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NY’s highest court sides with NYC retirees in Medicare Advantage fight. Adams isn’t giving up.
By
Caroline Lewis
Published Dec 21, 2024
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By
Caroline Lewis
Published Dec 21, 2024
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The state’s highest court has sided with New York City municipal retirees who have been resisting the city’s plan to move them onto a privatized version of Medicare.
The Court of Appeals, in a unanimous decision, ruled this week that local law requires the city to pay the full cost of any health plan it offers the retirees, up to a statutory cap. That means the city can’t require retirees to pay more to stay on their existing insurance, as Mayor Eric Adams has attempted to do.
The ruling was the latest in a series of blows to the planned Medicare Advantage switch, which Adams inherited from former Mayor Bill de Blasio. The plan initially had the support of the leaders of the city’s largest municipal unions, despite pushback from many of their former members. Michael Mulgrew, president of the United Federation of Teachers, reversed his endorsement in June, saying the plan had “created all this fear and anxiety” among retirees.
With two related lawsuits still pending, an Adams administration spokesperson said the mayor’s not giving up on the effort to shift some 250,000 municipal retirees and their dependents off of traditional Medicare, with supplemental insurance paid for by the city, and onto a Medicare Advantage plan operated by Aetna.
The city has estimated the move would save about $600 million a year, which could help offset the cost of health care for current city employees.
“While we are disappointed in the court’s decision today, we will continue to pursue the Medicare Advantage plan – which would improve upon retirees’ current health plan and save hundreds of millions of dollars annually – and await the court’s next decision in the coming year,” mayoral spokesperson Liz Garcia said.
Adams and union leaders who support the move have sought to convince retirees the switch won’t diminish their coverage — and will even provide enhanced benefits. But many retirees have pushed back, expressing concerns that their doctors won’t accept the plan and that it could come with more delays or denials of care, an issue that has come up with other Medicare Advantage plans.
“The city’s plan to defund retiree healthcare has now been analyzed by 13 different judges across all three levels of the state judiciary,” Marianne Pizzitola, president of the NYC Organization of Public Service Retirees, said in a statement. She formed the group she formed to fight the Medicare Advantage switch. “Every single judge — all 13 of them — have concluded that the city’s plan is unlawful.”
Pizzitola called on the city and union leaders who have endorsed the plan to “end their ruthless and unlawful campaign to deprive retired municipal workers of the healthcare benefits they earned.”
City Councilmember Christopher Marte introduced a bill in October that seeks to preserve retirees’ option of staying on traditional Medicare with supplemental coverage funded by the city, regardless of what other health plans are introduced in the future.
The bill would require the city to offer eligible retirees and their dependents at least one so-called Medigap plan that provides benefits equivalent to or better than those that were offered in 2021, the year the city first started pushing the shift to Medicare Advantage.
“ Why are we going to wait for the courts to tell us what to do when we can do it right now and be creative on how we get there?” Marte said.
The bill currently has just seven sponsors. Marte said he is seeking to gin up more support before pushing for a hearing on the bill.
Tagged
education
Health and Science
new york city
eric adams
health care
Politics
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Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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