Some Thoughts During the Pause: NYC Retiree Healthcare

We are at a pause. New York City and the Municipal Labor Committee (the leaders of the city unions) have agreed on a plan with Aetna/CVS. They intend to move all – well most – city retirees into Aetna’s Medicare Advantage on September 1.

And we have, for a moment, a pause in the battle, the battle over retiree healthcare in New York City.

The Parties – Labor/Municipal Gov’t vs Labor (w/ Local Gov’t in the Middle)

There has been almost two years of wrangling. We know the parties. The City of New York (Mayor Adams, for short) on one side. They are usually represented by the Office of Labor Relations. The Municipal Labor Committee, strangely enough, on the same side. Harry Nespoli from the Sanitation Workers (a Teamsters Local) is the nominal head of the MLC. Henry Garrido of District Council 37 and Michael Mulgrew of the United Federation of Teachers are also parts of this crew. Might as well mention an arbitrator who often works for the UFT and OLR (and maybe the other unions, I am not sure) Martin Scheinman, who is being employed as a consultant, but has waved around his arbitrator’s credentials to confuse retirees and politicians.

There is a judge, Lyle Frank. Who heard of him before? Who will hear about him after? No matter. For this issue he has played a role.

There’s the New York City City Council. Usually they are not central to much, but by declining to act, they blocked one major Mulgrew/Adams play. And by declining to act just last week, they may have blocked a retiree strategy.

Retirees have activated around this issue. There are thousands of retirees who generally ignore this sort of stuff, but were drawn in because their own health care was at stake. There is the New York City Organization of Public Service Employees (for the preservation of benefits), widely identified with Marianne Pizzatola, previously associated with efforts to get 911 workers healthcare. There is the Cross Union Organizing Committee (CROC). Some individual unions have retired worker groups that have activated around this. Among them, Retiree Advocate, a caucus of retired UFT members stands out (I am a member of Retiree Advocate). Also vocally on this side has been the leadership of the CUNY workers union, the Professional Staff Congress (PSC).

That is a strange cast, and a strange line-up.

The Plan – As of Today – Aetna/CVS MAP Starting September 1

The Aetna/CVS plan is Medicare Advantage PPO, specifically negotiated in NYC. It will certainly be better than the first Mulgrew/Adams plan ‘The Alliance’ but it is still Medicare Advantage.

Opt out means total opt out, no City support. No reimbursement. No coverage for dependents. It will be a very expensive option – which means for most retirees it will not be an option.

Is This Done?

Nope. I expect there will still be challenges. There will be at least one lawsuit. Mulgrew and Adams will make at least partial revisions to the plan. Mulgrew and Adams are likely to find a way to offer at least one opt out that somehow fits within the rules.

Listen to the Aetna Webinar – especially if you think you don’t need to

But look – right now, if nothing stops it, it will be the plan most NYC public service medicare eligible retirees will be on come September. Even if you know it definitely will suck, because it’s Medicare Advantage, or even if you know it will be wonderful and you wish you could have joined earlier, because Michael Mulgrew told you so, and he knows so much and never lies, you have an obligation to yourself and your dependents, but also to your friends and former colleagues. Learn more. It’s not good enough to think you know. Aetna/CVS is running webinars. Yes, I know there will be a propaganda aspect, but in a way it does not matter. You should sign up. You should listen.

I will sign on, if I can (not medicare eligible, not sure). I would certainly prefer not to spend the time with a pitch. But I know it is important to listen to what they are saying.

What Did They Want?

By ‘they’ I mean Mulgew/Adams/Scheinman/OLR/MLC etc. Those guys.

Through all the twists and turns, and different sides arguing different things, there has been one constant: The Mulgrew/Adams side at each turn has intended to move retirees onto a Medicare Advantage plan. That’s where this started, when the news broke in the Spring of 2021. They never moved off it, even when they gave up on ‘The Alliance,’ it’s in every Scheinman document, and it is what they decided to move forward on, with a key vote taken earlier this month. It is also the plan that they have in place, as of today, for September 1.

They argued about options, and opt outs. They argued about additional choices. But their eyes never left their prize:

Mulgrew’s Prize
Medicare Part C
for you and for me
(eventually)

Privatized Medicare.

Where Will the Savings Money Go?

I think this is an important question. “Savings” come from providing (you and me, eventually) less medical care (eg, denials), and making the patients (you and me, eventually) pay a larger share of the care we do get (eg. copays). But where does the benefit accrue?

Directly to the City? That’s not how our health care is funded – I don’t think.

Directly to the unions? Nope. At least I don’t think so.

I think we need to look at the payments into the Stabilization Fund.

Stabilization Fund Almost Broke?

No matter what happens next, the Stabilization Fund will be involved.

There were claims by the Mulgrew/Adams side that the fund is broke, or about to be. There were people on my side who said it’s not. There were arguments about how broke it is, and how broke is broke.

I’m not engaging in that argument. It seems to me that the fund is in bad shape. It is not so important if the crisis has already been reached, or is on the horizon. The future of the fund was clearly (to me) in jeopardy.

In fact, it seems like Mulgrew was highly motivated by a need to protect this fund. Mulgrew acted like he was more concerned with the health of the fund than with the health of the members.

Stabilization Fund

But we know very little about the fund. And we should know more.

• Who runs it? Organization + Names.
• Which unions have a role in administering it? Or is it just the City? (I doubt that)
• How is it funded?
• Where do the funds come from?
• Is there an accounting of the funds it takes in?

And on the other end, I have even more questions. We all should.

• Does the fund employ anyone directly?
• What is the money spent on? (some of these items will be obvious, others, no)
• Does each union participate equally in drawing from the fund?
• Does the fund pay salaries? How many? Whose?

Big picture: right now the Stabilization Fund is a black box. I think there’s never been an audit. I have been unable to look up even basics of it online, through New York City government pages.

The fight over Medicare Advantage may turn out to have really been a fight over the Stabilization Fund’s health. In that case we really should know a lot more about the patient.