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. Story from The Chief by Michel Friang. June 4
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.
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.
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.”
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.