Medicare covers up to three months of physical-therapy treatment, she explains, while Medicare Advantage plans typically cover only 10 days.
Hysyk is also irked by the lack of transparency in the process. “They never once consulted retirees,” he says.
Retirees did not find out that the plan was under consideration until late March, when the Professional Staff Congress, the union that represents City University academic staff, found out about it.
“I feel the union did a backdoor deal,” says DC 37 member Dan Cimini, a retired research scientist for the Department of Health. He didn’t hear about it until two or three weeks ago, saying he saw an unclear message on the back page of the union bulletin, and then learned more details from a friend, a retired city librarian who’d moved to California.
The mayor’s press office did not respond to questions from LaborPress about the issue.
Fischer, a member of the UFT’s retirees health-care committee, says the official and unofficial groups involved in the protest all agree that the unions and the city should stop the negotiations, let the members know what’s going on, and seek input from the retirees affected before proceeding.
As voting in the Municipal Labor Committee system is weighted by membership, the UFT, with 78,000 retirees, and DC 37 are the two most powerful unions in it. UFT President Michael Mulgrew told members at a telephone town hall in May that the union might decide to opt out of a conversion to Medicare Advantage, according to the Cross Union Retirees, but the negotiations have continued.
“Even if it’s good now, what happens in the future? What happens if they have to renegotiate for more savings?” Fischer asks.
“We are going in the wrong direction. We need Medicare for All,” says Gloria Brandman.
“If there’s one thing we learned during the pandemic, it’s that employer-paid insurance is ephemeral,” Fischer told the rally — but, he added, key local union leaders joined with insurance companies last month to block a bill that would have created a Medicare for All-style single-payer system in New York State.
The bill, the New York Health Act, was passed by the Assembly Health Committee, and a majority of state Senators had signed on as cosponsors. But on June 4, a coalition combining health-insurance and other business trade groups with several leading labor unions sent an open letter to Assembly Speaker Carl Heastie and Senate Majority Leader Andrea Stewart-Cousins, urging them to oppose it.
The letter called the legislation a “disastrous” attempt to force New Yorkers into “a new, untested, one-size-fits-all government-run health-care system” in which “union members would lose the benefits they have earned.” The signers included DC 37, the New York State Building and Construction Trades Council, several police unions, the Sanitationmen, and the UFT.
The New York Health Act never made it to the floor for a vote.