By J. Taylor Basker & Jesse Kasowitz
While you were enjoying the summer on the beach, sunning, swimming, or boating, the city unions sank the secure medical coverage you thought you had for life, as a retired city worker, behind your backs. Your sunscreen did not protect you from this dangerous change privatizing your Medicare. Your union leaders were part of this conspiracy to drown you in the shark-infested waters of private medical insurance.
This happened because Mayor de Blasio’s administration concluded a deal with the Municipal Union Leadership that will change the health care coverage of city government retirees—not in a good way. Medicare is to be converted into Medicare Advantage. However, Medicare Advantage is a disadvantage to present and future retirees. The deal will save the City some $600 million annually by cutting benefits promised to retirees and their dependents. Medicare Advantage was initiated during the Bush Administration as a first step to the privatization of Medicare. Medicare Advantage is not Medicare. It is to be run by a for-profit insurance company.
What are the negative consequences for retirees? They are as numerous as the sands and as treacherous as tsunamis. There are likely to be higher copays in the future. Despite protestations of the city and unions, there will be fewer doctors and hospitals to choose from in the future. Hospital for Special Surgery, and Memorial Sloane Kettering for example, now take Medicare Advantage on only a provisional basis. There is no contractual commitment on their part to work with it in the future. If a retiree has been under the care of a particular doctor, rehab center, cancer treatment center and that entity does not accept Medicare Advantage, the retiree will have their treatment abruptly terminated. There are serious unanticipated consequences to retirees living outside of the City, such as in Florida. There have been interviews with many doctors and hospitals both in and outside of New York, who say they will not take Medicare Advantage patients. In the future, a private for-profit insurance company is likely to impose gatekeepers to decide on pre-authorization of expensive diagnostic or treatment procedures. This could include ambulance transport, rehab services, limits on hospital stays, quality nursing home facilities, elective surgery, and mental health services. Pre-approval could deny or delay treatment inappropriately. Networks would be limited to less costly providers. The focus will be on the bottom line rather than our health. Instead of finding new municipal revenues, this will be paid by a significant give-back on the part of workers and retirees. This policy will create an imbalance between higher and lower paid city workers, and will especially impact minorities. The City cannot prohibit retirees from rejecting Medicare Advantage. Workers and retirees can elect to take Federal Government Medicare, which retirees paid for during their careers. If a retiree chooses to keep traditional Medicare Part A and B however, they will be denied group health insurance for Medigap (secondary) insurance and would have to pay higher premiums for non-group individual coverage. The relative costs and advantages of supplemental insurance offerings are not clear at this time. If as expected, a significant number of retirees and workers opt out of Medicare Advantage, they will in effect create a two-tier system of healthcare. Higher paid workers and retirees will pay for and receive premium benefits, while lower paid workers will be stuck with the Medicare Advantage option. There will be income and racial disparities. Additionally, if a significant number opt out, it will likely become less profitable for the insurance company, (in this case Emblem Health) and result in higher copays to those in Medicare Advantage.
This dangerous plan has Medicare Advantage going into effect on January 1st 2022. Dissident union members are opposing their respective municipal unions, and the Municipal Labor Council. Retirees were betrayed by the City and the public employee unions. This significant and stealthy change had been in negotiation for several years with no transparency—all under the radar. Retirees and union members were not consulted about it, nor were they ever offered a choice. And, inevitably, this change will ultimately extend to all city workers, using the retirees as front-line guinea pig victims before dropping this bomb on all New York City employees.
The remedy would be the New York Health Care Act, a single payer health care system. This would provide Medicare for all, not based upon employment. It deserves our support. Yet this threatens the interests of insurance companies, the pharmaceutical industry and public employee unions. A constituency of all the administrative employees of the union benefit fund departments would be threatened. The act failed to pass in the current legislative session despite Democratic Party majorities in both the Assembly & Senate. Special interests blocked it from coming to an up or down vote in the legislature.
There are ongoing cross-union member protests with actions that include rallies, demonstrations, die-ins, lawsuits, petitions, fundraising and pressure on politicians. Check out firstname.lastname@example.org for information on how to help pressure the city to reverse this disastrous policy, endangering the health and lives of retirees, and eventually, all city workers. There is also a Facebook page set up, Preserve Medicare Parts A & B for NYC Retirees. We all depend on the health and safety of city workers if we live in New York City.
Taylor Basker, Ph.D. is a retired DOE teacher and UFT member. Jesse Kasowitz is a retired Union Shop Steward & Board, Local 237 activist, former city government attorney