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Home » Clarion » 2021 » December 2021 » Judge’s ruling delays MA+

Judge’s ruling delays MA+

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City still pushing the plan

Retirees continue to protest the city’s plan to privatize their health care. (Photo Credit: Dave Sanders)
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In a reprieve for retirees, on November 29 a state judge declined to lift his injunction suspending the “opt-out” deadline and temporarily preventing New York City from moving retirees into the privately administered NYC Medicare Advantage Plus (MA+) health benefits plan imposed by New York City and the Municipal Labor Committee (MLC). On December 3, the city, the “Alliance” of health insurers that will provide the new plan, and the MLC issued a joint statement effectively conceding that the city may be unable to implement the plan in January as planned. The court held another hearing on December 8.

POSSIBLE DELAY

The joint December 3 statement read, in part:

  • Until there is a court decision, no retirees will be moved into the new Medicare Advantage plan. Retirees will remain in the plan they were in for 2021 unless they utilized the once-in-a-lifetime option to change plans or transferred plans during the annual transfer period. Retirees do not have to take any action at this time.
  • The EmblemHealth and Empire BlueCross BlueShield Senior Care plan will remain premium-free until the new Medicare Advantage plan is implemented.
  • Once the court announces an implementation date, we will notify retirees of the period of time they will have to opt out of the Medicare Advantage plan.

MOVING DATE

On December 7, the city’s corporation counsel submitted an 87-page proposed implementation plan to the judge. The city proposed to move the implementation date of the MA+ plan from January 1 to February 1, 2022, and to extend the opt-out deadline to January 31, 2022. The city also proposed that every retiree be able to switch once in either direction between Senior Care and MA+, between February 1 and June 30, 2022. The city’s plan also proposed minor changes to the enrollment guide, which it said it would not re-mail, and a stepped-up informational campaign to providers. Counsel for the retirees challenging the MA+ plan filed objections to the city’s new plan on December 8.

The judge did not issue an immediate ruling on the city’s proposal at the hearing on December 8.

The PSC retirees chapter has joined with other municipal retirees groups over the past year to fight the plan. These groups have argued that it is not just a privatization of retiree health benefits that save the city money at the expense of retirees, but that it puts retirees between a rock and a hard place: either join the privatized plan or stay with the current plan but at an extra annual cost.

PSC POSITION

The PSC, a member union of the MLC, voted against the plan early this summer, in part on the grounds that participating unions needed more time and information to make an informed decision. Retiree advocates at the PSC protested the implementation of the MA+ plan, arguing that privatized coverage would ultimately lead to higher medical expenses for seniors and more restrictive health-care coverage.

PSC President James Davis informed members in a November 29 email that “The city had asked the judge to lift his injunction by December 1 to allow them to transfer the data for retirees who do not opt out by November 30 to the Center for Medicare Services, a federal agency. Through this action, the city would have effectively enrolled into the MA+ plan those who have not yet opted out. Since the judge has declined to modify his October 21 injunction, the city is unlikely to transfer retiree data by December 1, thus making a January rollout of the privatized plan unlikely.”

This is significant because Eric Adams will be sworn in as mayor on January 1, and he “will have the ability to pause or alter any potential de Blasio proposal that gets the green light from Frank, [the judge], before then,” as he has been critical of the deal, the Daily News reported.

Bill Friedheim, the PSC retirees chapter chair, still believes that the city and the new privatized provider, the Alliance, “seem hell-bent” on enrolling all retirees into the new plan.

Bill Friedheim
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“Retirees are pawns in this process, objects of contempt by the city and Alliance,” Friedheim said. “The confusion generated by the city has only exacerbated the angst of retirees about this whole rotten scenario moving them from traditional Medicare to a privatized, for-profit Medicare Advantage plan.”

Davis joined retirees in calling for voiding the contract between the city and the Alliance in testimony prepared for a hearing on the issue before the NYC Office of Labor Relations on November 10.

REJECT THE CONTRACT

“PSC urges the elected officials of the city to reject the contract because it is significantly flawed,” Davis said in his written testimony. “Simply put, the draft contract contains no accountability [with] no requirement for periodic reporting beyond standard financial and claims auditing. The draft contract permits the ‘Alliance’ to unilaterally change the coverage terms – plan design, rates and benefit provisions – of the Medicare Advantage Plus plan, based on federal rule changes, without any consultation with the city or the MLC. And the draft contract does not cure the central defect identified by the judge: the fact that a large number of health-care providers that retirees currently use have not committed to accept the MA+ plan, which will force retirees to choose between paying $2,400 more per year to ensure they can keep their current provider or potentially suffering a disruption in their continuity of care.”


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