Mayor Adams forces through privatized Medicare plan for retired NYC workers, overruling Lander’s rejection [New York Daily News] - Insurance News | InsuranceNewsNet

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June 15, 2023 Newswires
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Mayor Adams forces through privatized Medicare plan for retired NYC workers, overruling Lander’s rejection [New York Daily News]

New York Daily News, The (NY)

Mayor Adams used executive authority Thursday to enact his controversial Medicare Advantage Plan for the city’s retired municipal workforce — overruling Comptroller Brad Lander, who has refused to sign off on the private health insurance switchover.

Last week, Lander announced he had invoked a rare comptroller authority to block Adams’ contract to shift the city’s roughly 250,000 retired workers into an Advantage plan administered by private health insurance giant Aetna.

Lander pegged his move on concerns about the legality of the Advantage plan, as a group of retired city workers are actively suing Adams in Manhattan Supreme Court to prevent him from implementing it.

In a statement Thursday afternoon, Adams dismissed Lander’s argument and said he had used his executive power to overrule the comptroller’s rejection. That allows the city to move forward with its plan to eliminate traditional Medicare as an option for retirees in favor of switching them into the new Advantage structure, effective Sept. 1, Adams said.

“We are clearly within our authority under the charter to deem this contract registered, and we look forward to working with Aetna to ensure a smooth transition to the plan for our city’s eligible retirees and their dependents,” Adams said in a statement.

Adams has tried since taking office to move retired city workers into an Advantage plan.

Joined by most of the city’s public sector union leaders, Adams has said Advantage is a win-win because he estimates it’d save the city $600 million in annual health care costs — thanks to it being subsidized at a higher rate by the federal government than traditional Medicare options — while continuing to provide rigorous benefits to retirees.

But thousands of retired teachers, cops, firefighters and other municipal workers say Adams is wrong.

They’ve pointed to a federal study finding that Advantage plans sometimes wrongfully deny beneficiaries “medically necessary care.”

That’s in part because Advantage plans — unlike the traditional Medicare supplemental coverage most city retirees are currently on — outsource benefits processing to private insurance providers, which require some health procedures to be pre-authorized.

Waving off such concerns, Adams’ office also Thursday accused Lander of fueling “confusion and misinformation among retirees” by seeking to upend the Advantage plan.

Lander, who has sided with the retirees in voicing concern about “barriers to care” under Advantage, had a spokeswoman issue a statement knocking the mayor’s decision to overrule him.

“We believe a more prudent path would be to wait for the litigation to resolve,” said the spokeswoman, Chloe Chik.

The lawsuit referenced by Chik was filed last month by the NYC Organization of Public Service Retirees, a grassroots group that brought another legal action that resulted in courts blocking Adams last year from implementing the first iteration of his Advantage plan because it violated a local administrative law.

The group’s latest lawsuit alleges Adams’ new plan violates the same law, as well as multiple others on both the state and city level. The retirees have asked a judge for a preliminary injunction against the new plan by June 30, the deadline Adams has set for those who want to opt out of the premium-free Advantage coverage in favor of purchasing their own insurance in the marketplace.

City law requires the municipal government to provide its retirees with at least one premium-free health insurance option.

Asked for a reaction to Adams sidestepping Lander, Marianna Pizzitola, a retired FDNY EMT who leads the grassroots organization, said the mayor’s Advantage talking points should “be labeled a form of elder abuse.”

“We are not ‘confused’ or ‘fearful of change,’ we want the benefit we were promised and not be forced into inferior managed privatized Medicare that our providers will not accept,” said Pizzitola.

Manhattan Councilwoman Gale Brewer, a Democrat who opposes Adams’ Advantage plan, said she sympathizes with the anger coming from retirees who want to stay on their traditional Medicare coverage, made up of the universal federal program along with a city-subsidized supplement known as SeniorCare.

“I just talked to a woman the other day, she’s got stage 4 breast cancer and the medication she takes her doctor said will not be able to be purchased in any kind of economic form if she doesn’t have her SeniorCare,” Brewer told the Daily News Thursday afternoon. “Those are real people.”

©2023 New York Daily News. Visit nydailynews.com. Distributed by Tribune Content Agency, LLC.

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