Clarion Masthead

Judge delays retiree ‘opt-out’ deadline

Retirees fight against new plan

Bill Friedheim, PSC retiree chapter chair, tells New York City Council that the city should “hit the pause button” on the new Medicare Advantage plan.
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In a victory for municipal retirees and the PSC, a city judge struck down an October 31 “opt-out” deadline for the newly privatized NYC Medicare Advantage Plus (MA+) retiree health benefits plan imposed by New York City and the Municipal Labor Committee.

The contentious Medicare Advantage Plan, co-managed by an “Alliance” of EmblemHealth and Empire Blue Cross Blue Shield Retiree Solutions, is part of a move toward health-care privatization by the city and MLC in a bid to save money. As part of that plan, municipal retirees were given until October 31 to decide between two options: “moving into a premium-free Medicare Advantage plan or…staying in their NYC current plan, but paying a premium for supplemental insurance.”

The judge, while not striking down the agreement outright, has ruled against the implementation of the deadline, postponing it indefinitely.

A BAD DEADLINE

New York State Supreme Court Justice Lyle Frank wrote in his injunction, “While the Court has already determined that [the city’s] ultimate determination of choosing a Medicare Advantage Plan provider was rational and does not intend to disturb that determination, the Court finds that the implementation of its program is irrational and if the petitioners and similarly situated individuals are required to opt-in or out of a medical program by the October 31, 2021, deadline there would certainly be irreparable harm.”

A joint report from The City and New York Focus said that “The suit was filed by the NYC Organization of Public Service Retirees, a group formed in opposition to the move to a privately administered Medicare Advantage plan,” and that the judge “tentatively prohibited the city and the new insurer – a partnership between EmblemHealth and Empire Blue Cross Blue Shield known as the Retiree Health Alliance – from enforcing a planned Oct. 31 deadline for retirees to opt out of the plan.”

The two outlets previously reported that many municipal retirees were rushing to avoid the new privatized plan: “Droves of city government retirees are preparing to pay thousands annually to keep their existing health insurance rather than taking a chance on a new cost-cutting plan.”

DECISION WELCOMED

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 Medicare Advantage plan, arguing that privatized coverage would ultimately lead to higher medical expenses for seniors and more restrictive health-care coverage. Some PSC retirees feel the change signals the need to scrap employer-provided health-care plans altogether and instead support legislation to create a single-payer health-care system in New York.

PSC retirees hailed the judge’s order.

“It’s too early to break out the champagne since this is only a delay not a rescinding of the city’s decision to pressure retirees into a privatized [Medicare] Advantage plan with heavy costs to opt out. For retirees, the pause is most welcome as it provides more time for retirees both to get their questions answered and to build their organized resistance to the switch,” said Eileen Moran, a member of the PSC retiree chapter. “The ruling highlights the ineptness of both the city’s rollout, its failure to reach the retirees most impacted by the change, changing deadlines and the false assurances and misinformation about all doctors being in the plan.”

Mayor-elect Eric Adams has criticized the plan and welcomed the court ruling. He has been quoted in the press saying, “We need to look at it and make sure it’s not a bait and switch. I’m a retiree. I get retiree benefits. Their plan is my plan.…We want to make sure that it is a fair plan. Nothing is more frightening for a retiree than health care. That is frightening for a retiree, having health care be unsure, that’s scary.” The MLC still supports the plan, as does the Daily News editorial board, which called it a “good deal for retirees” as well as a cost savings for the city.

“When I retired, I thought that the package of health-care benefits I received was part of my compensation for my years of service,” said Mary Jean Holland, a Baruch College retiree, who testified to a city council panel on the issue held on October 28. “I now know that the city can reduce these benefits at any time. I fear this is only the beginning. I am especially upset by the lack of choice the city is giving its retirees under the newly adopted program.”

PSC President James Davis told the panel, “There is also a bigger picture to consider. The decision to privatize city retirees’ Medicare was driven by a real crisis in rapidly escalating health care costs, which threatens the health care of active employees too. The privatized, profit-driven model upon which this decision was based will neither control costs nor deliver quality care. The bottom line is that we need national single-payer to achieve the goal of affordable, universal health care. There are many intermediate steps the Council could take to help move us towards that goal. For example, the Council could pass legislation to curb exorbitant hospital costs, as Maryland has done. It could do more to ensure health-care funds are distributed to address race and class injustice, including the disparities between rich and poor hospitals. It could carefully consider whether self-insurance would save the city hundreds of millions if not billions by recouping excess payments to insurance companies and avoiding premium taxes.”

HIT THE BRAKES!

Bill Friedheim, the PSC retirees chapter chair, in his testimony, blasted the city’s process for reducing its health-care costs. “Which did they choose: self-insurance, with potentially hundreds and hundreds of millions of dollars in savings? Negotiating fairer prices with private hospitals? Neither,” he said. “Instead, they reached for the low-hanging fruit, retiree benefits. In the middle of a pandemic they targeted retirees, New York City’s most vulnerable health-care population, who had no agency in this process.”

He added that his chapter’s members were angry because the new plan means that “Medicare Advantage is the default and to keep traditional Medicare with supplemental NYC Senior Care we must jump through hoops, must submit opt-out forms for which there is no timely confirmation” and “must pay a $191.57 a month penalty to keep a plan that was once free.”

Friedheim implored the city council to step in and stop the deal, saying, “Tell New York City to hit the pause button, to stop implementation of this plan and to honor its commitments to its retired workforce.”