UFT Members Take Note – It’s Not Looking Good for Healthcare

At the October 3rd, 2022 session of the UFT Executive Board, buried mostly at the end of an unusually long session with 5+ pages of unofficial minutes, we finally got a decent healthcare debate. Healthcare is now one of the major disagreements between the controlling caucus of our union (Unity) and the progressive opposition (the caucuses, including New Action, that banded together to form United for Change in the last election). The problem, which UFT President Michael Mulgrew to his credit correctly identifies is this: healthcare costs have risen so astronomically over the last several years, that if we can’t find a way to cover the rising prices, we are going to start seeing healthcare eat up our raises. Unity Caucus has therefore championed strategies to cut healthcare costs by hundreds of million dollars. Their argument is that this will free up money for other purposes (like raises) and will also either not affect our healthcare or–somehow–actually improve it.

Opposition caucuses, such as Retiree Advocate, MORE, ICE, Solidarity, and New Action, have pointed out that for a number of reasons, these cost saving mechanisms do so at massive expense to our membership, both in-service and retired. Many of these arguments are summarized well in the Resolution that I motivated at the Executive Board Meeting last night. This resolution, written principally by members of Retiree Advocate, especially Gloria Brandman, with some revisions/edits by myself and Ronnie Almonte (MORE), and endorsed by the entire High School Executive Board, along with the independent Mike Schirtzer, is worth reading in its entirety:

RESOLUTION IN OPPOSITION TO THE PRIVATIZATION OF MEDICARE

WHEREAS the UFT and our national organization, the American Federation of Teachers, has previously declared that “access to high-quality healthcare is a basic human right” and healthcare should be treated as a “public good”; and

WHEREAS, the United Federation of Teachers in 2015 supported the New York Health Act to establish single-payer universal health coverage in New York and passed a resolution in 2017 stating that the most sensible and cost-effective solution for health coverage is a single-payer system modeled after the federal Medicare system; and

WHEREAS Medicare has been a highly successful program of government-funded health insurance for seniors since 1965, spending under 2% on administration so that 98% of money in traditional Medicare goes directly to people’s health care; and

WHEREAS UFT retirees rely on Medicare for health care in their retirement, and active members need to be able to rely on Medicare when they retire, so the continuing viability of Medicare is of vital concern to all members; and

WHEREAS since the start of Medicare, there have been continuing efforts to privatize Medicare, including 2003 with the introduction of Medicare Advantage plans, which profit by limiting member access to providers, tests, and procedures and has consistently cost the federal government more than traditional Medicare; and

WHEREAS the NYC Municipal Labor Coalition’s 2021 attempt to replace traditional Medicare with a privatized “Medicare Advantage Plus” plan met significant opposition among UFT retirees, and was rejected by the Court in 2022, and

WHEREAS employers (including public employers) are increasingly enrolling retirees in for-profit Medicare Advantage plans; and

WHEREAS in 2019, the Centers for Medicare and Medicaid Services Innovation Center (CMMI) developed a program to turn the administration of Medicare funds over to Direct Contracting Entities–for-profit intermediaries including insurance companies and hedge funds, as well as provider practices; and

WHEREAS after public outcry, CMMI has rebranded Direct Contracting Entities into “ACO (Accountable Care Organizations) REACH” but has not changed the basic structure of the program, with the goal of incorporating such entities into all of traditional Medicare by 2030;

Therefore be it

RESOLVED, that the UFT opposes the continuing movement to force retired union members into any and all privately owned and administered Medicare Advantage plans; and

RESOLVED that the UFT opposes grandfather clauses to preserve traditional Medicare coverage for current retirees but not for future retirees.  

RESOLVED that the UFT will champion only those funding mechanisms to preserve traditional Medicare that would also preserve funding for in-service healthcare and raises for in-service members.

RESOLVED that, just as the UFT opposes attempts to privatize public education, the UFT also opposes any other attempt to privatize Medicare, including through Direct Contracting Entities, ACO Reach, or any similar programs; and

RESOLVED, that the UFT opposes the continuing movement to force retired union members into any and all privately owned and administered Medicare Advantage plans; and

Resolved, that  the UFT opposes amending City Council Code 12-126 as the proposed change would result in a private Medicare Advantage Plan being the only cost free Health Plan available to UFT Retirees; and

RESOLVED that the UFT will, as appropriate, support efforts by organizations working against the privatization of Medicare; and

RESOLVED that the UFT will work to encourage our affiliates, AFT and NYSUT, to oppose all privatization of Medicare and act to reverse these private programs that drain resources away from actual health services. 

That’s the text of the reso, which I motivated, and most of the 7 got a chance to endorse. (New Action’s Ed Calamia, who gave a showstopping speech in the last executive board meeting, was prevented from giving another tonight by an early call-to-question.) However, only the 7 and Mike Schirtzer, to my recollection, voted in favor of the resolution. That means, assuming good attendance, the resolution was defeated by roughly a 90% margin. So let’s take a close look at the debate, which really started during Mulgrew’s President Address (before the resolution was even endorsed).

Mulgrew: Healthcare: we will have our inservice healthcare committee. Joe ? will be chairing it. Down in DC. What is going on in this country for healthcare is an absolute disgrace. We have the opportunity to work with the other unions to do a variety of things to solve the problem. We are fighting like no one else. But in DC, the new legislation has some improvements – we can negotiate drug prices in medicare, for instance. But so many good things were ripped out because of the insurance companies. Money doesn’t go to the people doing the work. So what is healthcare doing to salaries? It’s destroying it. So here in NYC, we’re saying we’re going to take this on. This is a national outrage, it doesn’t matter if you are public or private. At least we’re doing something – everyone else is just eating the cost. At least, we are fighting. But, while we are doing that we have to be clear – our healthcare costs have doubled, even with us pushing the costs down, which is why we’ve remained premium free. Most other countries have universal healthcare, which is why we pay more than everyone else. It’s all very complicated. Prostate exams should take place at a doctor not a hospital, because costs are much lower in medical offices. We looked at a state level and decided that if we did it as a state we would ‘destroy ourselves as a state.’ Something must be done at the national level or we’ll destroy ourselves. Medicare Advantage is only one piece of what has been going on, which is why we need an in-service committee. We go to the doctors more than any other employees of the City. Never give your right to bargain away – like a judge did to us. ‘Medicare Advantage’ is still part of Medicare. We have the right to do this, so why not make our own? We want good quality premium free healthcare.

Nick Bacon: Endorses resolution in opposition to the privatization of Medicare. (Click hyperlink to left for full text). It was said earlier by Mulgrew that UFT supports a national single payer public option. Indeed we as a union have passed resolutions to this effect. It stands to reason that Medicare, the only current public option, which such a system would be modeled after, must be preserved. Therefore, we must resist privatization of Medicare. Medicare Advantage will get cost savings through privatization that limits access to care for our retirees (and future retirees) who dedicated their careers in service to our City and students. It will add to administrative costs and add barriers to care like prior authorizations. Medicare Advantage is much like charter schools, which we as a union also resist. Charter Schools offer to do the same as public schools but ‘better’ and often ‘cheaper’ through privatization. They erode public education by doing this. Medicare Advantage does the same to Medicare. Given our own obvious analogy in education,  our own precarious situation relative to privatization, we must argue for salvaging our public Medicare. And we owe it to the workers who have retired and one day will retire.

Sworkin: Stand in opposition. States things thee says things that are false and is misguided. ‘Sometimes we need to make tough decisions.’

Ilona Nanay: I stand in favor of the resolution. A year ago my mother died of breast cancer and she was on a medicare advantage plan. It was virtually impossible for her to obtain care. I think it is one of the reasons that she passed. It is still extremely frustrating – every time I hear him talk about the program. I would love a breakdown of why the NY Health Act hurts us as members of the union. We support the NY healthcare.

Vincent Gaglione: Medicare Advantage is still Medicare. Part C of Medicare. Also you have to look at what you’re getting. Not all Medicare Advantages are created equal.

Joe: Stands firmly against. My wife works for an insurance company that provides the product. If we were on her plan we’d pay 700 a month, which is reasonable in today’s world. We can negotiate better benefits.

Alex Jallot: Firmly in support of this resolution. Every time we play ball with these insurance companies. If we supported single payer, we could put more time and energy into better pay. The minute we give an inch, they want to take a mile. Healthcare is part of the boss’s ploy to keep us down. We have to have a single payer healthcare system or otherwise this will be the same story every years. We have to say no sometimes and let them know that we aren’t accepting any more inches being taken from us. For the sake of our retirees and workers everywhere we should accept.

Ibeth Mejia: Responds to Vincent. The private companies in Part C are for profit. We need Medicare for all. No free choice – MAP +, if they wanted to keep regular Medicare, they would have to pay over 400 a month.

Unity Caucus is stating the obvious, that healthcare costs are rising, and misrepresenting the level of privatization that already exists in Medicare. They recognize that private greed is causing the increases in healthcare costs, and yet don’t see the irony that their fix to costs caused by private greed relies on further privatization. To that end, they are also under-selling the real risks that come with a Medicare Advantage program, such as those pinpointed by Ilona Nanay and dismissed by Vincent Gaglione. Many of those problems are already apparent, such as prior authorizations. Many others, such as losing access to some providers or types of care, won’t necessarily become apparent until years after we finalize such a plan. Moreover, they miss the point that healthcare is something for which we must draw a line in the sand. If we allow Medicare to be uber-privatized now, we will lose the infrastructure to get a national single payer system like the one the UFT has already endorsed. And moreover, when a public sector union advocates privatization as a fix, we risk making that argument stick for our own public good – education. And that’s dangerous.

In-Service Must also Beware

This post has already gone a bit longer than intended, but I want to close by pointing attention to another key conversation that occurred on healthcare at the Oct. 3rd Executive Board – Mejia and Sorkin’s back and forth on in-service healthcare:

Ibeth Mejia: According to Article 3G1, “ The Board agrees to arrange for, and make available to each day school teacher, a choice of health and hospital insurance coverage from among designated plans and the Board agrees to pay the full cost of such coverage.” Why are we discussing limiting FREE plans when a choice of free plans is in our contract?

Response: We are championing choice.

Ibeth: Don’t we already have two not premium free plans, GHI and HIP?

Sorkin: We are looking to preserve good ‘premium free options.’

Ibeth: Presses.

Sorkin: Notes rises costs. Would love to pass costs on to members. So we need to see what else is out there. We have dictates from decades of negotiations over healthcare.

Make no mistake. We just got notice that in all likelihood either GHI or HIP will no longer be premium free to all in-service UFT members in the near future. And that’s something to which we must pay very close attention.

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