Judge temporarily blocks Mayor Adams from switching NYC retirees to Medicare Advantage
A trial court judge has temporarily blocked Mayor Adams from switching retired city workers to a cost-cutting Medicare Advantage Plan.
Manhattan Supreme Court Judge Lyle Frank granted a temporary restraining order Thursday that, until he issues a final ruling, prevents roughly 250,000 city retirees and their dependents from losing their current health insurance.
The retirees who brought the lawsuit “have shown that numerous promises were made by the City to then New York City employees and future retirees” about their coverage, according to court documents.
The court found a likelihood of it ultimately ruling in their favor, and that any switch in the meantime could cause “irreparable harm” and unevenly burden the former city workers concerned about their health benefits.
“As this matter deals with health decisions of an ageing and a potentially vulnerable population, mostly on fixed incomes, any lapse in care for these people could lead to deleterious impacts,” Frank wrote in 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 last year to prevent Adams from implementing an initial version of the Medicare Advantage plan.
Adams’ team this year devised a new plan that eliminates traditional Medicare as an option altogether and makes Advantage the only health insurance available to the city’s municipal retirees.
By removing a penalty from the picture found unlawful in the first lawsuit, Adams has argued the new plan is compliant and signed a contract in March with private health insurance giant Aetna to enroll retirees in it, effective Sept. 1.
“We are thankful the Judge saw our retirees would be harmed by being forced into Medicare Advantage with no ability to stay on traditional Medicare and supplement,” said Marianne Pizzitola, a retired FDNY EMS who serves as president of the retiree group.
A representative for Mayor Adams indicated that City Hall could appeal the temporary measure.
“We are extremely disappointed by this misguided ruling,” said Jonah Allon, a spokesman for City Hall, who argued that Medicare Advantage offers a lower deductible, a cap on out-of-pocket expenses and new benefits, such as transportation, fitness programs, and wellness incentives.
“Further delay in implementing it will only cause greater uncertainty for our retirees and have a detrimental impact on our city’s budget.”
Harry Nespoli, chair of the Municipal Labor Committee, which is made up of reps for all local public sector unions, alleged the decision “misconstrued the appropriate legal standards and accepted unsubstantiated allegations as fact.”
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 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.
Balancing the city’s argument that the new benefits are not inferior and delaying their implementation would derail plans, with the potential for hundreds of thousands of retirees to face lapses in their health care coverage, the court sided with the former city workers.
“Should this plan go forward, irreparable harm would result,” read the decision. “There can be no more specific irreparable harm than this.”
