NYC’s Retiree Health Plan Lays an Egg

Story from New York Daily News by Marcia Biederman. Feb 23.

The city’s plan to move municipal retirees off their current health coverage into a jerry-rigged Medicare Advantage plan has yet to begin. But the show has been in previews, the word has gotten around, and the audience is heading for the exits.

By crowdsourcing standards, the plan has failed even before its projected April 1 launch date. As of last week, more than 45,000 retirees had opted out of the plan. They chose to keep their current coverage even though it will cost them thousands of dollars annually to do so.

That number is likely to mount fast. Thousands of retirees in many states and Puerto Rico have been watching videos made by three former emergency-service workers. The trio patiently answers questions about opting out, by phone or online. Lines to the plan’s so-called welcome center seem jammed with goodbyes. On a recent day, one caller was twice placed on hold and disconnected.

Municipal Labor Committee Chair Harry Nespoli has dismissed opponents as ”only a small fraction of the retiree community,” insisting that “the vast majority of retirees understand the benefits of the new plan.” But of the quarter-million people set to be moved into Medicare Advantage, nearly one in five are willing to pay the high price of rejecting it. Nespoli needs to do the math, this time with a calculator.

Among the refusers are the hundreds of retirees who rallied near City Hall on Valentine’s Day, asking Mayor Adams to halt the impending health care switch. And the 1,800 who signed their names to a “Wall of Broken Hearts,” displayed at the event.

Nespoli is partly right, however: Most retirees will land in the new plan, like it or not. Many can’t pay the stiff new premiums to keep their current coverage, which for most is traditional Medicare and a supplement. Others could be trapped while searching for an escape. If, as expected, a court-ordered stay on the plan’s launch is lifted next month, the city will toggle masses of former firefighters, teachers, cops and clerks into the brand-new NYC Medicare Advantage Plus plan.

Some won’t know what hit them until their Medicare Advantage cards are turned down by the doctor’s office. Those wanting out of the new plan will find it’s like a Roach Motel: easy to check into but tough to check out of. That may be why the city, under the guise of a “trial period,” is offering a second opt-out deadline of June 30. Unwitting enrollees could be mired for months.

The three former emergency-services workers have made videos pointing the way out. They are board members of the NYC Organization of Public Service Retirees, whose lawsuit won a temporary stay on the plan’s rollout, which a Manhattan judge called “irrational.” Next week, lawyers for both sides will argue whether the city has the authority to make this change, with a ruling expected next month.

The group’s leaders are optimistic about the outcome. But given the difficulties of disenrollment, they advise those wanting to opt-out to act now, before the glue sticks.

Like FDR’s fireside chats, these evening advice sessions have calmed retirees in a time of adversity. Some viewers can’t opt out, some are thinking of giving the new plan a whirl, others want to switch to a different Medicare Advantage plan, still offered by the city for a limited time. The chat hosts don’t judge, leaving that decision up to each retiree.

If only the municipal unions took that attitude. Having raided a city fund meant for health benefits to find money for workers’ raises, the unions are desperate to save costs on retiree coverage. Hence, we find Michael Mulgrew, president of the United Federation of Teachers, dismissing the worries of the many retirees whose doctors say they won’t accept the new insurance.

“They don’t know what network they’re in. Their billing departments do,” Mulgrew said in an October webinar. Indeed, when one of Mulgrew’s own doctors said he wasn’t in the new plan, Mulgrew refused to believe him. “He had no clue,” the union president said. Why else would the doctor be listed in the plan’s provider directory?

Because mistakes happen, as Memorial Sloan Kettering discovered. After lengthy negotiations, MSK signed a short-term contract with the city’s new plan. Yet it continued to print bills warning that no Medicare Advantage plans were accepted, alarming retirees. As this paper reported, that was a hospital error, since corrected.

That didn’t prevent Mulgrew, so trusting of billing departments, from pointing his finger elsewhere. In an email to UFT retirees, he wrote, “The spreading of misinformation by the plan’s opponents has got to stop. Our retirees are getting hurt.”

Yes, they are. Mr. Mulgrew, Mr. Nespoli, and Mayor Adams. Legions of resisters have sent you a message: This plan has got to stop.

Biederman is a writer and member of the Cross-union Retirees Organizing Committee. In 2016, she retired from teaching for the Department of Education.