Key Vote Moves Controversial Mandatory Medicare Advantage Plan for NYC Senior Citizens

A key municipal union committee has put forward a highly controversial plan to make Medicare Advantage the only insurance option available to city retirees, setting the stage for a final vote next week, people familiar with the matter said.

The move, taken Thursday by the municipal labor committee’s steering group, allows the committee to hold a full vote on March 9 to formally push through the proposed Aetna Medicare Advantage Plan, a measure that would make traditional Medicare virtually unaffordable for some 250,000 retired city workers. as of September 1st.

Adams officials have for months pushed for Medicare Advantage for retirees, citing the potential savings of hundreds of millions of dollars annually from the plan during rising health care costs and financial uncertainty for the city government.

Retirees claim Advantage benefits are inferior to traditional Medicare.

Key Vote Moves Controversial Mandatory Medicare Advantage Plan for NYC Senior Citizens

Initially, the administration wanted to offer retirees both plans, with those opting for traditional Medicare paying a premium. But the plan ran counter to local law and was blocked by several judges.

The administration has been signaling for months that unless the city council changes this basic law to make its two-tier coverage system legal, it will move more forcefully to eliminate all other options but Mayor Adams’ preferred Advantage Plan.

The city council resisted Adams’s demand for an amendment to the law, and Marianna Pizzitola, president of the New York Public Service Retirees Organization, said she had been on pins and needles for weeks, waiting for this development.

“I had a bad feeling this was going to happen,” said Pizzitola, a former FDNY EMS employee whose group was behind the lawsuit that blocked the city’s first Medicare Advantage plan.

Pizzitol’s grassroots group is likely to challenge the latest version of the proposal in court, she said.

“We need to wait and see how they do it,” she said. “As soon as the official statement comes out, we will get down to business.”

Retired municipal workers gather outside City Hall on Monday, Feb. 14, to tell Mayor Eric Adams that he is breaking their hearts with his plan to change their Medicare coverage.

Retired teachers, emergency room physicians and other municipal employees have argued that the change will strip them of their insurance, pointing to federal studies showing that Advantage plans operated by private health insurance providers can deny recipients “medically necessary” care.

“It is very important that the unions that represent workers and families who will use any health insurance plan are involved in the choice of health insurance provider,” United Teachers Federation President Michael Mulgrew said in a statement to the Daily News on Friday. “We can’t leave such decisions up to bosses and insurance companies.”

“As part of this process, UFT had a list of requirements to ensure our retirees get all the services they need. It was clear to us that we could not accept any plan that did not meet these needs. Now we are working on the proposal line by line to make sure that our concerns are taken into account, ”he added.

State courts have twice blocked the administration from implementing the original plan, which allowed for multiple insurance options, but charged monthly premiums of $191 to retirees who remain in traditional Medicare, saying it violates local law that guarantees no coverage for the entire life.

This prompted Adams to pressure the Board to rewrite section 12-126 of the law to make the fee legal, a move overwhelmingly not approved by Board members.

Mayor Eric Adams in Manhattan on February 7, 2023.

The officials argued that the elimination of all other options was in line with the court’s rulings, given that such a proposal would not entail financial penalties. At the end of last year, this was confirmed by an independent arbitrator.

“The Administration has never wavered in its commitment to offering quality and sustainable care to our retirees,” Adams spokeswoman Jonah Allon said Friday.

He pointed to benefits for retirees in the new plan, including a smaller deductible, maximum cash and new perks from transportation to fitness programs, and said Aetna had addressed concerns about the number of services requiring prior authorization under the proposal.

“We believe this plan is in the best interest of retirees and taxpayers and look forward to a full MLC vote on the contract,” he added.

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