Medicare

FEARS UNFOUNDED?: Roughly 120 retirees massed outside City Hall May 24 to protest what some of them characterized as a privatization of Medicare benefits through a shift to a Medicare Advantage program that they feared would force them to go to other doctors and/or require higher co-pays or cuts in coverage. City and union officials who are negotiating on which of two groups will run the program insist, however, that the savings they realize will not come at retirees' expense and that coverage will be equal to or better than what currently exists.

The Municipal Labor Committee and the Office of Labor Relations have yet to reach final terms on a Medicare Advantage plan for retired city workers, but contrary to a persistent rumor, they aren't at an impasse in their discussions, according to MLC Chairman Harry Nespoli.

"We're still negotiating, and we're still trying to get to a conclusion and decide which company will be running the program," Mr. Nespoli, who is also the president of the Uniformed Sanitationmen's Association, said in a June 3 phone interview.

Choosing Between 2 Groups

There are two providers that are finalists to administer the program, he said: Aetna, and a collaborative effort by EmblemHealth and Empire Blue Cross.

"We're negotiating to make it the best plan we can for our members," Mr. Nespoli said of a group that includes 250,000 retirees who would immediately be affected when the transition was made. "We don't want to bury our members in a whole bunch of co-pays."

The decision, he said, will ultimately come down to "who's gonna give city workers the best deal, with quality health care, not cheapening it in any way. There's some very good things in this program," referring to what each of the competing groups was offering.

He reaffirmed, as had top city labor-relations officials led by Renee Campion, and United Federation of Teachers President Michael Mulgrew, earlier this spring, that in almost all cases, retirees will be able to continue being treated by their current physicians—a major concern among retirees because of other Medicare Advantage plans elsewhere that did not allow that continuity.

Ms. Campion had previously said that the city would not insist on the cheapest deal possible precisely because it wanted to preserve a level of benefits that was equal to or somewhat better than what municipal retirees currently receive. But the $450 million the city is hoping to save annually in health-care costs compared to the current coverage is important to the unions as well, Mr. Nespoli said.

Eye on Pay Hikes

The reason, which was previously cited by Mr. Mulgrew, is simple, he said: "so our workers can get a decent wage increase."

Rising health-care costsoften by double-digit numbers for more than a decadehave forced the two sides to devote money for coverage that might otherwise be available for employee pay raises. Mr. Mulgrew remarked in early May, "The last thing I want is for health care to be at the center of every collective-bargaining negotiation."

Ms. Campion and Claire Levitt, her Deputy Commissioner, Labor Strategies, in mid-April declined to specify a date by which they wanted to conclude the process, but the Labor Commissioner said, "We want the vendor in place as soon as possible."

Toward the end of last month, a rumor began to circulate among retiree groups that the talks had stalled and that veteran arbitrator Martin F. Scheinman had been called in.

The rumor was based on a misunderstanding. Going back to the beginning of the de Blasio administration in 2014, Mr. Scheinman has served as a facilitator in the health-benefits negotiations and continues to do so. His role is that of a mediator, moving the process along, rather than an arbitrator called in to resolve an impasse by issuing an award.

Retirees Protest

Nonetheless, a group of roughly 120 retirees massed outside City Hall late last month to again voice their fears that the new program would either curtail benefits and their choice of doctors or force them to pay more for coverage.

Both union leaders and city officials have been emphatic that this will not happen.

In April, Ms. Campion had said, "We're buying a Group Medicare Advantage Program. It's still going to be a free program for retirees, and they'll still get Medicare Part B" reimbursement from the city.

Ms. Levitt had added, "In the Medicare Advantage programs that we're looking at, you can still go to any doctor or hospital that accepts Medicare."

There will be some instances in which pre-authorization will be required for services such as hospital inpatient, behavioral-health inpatient and ambulance service and step therapy for certain high-cost drugs, she had said. All those services and others already required pre-authorization for active employees, she noted, and traditional Medicare included medical-necessity provisions that, for example, paid for ambulance services, according to its regulations, "only if they are furnished to a beneficiary whose medical condition is such that use of any other means of transportation is contra-indicated."

Adding Hospitals

After Stu Eber, the president of the Council of Municipal Retiree Organizations, expressed concern last month that two leading Manhattan hospitals, Sloan-Kettering and the Hospital for Special Surgery, didn't accept Medicare Advantage, a UFT official said that the two hospitals would be participating in the city's plan regardless of which health-care provider was chosen to administer it.

Part of the savings from the eventual deal, Mr. Mulgrew said then, will be placed in the MLC Stabilization Fund, while also helping to cover optical and dental benefits and hearing aids that presently are generally covered by union welfare funds.

While some of the protesting retirees have objected to not being part of the negotiations on the changes, Mr. Eber said that both the unions and the city had been more responsive lately regarding the progress and parameters of the negotiations.     

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(3) comments

Bennett Fischer

Is this a news feature or an op-ed? Mr. Steier blindly accepts OLR-MLC's unsubstantiated claims about the Medicare switcheroo, and he is cynically condescending to rank-and-file retirees who have the temerity - and the right - to be skeptical about those claims. The Chief Leader appears more focused on espousing the party lines of union leadership and OLR than it is about investigating the life-and-death health care concerns of union members.

And if UFT President Michael Mulgrew, or any other union leaders, truly don't want health care to be at the center of every collective-bargaining negotiation, why don't they step up and support passage of the New York Health Act?

richardk Staff
richardk

Richard Steier replies: We can only report what’s known. Until a deal is reached, anything else is conjecture and speculation.

Barry75

Medicare Advance Plans have ZERO Advantages to NYC Retired Teachers, no matter what Mulgrew says. You will go onto

an HMO MEDICARE PLAN——Where’s the ADVANTAGE ? The question always asked is :

“Will my Dr. be on the Medicare Advantage Plan?” UFT will say “Of course”. The actual answer is “Probably Not As M’Care Advantage PAYS DR.’s LESS $$$$”. Any retired NYC Teachers want to go back to GETTING REFERRALS FROM YOUR PRIMARY DR. TO GET ALMOST ANYTHING DONE ? Hell no.

THE CITY WILL SAVE BIG BUCKS ON THIS AND WE, THE RETIRED TEACHERS WILL BEAR THE BRUNT OF LESS BENEFITS.

Why ? So Mulgrew can raise active teachers salaries——-No Respect For Those Of Us Who Paid With Our Sweat Who Are Now Retired.

Please, We’re Older….But Smarter Than To Lay down And Take Whatever They GIVE US !!!

S P E A K UP R E T I R E E S BEFORE THEY TELL US….”Too late now, it’s a Done Deal.

We DESERVE BETTER. Leave Our Medicare Alone——No Advantage For Us.

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