[ New York City has kept a covenant with its workers: your wages
will be modest — lower than those of your counterparts in the
suburbs or the private sector — but as a full-time employee you will
be entitled to health care coverage without premiums.]
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A BETTER WAY FOR RETIREE HEALTH CARE  
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Barbara Bowen and Barbara Caress
January 9, 2023
New York Daily News
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_ New York City has kept a covenant with its workers: your wages will
be modest — lower than those of your counterparts in the suburbs or
the private sector — but as a full-time employee you will be
entitled to health care coverage without premiums. _

Retirees protesting the Medicare Advantage situation relating to the
12-126 law outside of City Hall, Manhattan, New York, Wednesday,
October 12, 2022. (Shawn Inglima/for New York Daily News),

 

For more than half a century, New York City has kept a covenant with
its workers: your wages will be modest — lower than those of your
counterparts in the suburbs or the private sector — but as a
full-time employee you will be entitled to health care coverage
without paying premiums. If you retire with enough years of service,
you will be guaranteed Medicare coverage, with the city picking up the
20% Medicare does not pay.

Through the years, the city has added copays and deductibles,
whittling away the value of the coverage. But the basic agreement has
lasted through major recessions and the city’s catastrophic budget
losses after 9/11. Until now.

Today,[Jan. 9] the City Council will hold a hearing on a proposal that
would break the compact. The proposal to amend the city’s
administrative code would legalize degradation of retiree health
benefits and permit negotiations about active employee benefits that
may diminish coverage.

Councilmembers who support the amendment may believe they have no
choice. If they refuse to amend the law, the argument goes, city
retirees will be pushed off Medicare into a private Medicare Advantage
plan. Traditional Medicare and the current supplemental plan will no
longer be available, even for those willing to pay.

That argument is full of holes. Without changing the law, the city
could simply add a private Medicare Advantage plan and continue to
offer the existing Medicare and supplemental coverage —
premium-free. But the Adams administration has made “health
savings” a requirement for wage bargaining and appears committed to
charging premiums for coverage that has historically been free.

Most city retirees cannot afford the so-called “choice” to pay for
a supplemental plan. The average pension from the largest city
retirement system is $26,596. Buying out of the new Medicare Advantage
plan will cost $2,400 a year, $4,800 for a couple.

As a result, retirees from higher-paid city jobs will have access to a
Medicare supplemental plan that enables them to get all the medical
care they need, while the majority of city retirees — many of whom
are women and people of color — will be left with a for-profit
Medicare Advantage plan that saves the city money by controlling
access to care. Generations of workers and their unions have fought
for the principle that all city workers, regardless of race, gender,
income, or job title, should have access to the same health coverage.
If the Council votes to change the law, that principle is betrayed.

The fallacy of the proposal before the Council is that it risks the
health of thousands of older New Yorkers and erodes a bedrock right to
health care — yet still fails to grapple with the real sources of
spiraling costs. Even if the Medicare Advantage plan were implemented
today, New York would find itself right back in the same health care
crisis in a few years. The fundamental problem is that this country
lacks universal health care, but even within the current system, NYC
is paying too much. The city has not effectively used the leverage of
the 1.25 million people whose health care it covers to achieve fair
hospital and drug pricing.

A better solution is within reach. Our union, the Professional Staff
Congress/CUNY, has proposed an approach that both addresses the need
for immediate relief and creates a framework for solving the
underlying problem. The PSC proposes Council action that would:

Keep premium-free Senior Care in place along with traditional Medicare
while buying time to develop a sustainable solution. The city can
address the immediate crisis while maintaining benefits over three
years by redirecting funding to current benefits instead of continuing
to build reserves in the Retiree Health Benefits Trust
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Create a stakeholders’ commission charged with finding a path,
before the temporary funding is depleted, to reducing hospital prices
The Council should appoint a commission of elected officials, leaders
and members of the Municipal Labor Committee (MLC), representatives of
hospitals and hospital workers, health providers, insurance companies,
and elected retiree representatives.

End the city’s reliance on unstable and outdated funding mechanisms
and rethink how the city pays for health insurance.

Affirm the right of the MLC to bargain about health insurance.

As a health policy professor and a former union president, we are not
naïve about what it will take either to design or to implement a new
health care structure. But New York City can do better than
sacrificing the most vulnerable while leaving the fundamental problem
unsolved.

_[BARBARA BOWEN, PSC president from 2000 to 2021, is professor of
English at Queens College and the CUNY Graduate Center. BARBARA
CARESS, a PSC member, is a health care consultant who teaches health
policy at Baruch College.]_

See:

PSC/CUNY Proposal for NYC Employee Health Benefits Program
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* Medicare
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* Medicare Advantage
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* Medicare Advantage Plans
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* Public Employees
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* New York City
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* privatization
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* Donald Trump
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* Biden Administration
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* Mayor Adams
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* public sector wages
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