In July, the Centers for Medicare and Medicaid Services announced a plan to import the worst part of Medicare Advantage — prior authorizations — into traditional Medicare. Prior authorization requirements will be established for certain traditional fee-for-service Medicare services in six states starting in January 2026.

Traditional Medicare historically hasn’t required prior authorizations to access most drugs or services. It’s the most significant difference between traditional Medicare and privately run Medicare Advantage plans. Federal inspectors found in 2022 that prior authorization in Medicare Advantage prevented some seniors from getting medically necessary care.

For now, the pilot program will cover providers and patients in New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington. The change will apply to 17 items and services, including skin substitutes, deep brain stimulation for Parkinson’s disease, impotence treatment and arthroscopy for knee osteoarthritis.

These prior authorizations will be managed by private insurance companies, such as UnitedHealth and Humana, using artificial intelligence and machine learning. Following the Medicare Advantage model, these private companies will profit from the care they delay and deny us.

I sometimes hear from RTC members who want our chapter to stay out of national politics, or any politics. They see a clear separation between “bread-and-butter” union issues and the wider political world around us. They would like us to avoid issues that are far removed from our union hall and might unnecessarily divide our membership. Sometimes, that kind of thinking makes sense. But just as often, our local bread-and-butter issues are also national issues.

Many of us in the RTC pushed back — on the streets, in our union hall, at City Council hearings and in the courts — against the ultimately failed plan to switch retired New York City employees into a Medicare Advantage plan. And through our collective efforts, we made it politically untenable for any of the mayoral candidates on the November ballot to support Medicare Advantage for city retirees. That is a huge win.

All politics is local, until it isn’t. We can ignore national politics, but national politics will not ignore us. We cannot ignore the Trump administration’s attacks on Medicare and Medicaid, Social Security, the U.S. departments of Education and Labor and our immigrant student communities and expect to survive as a union.

I hope the New York City Council passes legislation to protect our supplemental health care benefits. But what good will that law do us if traditional Medicare is transformed into something that simply mirrors the privately run Medicare Advantage plans we have been fighting against for all these years?

The UFT is a large union — the largest local in the country — and the Retired Teachers Chapter is the largest chapter in our union. Our members have thousands of years of collective wisdom and experience. We have a history of political engagement and an institutional memory of activism. We have a strong state and national union, and we have allies across the city and the nation. We can do two things at once: We can fight for our bread-and-butter issues on the local level and, when we must, we can fight for them at the national level, too.