Uncertainty abounds ahead of MLC vote on city health plan

Citing a lack of details, a number of unions representing New York City municipal workers appear hesitant to sign off on a cost-saving health-benefit agreement city and union officials reached with two major insurance firms in late August. 

At least one large union, the Professional Staff Congress-CUNY, will abstain from an up or down vote Tuesday by the 100 or so unions comprising the Municipal Labor Committee, the umbrella organization of city public-sector unions.

Although city officials have said the plan, jointly run by EmblemHealth and UnitedHealthcare, would continue to provide premium-free coverage for 750,000 active and retired city employees, some unions have said they have received insufficient information about the provisional five-year agreement. 

In a statement posted on the union’s website, the PSC, which represents about 30,000 CUNY faculty, professional staff and others, said that while city workers covered by their current plan would likely “see little change in their coverage” in the first year, what would come next was unclear.

“[W]ithout being able to review the financial elements of the plan, including the City’s exact cost-reduction targets, we cannot know whether the City will seek to change the plan design after 2026. For that reason, the PSC Delegate Assembly voted that the union refrain from supporting the proposed plan at the September 30 MLC vote,” the union’s Sept. 22 statement reads. 

The proposal, while backed by union heavyweights District Council 37 and its executive director, Henry Garrido, and the United Federation of Teachers and its president, Michael Mulgrew, has drawn sharp criticism from rank-and-file activists who say the plan is risky and potentially irreversible. But they also object to the lack of transparency about the agreement, which has been only available for inspection to union leaders in a redacted fashion and for just a brief period of time earlier this month at DC 37 headquarters. 

“The issue is, what are you hiding?” said Wanda Williams, who spent 20 years at DC 37, including at its director of political action. “This is affecting 750,000 people and their families. So that you are sitting and denying people the opportunity to be educated about what it is that is going to happen to them…. And we want to have the opportunity to read for ourselves what, in fact, that is — unredacted with specifications — so that we're able to comparatively look at what this proposal is.”

Rank-and-file union members would only be able to read the agreement if the MLC approves the plan — again in redacted form — during a required public-notice period. 

Williams, a board member of Hands Off NYCare, also argued that savings tied to the new plan couldn’t help but reduce care. She also questioned how and why UnitedHealthcare, which Willams called “one of the most, if not the most egregious bad actors in healthcare in the United States,” was chosen to administer the plan. The healthcare giant is under federal scrutiny for potential criminal fraud related to its Medicare Advantage program.

The Police Benevolent Association, the city’s largest police union, also noted “unresolved” concerns on how the plan would impact its roughly 24,000 active members and its pre-Medicare retirees. 

“There are significant health benefits issues that remain unresolved, including the future of the Health Stabilization Fund and the critical benefits it provides for our members and line-of-duty families,” John Nuthall, the police union’s chief spokesperson, said in an email Thursday. “We will only support an agreement with the city that clearly addresses these issues and provides certainty for our members in the future.”

In a Sept. 24 note to union leaders, the MLC’s executive board, which includes Garrido and Mulgrew, said the redactions were routine and “limited to the propriety information, largely administrative fee pricing and network/clinical components” that could compromise EmblemHealth’s and UnitedHealthcare’s competitive advantages when it comes to securing other agreements. The board said the plan’s “scope of benefits,” such as network carriers and levels of copays, as well as a comparison with the current plan, were shared with union leaders. 

Savings would be less that 1% of budget

The self-funded insurance plan would trim the city’s healthcare costs by more than 10 percent, with savings expected at up to $1 billion annually, or just under 1 percent of the city’s budget, “while simultaneously expanding, instead of reducing, benefits and coverage,” city officials said in announcing the plan in late August. 

The agreement would for the first time offer a broad national network of providers for the more than 80,000 members currently covered by city health plans who live outside New York, according to officials. It would also bring an expected additional 200,000 members’ current out-of-network doctors into the system.

City officials have for years tried to reduce runaway municipal healthcare costs. The tentative agreement’s announcement, while expected, came after years of sometimes acrimonious disputes, including in court, over proposed changes to healthcare plans for municipal workers and retirees, most notably the Adams administration’s efforts to move roughly 250,000 city retirees into a Medicare Advantage plan. 

“We understand employees and pre-Medicare retirees have questions regarding the new plan, but these details would not be available at this stage of the procurement process for any city contract. While some details have been shared with the MLC because health benefits are a mandatory subject of bargaining, they would not be shared outside the collective bargaining process until the appropriate stage in the city's procurement process,” William Fowler, a City Hall spokesperson, said in an email Friday.

A faction of educators represented by the United Federation of Teachers vehemently opposes the agreement on several grounds, including a lack of information. But it is also skeptical that city officials can effectively manage the self-funded system, saying it could expose members to significant risks. 

The plan “would throw us into uncharted waters, handing our health and futures to corporate insurers and a self-funded structure that has never been tested in this city,” a group of city public-school educators wrote in a Substack post recently. “Worse, this entire scheme is being rushed forward without transparency, without accountability, and without the trust of the rank and file.

The educators also noted what they said was the city’s recent poor handling of the joint labor-management Health Stabilization Fund. The fund, originally established to buffer healthcare costs, has been repeatedly tapped for budget relief, leaving it depleted. The educators said that makes it hard to believe city officials would manage the new PPO plan responsibly.

Robert Croghan, the chairperson of the Organization of Staff Analysts and the dean of municipal labor leaders, said on Friday that while he did not yet have enough information to know which way he would vote, he expects to be given more details at a Monday morning meeting of the MLC’s steering committee. But Croghan said he was nonetheless displeased by the lack of time to debate such a consequential issue.

“I’m willing to let them talk to me on Monday morning to convince me further one way or the other,” he said. “I’ve already been unhappy about the fact that we are getting very little time and very little information in a very short period of time in order to make decisions and it's so difficult to therefore communicate the whole thing to our members.” 

The short window of time, though, could be attributed to the length of negotiations among the city, the MLC and the two plan providers, he said. “I just know I feel very uncertain of what to do. I'm going to suspect that most of my members are pretty uncertain about whether this is good or bad,” Croghan said.