Why Thousands of City Workers Could Lose NewYork-Presbyterian Coverage

Approximately 40,000 New York City civil servants, retirees and their dependents may lose in-network coverage at NewYork-Presbyterian's hospital network as early as next week, as the embattled hospital system continues a drawn-out dispute with insurer EmblemHealth over rates.

The United Federation of Teachers, the city's second-largest public sector union, accused the hospital of engaging in a "power play," demanding "sky-high" reimbursement rates to renew its contract.

The union on Thursday sent notices to members enrolled in EmblemHealth plans warning that they could lose access by April 10.

"NewYork-Presbyterian is trying to boost profits with no regard for how its price gouging hurts working families," UFT president Michael Mulgrew said in a statement on Thursday.

The coverage spat comes days after the U.S. Department of Justice sued NewYork-Presbyterian, claiming that it used its leverage to "stifle" competition among health insurance companies to keep prices high.

If Emblem and NewYork-Presbyterian can't reach a deal, tens of thousands of city workers and their families enrolled in the city's HIP-VIP, HIP-HMO, and NYCE PPO health plans will lose access to coverage at the hospital giant's entire downstate health system. Members enrolled in the city's GHI Senior Care program would not be affected, the UFT said.

NewYork-Presbyterian and EmblemHealth stressed that talks are ongoing.

"NewYork-Presbyterian is currently in-network with EmblemHealth and in negotiations to reach an agreement," hospital spokesperson Angela Karafazli said in a statement. "We believe that New York City employees covered by EmblemHealth deserve access to the hospitals of their choice."

Said EmblemHealth spokesperson Alex Gomez: "We are working hard to preserve and sustain affordable coverage for New York City workers."

Anti-trust suit targets hospital giant

In its March 26 lawsuit, the Trump DOJ alleged that NewYork-Presbyterian artificially keeps costs high by using its leverage to prevent health insurance companies from selling plans at lower prices.

The suit is the result of an anti-trust probe launched in 2025. The UFT says NewYork-Presbyterian charges 77% more for medical services than other New York hospital systems. (Karafazli said that the DOJ's claims are without merit.)

The dispute between Emblem and NewYork-Presbyterian also comes on the heels of a bitter nurses' strike at three of the hospital's campuses in Upper Manhattan, which ended in late February after more than five weeks — the longest and largest strike of its kind in city history.

First Deputy Mayor Dean Fuleihan noted that Emblem and NewYork-Presbyterian had agreed to a short-term extension through April 10 from a previous April 7 deadline, but added that "stopgap measures are not a substitute for a fair, lasting agreement."

The administration of then-Mayor Eric Adams announced last summer it had reached an agreement on a new, cost-saving health plan for the city's 750,000 employees and pre-Medicare retirees jointly managed by UnitedHealthcare and EmblemHealth.

EmblemHealth and NewYork-Presbyterian began their negotiations on a new contract later that year. The plan, which went into effect on January 1 despite lawsuits seeking to stop the switch, is projected to save taxpayers an estimated $1 billion a year.

Union healthcare promises threatened

When a consortium of public-sector union leaders approved the plan in September, they said it would save money while preserving existing coverage. The plan was ultimately approved by 88% of members of the Municipal Labor Committee, despite concerns from a number of unions, including the Police Benevolent Association, which voted to reject the plan.

"We've been able to improve benefits, expand the network of providers while allowing our members to keep their existing doctors, and maintain premium-free health care without increasing out-of-pocket costs — especially important in an economic climate where every cent counts for our members' bottom line," the Municipal Labor Committee said in a statement at the time.

Now, those promises are threatened by the standoff between NewYork-Presbyterian and Emblem.

A spokesperson for Henry Garrido, the executive director of District Council 37 and a co-chair of the labor committee, did not immediately return a request for comment. Mulgrew, also a co-chair of the labor committee, could not immediately be reached for comment on Friday.

"Our standard has always been high-quality, premium-free health care for city employees and retirees," Mulgrew said in his Thursday statement. "Other hospitals have worked with New York City to safeguard this benefit. NewYork-Presbyterian needs to do the same."

Marianne Pizzitola, the president of the NYC Organization of Public Service Retirees, said the dispute is "a major concern" for her members, who have been operating under the assumption that their care would not be disrupted under the new health plan.

"You are now three months into this health plan, and now [the agreement between Emblem and NewYork-Presbyterian] is expiring in seven days," Pizzitola said.

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