By Richard Khavkine
The Chief, October 1, 2024
Roberta Gonzalez made $5,200 a year when she came to work for the city in 1973, as a clerk with what was then the Department of Health, Hospitals, and Sanitation.
As the city’s fiscal picture grew ever more dire, and municipal posts started to dry up, she and her colleagues had clearly defined job descriptions. And they understood their roles, even if their salaries didn’t match the demands placed on them. “We are generally a dedicated and caring group,” Gonzalez, since retired, said late Monday morning in City Hall Park. “After all, we make the city run.”
What she and her coworkers did have, as part of what Gonzalez called “a reciprocal relationship with the boss” — aka, New York City officials — were assurances that they would receive a proper pension and good, lifelong health benefits when they retired.
But more than a decade into Gonzalez’s retirement, those guarantees remain under threat. As they have been for several years, as first the de Blasio administration and, since 2022, then the Adams administration have endeavored to shift roughly 250,000 retired municipal workers into a cost-saving, for-profit Medicare Advantage plan from their government-administered Medicare and supplemental insurance.
Although the retirees and their advocates, most prominently the New York City Organization of Public Service Retirees, have won successive victories in court challenging the city’s efforts, the Adams administration has filed appeal after appeal in a bid to push through the shift, which city officials have said would save the city some $600 million a year.
On Monday, about 250 retirees gathered in City Hall Park to demand that the administration drop its effort and instead endorse retirees’ continued access to their current plan. Following the late morning rally at City Hall, the retirees and their advocates walked a mile northwest to Spring Street Park, across the street from Aetna’s city headquarters. The managed-care giant was awarded the city’s Medicare Advantage program in late March 2023
But pronounced opposition from retirees has stalled the agreement’s implementation, with courts repeatedly siding with the retired city workers’ contention that switching them to a private plan would break assurances made decades ago. The retirees, health care professionals and others argue that the private-plan’s provisions are inferior, at best, to current coverage. They note that unlike regular Medicare, for-profit Medicare Advantage plans typically require pre-approvals, some of which, they contend, follow determinations generated by artificial intelligence.
They and their advocates maintain that private health-care insurers, rather than medical practitioners, essentially dictate care, since plan administrators often have the final say on which procedures will be covered. Private providers’ profit motives by definition outweigh consumers’ health concerns, the retirees say.
They are now making several specific demands of the mayor, principally that he essentially ensures the retirees continued access to their traditional Medicare and supplemental plan, including by dropping the appeals to court cases regarding Medicare and a copay issue, the president of the New York City Organization of Public Service Retirees, Marianne Pizzitola, said.
Adams should also publicly state his support for a City Council resolution that would guarantee the retirees’ current benefits as well as for state legislation, introduced in January, that would prohibit public-sector employers from “diminishing health insurance benefits provided to retirees and their dependents.” The state bill would also preserve the public entities’ contributions toward the benefits.
Pizzitola, a retired city emergency medical technician, also wants the mayor to back congressional legislation that would expand traditional Medicare to cover vision, hearing and dental benefits, add a cap on out-of-pocket expenses for beneficiaries, and also work to recoup government overpayments to insurance companies that have been upcoding and overcharging for treatment.
“Anything less is a broken promise to retirees,” she told the gathering at City Hall Park. “Our fight to get what we were promised continues.”
City Hall did not immediately respond to a request for comment about the retirees’ demands.
‘Unequitable care’
The rally was among several Monday in cities and states across the nation where public-sector workers and retirees are also facing the prospect of losing their Medicare. Gatherings also took place in Hartford, Conn., and Philadelphia, and in Illinois, Maine and Wisconsin.
Dr. Donald Moore, who runs a full-time general medicine practice in Brooklyn and is a board member of the New York Metro chapter of Physicians for a National Health Program, said switching the retirees to a Medicare Advantage plan would mean a loss of options for patients across a wide range of services, some potentially consequential.
He urged the retirees to fight to not give up their current coverage. “If you do, you’re going to lose access. You’re going to lose choice. You’re going to get unequitable care,” said Moore, who is also an attending physician at New York Methodist Hospital and teaches at Weill Cornell Medical College.
“Rich people,” he said, have Medicare, while those with fewer means or even none must contend with Medicare Advantage. “We fragment our insurance so we can give different care to different people. We should all get the same care,” Moore said. “What we need to fight for is an expanded Medicare, traditional Medicare for all.”
Gonzalez, who retired from the Department of Health and Mental Hygiene in 2011, worked through the HIV and AIDS epidemic, raising funds and setting up testing and prevention programs, and instituting needle-exchange programs. Her city career would also span 9/11, the anthrax scares and budget battles. Through fiscal crises, transit strikes and blizzards, she and her colleagues came to work doing the jobs they were hired to do, she said.
“We often made personal sacrifices to work in the jobs that make the city work,” Gonzalez said.
She’s since battled lung and thyroid cancer, both tied to her work in the aftermath of the September 11 terror attacks. And now, she said, “I and 250,000, a quarter of a million or more of my colleagues, are being forced by the city to make new health care decisions that can mean life or death for each of us.”
The city’s effort, she said, “is unconscionable.”
“When current workers see how easy it is for the city to go back on its commitments, to bait and switch with unkept promises, how will those workers feel about making any necessary sacrifices for the city? Who will they trust?” Gonzalez continued. “Who will be compelled to act to protect the city, its people, when the city shows that it does not uphold its end of the bargain?”
