Health care negotiation timeline
The Municipal Labor Committee (MLC), the umbrella group of over 100 municipal labor unions including the UFT, negotiates the health care benefits of all city workers with the city. The top priority of the MLC and the UFT is to maintain high-quality, premium-free health care for all city workers even as costs increase year after year.
Here is a timeline of events on health care negotiation:
- Health care costs skyrocket. The MLC constantly looks for ways to save money on health care while enhancing programs and services, but these rapidly rising costs make it harder and harder. As part of the MLC, the UFT worked to find a solution to rein in these health care cost increases and maintain premium-free health care for all members.
- In order to reach savings goals, the city forms the Tripartite Committee. As part of the last round of citywide bargaining, the MLC committed to finding $1.1 billion in health care savings over fiscal years 2019-2021. A committee composed of the MLC, the city and arbitrator Martin Scheinman was formed to find a way to reach these goals. If the city and the MLC cannot reach a mutual decision, the dispute will be referred to Scheinman for resolution. See the letter establishing this committee.
- MLC and the city look for a health care partner. The city and the MLC engaged in a bidding process to find a partner who could mirror and improve upon the GHI Senior Care benefits. An alliance made up of Empire BlueCross BlueShield and EmblemHealth was the winning bidder. This is a typical process as every few years, the city and the MLC send out a request for proposals to health care companies and are constantly looking for ways to save money and enhance programs and services.
- The NYC Medicare Advantage Plus plan is created. The NYC Medicare Advantage Plus plan was a brand-new plan that was created ONLY for Medicare eligible retirees to mirror their current benefits at less cost. Because it was a Medicare Advantage plan, the plan allowed the city and the unions to tap into federal funds to save approximately $600 million a year while providing retirees essentially the same coverage as GHI Senior Care. The MLC fought hard to make sure the new premium-free plan was a preferred provider organization (PPO) plan, not a health maintenance organization (HMO), so retirees could go to doctors outside the plan’s large network. They also fought to ensure that other health care plans, including GHI Senior Care, would remain as “pay-up” options for retirees.
- Poor rollout of information causes delays. The city and the alliance of Empire BlueCross BlueShield and EmblemHealth did a poor job of communicating to both retirees and medical providers how the new NYC Medicare Advantage Plus plan would work. They did not make clear that it was not a typical HMO Medicare Advantage plan so many doctors mistakenly told members they would not accept it, even though all doctors would receive the full standard Medicare payments for their services under the new plan.
- Panic causes a lawsuit to be filed. A small but vocal group of retirees went to court in August 2021 in an effort to block the new plan. In October, the judge ordered an extension of the deadline for retirees to opt out of the NYC Medicare Advantage Plus Plan to give retirees and medical providers more time to learn about the plan and make informed decisions in light of the poor rollout.
- Rising health care costs lead to a GHI Senior Care doctor visit copay. Due to rising medical costs, GHI Senior Care instituted a $15 copay for doctor visits that took effect on Jan. 1, 2022. The new copay was agreed upon prior to the pandemic but its enactment was delayed for a year because of it. The retiree group challenged the copays in its court case and lost that point. The new copay had nothing to do with the new NYC Medicare Advantage Plus plan.
- The judge rules in the lawsuit that NYC Medicare Advantage Plus can go forward, but he interprets the administrative code to eliminate all other options. In June, the judge ruled that there was no issue with the NYC Medicare Advantage Plus plan, but he said the administrative code required the city to only offer premium-free plans for seniors, or in fact, was only obligated to offer one plan and did not need to provide options at all. Such a mandate would eliminate the MLC's and the city's authority to offer multiple health care plans, since the city and the MLC would be unable to absorb the cost of multiple premium-free plans. This ruling is currently being appealed.
- The delays cause Empire BlueCross BlueShield to withdraw. Because of the costs associated with the slow rollout and the pushback, Empire BlueCross BlueShield withdrew as the plan’s administrators. As a result, there is no NYC Medicare Advantage Plus plan in existence at the moment.
- The MLC looks for a new plan administrator. The MLC began to look for another partner for the plan. Aetna, another large health care company and the runner-up in the original bidding process, stepped forward to express interest. The city and the MLC are engaged in ongoing discussions with Aetna to see if it can provide a plan that matches the quality of the original NYC Medicare Advantage Plus plan. We have made it clear to Aetna that unless it can provide a plan that meets our current standards, we will not move forward. Whether or not Aetna will be able to do so remains to be seen.
- The MLC asks the City Council to amend the code to protect choice and premium-free health care. The MLC is asking the City Council to add a clause to the city’s administrative code to codify the past practice of the last several decades allowing unions to be able to negotiate health care costs and give health care plan options to members. The administrative code would continue to require the city to provide a comprehensive, premium-free health plan. The additional clause would only strengthen the current code by clarifying and reaffirming the MLC’s right to negotiate for all members and ensure the city must offer options when it comes to health care plans. Without this change in the code, the city could likely choose to save costs in the future by offering only one health care plan option to retirees.
- The city threatens to only offer Medicare Advantage to retirees or charge premiums. The city sent a letter to the MLC announcing its intent to ask arbitrator Martin Scheinman to enroll all Medicare‑eligible city retirees in a NYC Medicare Advantage plan and eliminate all other retiree health plans, including GHI Senior Care, if the City Council fails to amend the administrative code. In response to a request from the City Council for clarification on the issue, Martin Scheinman wrote in a letter that if the code is not amended, the city may have no alternative but to impose annual health care premiums of roughly $1,500 for all in‑service municipal employees and potentially also non-Medicare-eligible retirees. We need to persuade the City Council to change the code