By J. Taylor Basker and Jesse Kasowitz
Medical insurance issues are now making NYC Government retirees sick. NYC retirees had some of the best insurance in the country. Despite its reputation, New York City is the eight healthiest American city to live in. Now all that is about to change.
Some 250,000 retirees from NY City Government service are currently struggling to keep their Medicare Senior Health Care. Medicare provides 80% of the benefit and the remaining 20% “Medigap” is provided by the City. Additionally, the City provided an annual partial reimbursement for out of pocket medical expenses. In a budgetary cost saving effort, the City is now insisting that the unwilling municipal retirees enroll in a Medicare Advantage Plan run by Aetna. Mayor Eric Adams signed off on a contract that will eliminate traditional Medicare coverage for retired city government workers and move them into a privatized version of the program. This controversial move immediately drew lawsuits from a grassroots retiree group.
Medicare Advantage (MA) was a creature of the Bush administration. It aimed to privatize Medicare. It is an artifice, a chicanery of private insurance companies to exploit seniors and the disabled. Patients are confused and often deceived because MA bears the Medicare name. The insurance companies take Medicare money, and then profit by limiting and denying necessary medical care. Patients are not told that pre-approval is needed before a doctor can treat an MA patient. Alarmingly, many doctors and hospitals will not serve MA patients. If a patient unwittingly sees an out of network doctor, he/she may be surprised by a bill to the patient personally, for several thousands of dollars.
Municipal workers signed on to work with the NYC Government, with the understanding that the Senior Care Medicare and Medigap benefit were inviolable. Government retirees claim that they eschewed work in the private sector or self-employment to take advantage of the government health care benefits. A stable predictable health care plan is particularly necessary for aging retirees. Now they are betrayed by this reversal during their retirement years, following a lifetime career of public service. Many endured difficult and sometimes dangerous jobs as teachers, policemen, firemen, hospital workers, paramedics and social workers during Covid. Now they are betrayed. As they say, no good deed goes unpunished.
Unfortunately, most of the retirees affected do not even belong to unions at all. Those in unions discovered that their unions betrayed them. The Municipal Labor Council and several of the City’s largest unions do not represent them. The leadership of the Municipal Labor Council and the unions presumptuously bargained away the rights of retirees that were never represented by unions. The unions claim that they are persuaded that the municipality cannot afford to pay periodic contractual pay increases to active workers while they continue to pay for the traditional senior care of retirees. So the unions have betrayed the retired unionized workers. Retirees are no longer dues paying union members and therefore they lack the right to vote in union elections. The unions are in effect, pitting existing workers against powerless retirees.
The retirees’ organizations cannot even get the contact numbers or emails of the great majority of union retirees to provide them with information that would enable them to make an informed decision. Additionally, this Aetna MA reform discriminates. If the retiree decides to waive all of the MA benefits, they would be on the hook for the full cost of a Medigap plan (the 20% not covered by Medicare) plus the loss of Part B reimbursement, which is now provided to retirees. A combination of the loss of reimbursement and the Medigap payment has been estimated at more than $5,000. per year- affordable by only the most affluent of retirees.
Retirees aware of the significance of this change, are organizing. They are led in part, by a devoted and articulate former paramedic, Marianne Pizzatola. She formed the Organization of Public Service Retirees. They write letters and make contributions to a legal fund in order to reverse this unlawful reform to our healthcare, as if our lives depended upon it. They engage in street demonstrations. They join the ranks of the Gray Panthers. Many in this age category were union activists, and protesters of the Vietnam war. Now we show up decades later balding, gray haired, some with hearing aids, canes, walkers, and wheelchairs, taking to the streets with tenacity.
Retiree organization lawyers initiated several court cases that has delayed this change for three years. If you are a City Government retiree and you are affected by the new plan, please ask your council person to support Intro 1099. It was introduced by Councilman Charles Barron and it would restore our medigap contribution. They also have a Facebook page under CDRO for info.
Please also make an affordable donation to the legal fund. It is now our best hope.
Make your check out to: NYC Organization of Public Service Retirees c/o JSH Accounting Services LLC PO Box 143538 Fayetteville, GA 30214 (this is the organization’s accounting professional)
Or go to this Paypal link:
Finally, the retiree health care dilemma could be resolved by the State Senate and Governor Hochul. We urge your support for the New York Healthcare Act, a single payer health care bill. This has already been passed by the State Assembly. It would provide guaranteed Medicare for all in NY State, affordable and universal. It would be the first of its kind in the nation. It would cover everyone regardless of income or immigration status. There would be no premiums, deductibles, or copays. It would require a rise in taxes of the wealthiest New Yorkers.
There inevitably is opposition from the insurance companies. Opposition also comes again, from our public employee unions. They would lose the benefit fund administration and staffing. We should not underestimate the critical importance of public employee unions. Nonetheless, they now fail to represent the interest of their retirees and non-unionized retirees on the critical matter of health care. They should never deviate from their mission of representing their members on wages, benefits, schedules, etc. They mustn’t become self-serving bureaucracies.
Mayor Adams is determined to make this change to private insurance. If we follow the money, we see large donations from insurance and health care entities to the campaigns of both Mayor De Blasio and Mayor Adams. Billionaires gave Super PACS over $16 million in the last mayoral primary campaign In 2021, with overall spending of $24 million. Adams received millions. Insurance, the health care industry, and real estate interests gave for a reason. Connect the dots . . .
The Aetna Company has been the object of Federal prosecutions for Medicare fraud. Additionally, in a possible preview of things to come for retirees, United Health Group (NYSE:UNH) and the Aetna unit of CVS Health (NYSE:CVS) have entered into settlements with the New York State Department of Financial Services over allegations of charging unapproved rates in student health plans. The agency found that unapproved premiums were charged to students covered under blanket health insurance contracts with colleges and universities. Will retirees be their next victims? Stay tuned.