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What's Happening to our Healthcare

History and Timeline

2018 - 2023

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Over the past decade, there has been a slow but relentless decline in health benefits for municipal workers, mainly for in-service employees – a co-pay here, a deductible there, a shift of health insurance in 2018 for new hires from Emblem Health to HIP. But then, in July 2021, the “slow” decline metastasized into something much more ominous. The New York City Office of Labor Relations (OLR) and the Municipal Labor Committee (MLC) announced a massive restructuring of NYC retiree health-care insurance.

While city unions individually bargain directly with the city on wages, the MLC negotiates health-care benefits for more than 100 municipal unions, including the PSC.

The story does not end with retirees. The re-engineering of retiree health care grew out of a June 28, 2018, OLR-MLC agreement. On a recurring basis from fiscal year 2022 forward, that agreement calls for “$600 million per year savings” in municipal employee health benefits. Savings in effect meant cutbacks. Given this grim reality, the health-care benefits of every municipal union member, including NYC and PSC union members, are potentially next on the “$600 million per year savings” cutting block.

When OLR and the MLC signed the June 28, 2018, agreement, they targeted eight areas of potential savings, but only seriously considered one, reaching for the low- hanging fruit: retiree health benefits. For all but a few MLC unions (the PSC being one), retirees are denied membership and effectively any voice in union decisions. Cutting retiree benefits was easier and preserved the fiction, over the short term, that in-service benefits remain whole.

Among the menu of eight options, there were two with potential for major cost-savings that OLR-MLC did not pursue: (1) Exploring self-insurance (many states and cities self-insure to reduce costs); and (2) Municipal unions and the NYC government exercising their collective leverage to reduce runaway hospital costs. The PSC has subsequently joined a labor coalition examining how to reduce hospital costs, but this is outside the MLC.

Consider the path chosen by the OLR and MLC: Most NYC retirees and their spouses are Medicare eligible, so traditionally it became their primary health insurance, covering 80% of costs. The City provided premium-free, secondary insurance (e.g. NYC Senior Care), paying most of the remaining 20% with few out-of-pocket expenses for municipal retirees. Combined with robust benefits (particularly prescriptions) from the PSC-CUNY Welfare Fund, PSC retirees had excellent, affordable health-care benefits, before the proposed restructuring of retiree health insurance.

The goal of the restructuring, approved by the MLC in July 2021 (with the PSC and several health-care unions in the minority, voting “NO!”) was to move the bulk of New York City’s 250,000 retirees from traditional Medicare administered by the government to a privatized Medicare Advantage Plus plan (MA+).

There was massive pushback by municipal retirees.  The PSC Retiree Chapter started mobilizing its members in opposition in March 2021 when it first learned that NYC was considering moving municipal retirees from traditional Medicare to privatized, for-profit Medicare Advantage.  When the City awarded a Medicare Advantage contract to the “Alliance” (of Anthem and Empire), the NYC Organization of Public Service Employees filed a successful lawsuit delaying implementation of the move to Medicare Advantage and stopping NYC from charging a premium for secondary insurance (e.g. NYC Senior Care) for those retirees who chose not to go into the Medicare Advantage program and to stay in traditional Medicare.

On July 18, 2022, the Anthem/Empire Alliance withdrew its NYC Medicare Advantage plan.  Subsequently, on September 8, 2022, the MLC voted to join OLR in pushing for a Medicare Advantage contract with Aetna Insurance and pushing to amend the NYC Administrative Code so that the City could charge retirees a premium for NYC Senior Care.  The PSC voted against amending the NYC administrative code, arguing that such a change would not only diminish retiree healthcare, but ultimately health insurance for in-service members as well.  On March 9, 2023, joined by 25 other unions, the PSC voted “NO” on an MLC proposal to (1) approve a contract with Aetna Medicare Advantage and (2) to remove premium-free NYC Senior Care as an option for Medicare elligible retirees.  But the “yes” vote prevailed.  Click here for more recent updates on the pushback against the move to Medicare Advantage and the elimination of premium-free Medicare as an option.

CONTEXT AND HISTORY:  For a more detailed history of PSC and retiree pushback from 2018 to July 2022, you can go here to the old PSC website and here for a February 2022 Clarion article.  And here for updates from the summer of 2022 to the present.


Here is a list of both PSC and city-wide key events on the proposed NYC changes in healthcare benefits for municipal retirees and employees — and the pushback against them.

–Return to What’s Happening to Our Healthcar

Published: January 31, 2023 | Last Modified: October 31, 2023

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Protest at the CUNY Trustees Meeting-NEW LOCATION-May 20th at Bronx Community College