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Mayor Adams’ Medicare Advantage switch mandate for

NYC retirees blocked by judge
By Chris Sommerfeldt and Cayla Bamberger
New York Daily News • Last Updated: Aug 11, 2023 at 2:08 pm

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New York City Mayor Eric Adams speaks during press conference in Manhattan on Monday, July 24, 2023. (Luiz C. Ribeiro/for
New York Daily News)

A trial court judge has blocked Mayor Adams from switching hundreds of thousands of
retired city workers to a cost-saving Medicare Advantage Plan , a decision city plans to
appeal.

Acting Manhattan Supreme Court Justice Lyle Frank — who last month paused the
scheme until a final decision was reached — ruled Friday that the city cannot make the
Aetna Medicare Advantage Plan the only premium-free option and must continue
providing retirees with traditional Medicare.

“Respondents are permanently enjoined from requiring any City retirees, and their
dependents from being removed from their current health insurance plan(s), and from
being required to either enroll in an Aetna Medicare Advantage Plan or seek their own
health coverage,” read the decision.

The most recent lawsuit, brought by nine retired municipal workers and the NYC
Organization of Public Service Retirees in May, comes after retirees took legal action LATEST
last year to stop Adams from rolling out an earlier version of the Medicare Advantage Mets
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Retired municipal workers are pictured on the steps of Brooklyn Borough Hall to call on Eric Adams to preserve their 3h
Medicare coverage in 2021. (Luiz C. Ribeiro/for New York Daily News)

Adams’ team this year devised a new proposal that cuts traditional Medicare as an
option, making Advantage the only health insurance available to the city’s roughly
250,000 municipal retirees.

The city argued that the new plan was in compliance with the court order by removing
a penalty found unlawful in the first lawsuit. Mayor Adams signed a contract in March
with private health insurance giant Aetna to enroll retirees in the plan, effective Sept. 1.

But before a key deadline that would have required critics of the controversial plan to
opt out, Frank granted a temporary restraining order, ruling that “numerous promises
were made by the City to then New York City employees and future retirees” about
their coverage, according to court documents.

Marianne Pizzitola, a former FDNY EMT who leads the retiree group behind the
lawsuit, said that her team is “absolutely ecstatic” over the ruling.

“The decision vindicates exactly what we’ve been arguing, that this was not the right
thing to do,” Pizzitola said. “[The judge] based his decision on promissory estoppel,
that promises the city made to us about our health care should be promises kept and
that they can’t change things at this point in the game.”

“We’re fully expecting that they will try to appeal this, and we’re prepared for that too,”
she said. “They’re not going to stop trying to screw us over.”

Retired municipal workers gather near City Hall on Monday, Feb. 14, to tell Mayor Eric Adams he's breaking their hearts with
his plan to change their beloved Medicare coverage. (Chris Sommerfeldt/New York Daily News)

The city confirmed its plans to appeal on Friday afternoon.

“We are extremely disappointed in this ruling, and intend to appeal,” said mayoral
spokesman Jonah Allon, who pointed to improvements to the current plan, such as a
lower deductible, cap on out-of-pocket expenses, and new benefits from transportation
to fitness programs.

The Medicare Advantage plan would also save $600 million each year, Allon said,
which he called “especially critical” while the city is facing significant fiscal and
economic challenges.

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“This decision only creates confusion and uncertainty among our retirees,” he added.

The ruling indicated that the city informed the judge they did not “wish for the Court
to hold any additional argument.”

A member of the Municipal Labor Committee, who was not authorized to comment
individually, told the News that the city and union brass agreed to move more quickly
to an appeals court.

“The Law Department and the retirees agree to have the judge decide on the merits on
what was already submitted so that we could have a final, appealable decision sooner
rather than later,” the member said.

“This decision relies on prior decision and doesn’t say anything new. But it allows the
city to press its appeal of the final order.”

Unlike traditional Medicare, Advantage plans are administered by private health

insurance companies. The plans are also subsidized by the federal government at a
higher rate than traditional Medicare options are, which Adams has said could net
savings — at a time when his administration is staring down multibillion-dollar budget
deficits in the coming years .

During oral arguments, an attorney for Aetna acknowledged it is “very likely” that
medical care deemed necessary by a doctor or certain medical facilities could be turned
down or unavailable to retirees, according to court documents.

Originally Published: Aug 11, 2023 at 1:01 pm

2023 > August > 11

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