New York City retirees good reason to want to hang on to their Medicare

by Barbara Nevins Taylor

New York City retirees have good reason to want to hang on to their Medicare and Medicare supplemental plans. And New York State Appellate Supreme Court Judge Lyle Frank encouraged them. The judge issued a temporary injunction on July 6 that blocked Mayor Eric Adams from requiring an estimated 250,000 retirees to switch to a Medicare Advantage plan. Judge Frank wrote in his ruling, “As this matter deals with health decisions of an aging and a potentially vulnerable population, mostly on fixed incomes, any lapse in care for these people could lead to deleterious impacts.” 

Mayor Adams, in an attempt to save an estimate $600 million, negotiated with the the Municipal Labor Committee for retirees to switch to an Aetna Medicare Advantage plan. But the shift to Medicare Advantage could leave the retirees with shrunken health care options.

Medicare Advantage can be great for some. Many plans include dental and vision coverage and pay for gym memberships. But Medicare Advantage is run by private companies like Aetna and functions pretty much like an HMO, or PPO. You have to use the doctors and hospitals in their networks. With traditional Medicare and a supplemental plan that picks up the 20 percent of what Medicare doesn’t cover, you can choose your own doctor or hospital. That means retired city employees who already have doctors and hospital relationships may have to change them.

In his order, Judge Frank cited an Aetna representative’s statement during oral arguments. The judge wrote, “…the attorney for Aetna acknowledged that there would very likely be situations where medical care deemed to be needed by a doctor for a retiree could be turned down, and certain medical facilities would be unavailable to retirees.”

The city had given retirees until July 10 to opt out of Medicare Advantage and pay for their own Medicare supplemental programs. Judge Frank’s order means that there is no opt-out deadline and that all current health plans remain in effect.

Groups representing retirees including AARP praised the ruling. In a statement, AARP New York State Director Beth Finkel said, “We are encouraged by the ruling to halt the City’s flawed attempt at diminishing care for retirees as the court considers the Mayor’s ill-advised effort – which would risk retirees’ long-term health and retirement security.”

James Davis, the president of PSC CUNY, the union that represents me and others who work for the City University of New York (CUNY), said, “Our elected leaders need to take steps to clarify the City’s commitment to continue to pay for Medicare supplemental coverage. They need to control skyrocketing health insurance costs that contributed to the ill-advised decision to force retirees into Medicare Advantage.”

Mayor Adams and his administration plan to appeal the judge’s decision.

Read the judge’s order here: