It Is Not Finished –   The Struggle (Against Medicare Advantage) Continues

(CROC) Evelyn Jones Rich, March 23, 2023

“Father, forgive them for they know not what they do!”  illustrate  the first  “word” of Joseph Haydn’s   famous sonata– The Seven Last Words of Christ – which reverberates throughout churches – Black and White – every  Easter season.    For many of us the sonata – usually presented on Good Friday – symbolizes our recommitment to Christian teachings.  Usually Easter and the Jewish celebration of Passover occur around the same time!  In both religions Easter and Passover   symbolize rebirth and renewal.

The problem for many of us here in NYC – Christian and non-Christian – is that for many of us the words, “Father, forgive them for they know not what they do”, suggest that THEY know EXACTLY what they’re doing!  THEY are selling out 250,000 municipal retirees, our dependents, the 18% of the current City workforce  eligible to retire now and the 29% who are  “retirees in training” , eligible to retire over the next five years! That totals a lot of New Yorkers!  Ultimately THEY are after the City’s current work force as well.    

“THEY” are the “leaders” of the Municipal Labor Committee,  sanctioned to represent the members of the City’s work force and retirees in collective bargaining with the Office of Labor Relations, (OLR) representing the Adams administration.  THEY are about to ratify an Agreement with AETNA, a wealthy and powerful insurance company owned by CVS, which will deny us access to public, premium free, affordable, quality, comprehensive health care!

Our current health care – GHI Senior Care – fulfills the promise NYC made to us when we joined the workforce at salaries significantly less competitive than those in the private sector.

The move to AETNA responds to a promise by the MLC to the OLR to “save” New York City $600 million by having the   federal government pick up the 20% in health care costs which the City has been paying.  Note these proposed “savings” are part of an effort to “save” NYC a predicted budget gap of billions of dollars of which retiree health care is but a small part! Note also that the federal government is no longer picking up 20% of the Supplemental costs but picked up only 4% of these costs in 2022 and is predicted to pick up only 2%in 2023.

 The MLC assures us that this Agreement is fair and will be even better than the affordable, quality, comprehensive medical care we currently have!  

How is this possible?  CVS – a private company with its subsidiary, AETNA, is in business to make money for its shareholders.  Each year their profits increase.  In 2022 CVS made $4.1 billion.  Aetna made about $1 billion.  CVS’ CEO, Karen Lynch received $20 million in salary andbonuses.  Note that the money comes from federal payments – not enrollee premiums.  The federal government pays more to private Medicare Advantage insurers than it spends for comparable patients in public traditional Medicare.

  The MLC touts the advantages of the AETNA program which include a fixed fee to AETNA for each enrollee.    These advantages include   minimal co-pays and deductibles, access to hearing aids, glasses and dentistry as well as   “perks” which may include membership in a health club, transportation to doctors and other services designed to promote health and wellness. 

The MLC doesn’t say that studies show that enrollees use less care or lower cost care.  True, the fixed fee is less than what the CMS allots for each Medicare enrollee.  And, it is indeed true that the Proposed Agreement limits the numbers of items which require prior approval (for a restricted time period) in response to the criticism that the Medicare Advantage Programs often delay or deny care. 

Also missing in the Proposed Agreement is the important statement, Don’t Get Sick!   For the most part, then, the Proposed Agreement sounds good!  But, it isn’t.   The Proposed Agreement doesn’t describe the widespread use of “upcoding” where insurance company staffs scrutinize the health records of enrollees to claim additional fees for real or imagined illnesses.     Studies show that Medicare Advantage enrollees use less hospital care than traditional  Medicare  ( even up to 20%-30% less emergency department and outpatient surgical care) .  These same studies show that Medicare enrollees receive fewer hip and knee replacements. They also show Medicare beneficiaries who enroll in a Medicare Advantage Plan are more likely to be denied hospital care than beneficiaries who remain in traditional Medicare.  Care is denied in two ways – by discharging patients directly from the Emergency Room or placing patients on “observation status – at astonishing rates. 

Finally, Medicare Advantage Plans receive government payments in excess of their administrative and marketing costs.  These payments amount to millions of dollars.

The MLC’s attitude as well as that of the OLC is that the federal government is paying these costs so why should each of us be concerned.  These are tax payer dollars and we – union members and retirees – are the taxpayers! Aetna is a private, for-profit company. We want to retain our public, traditional Medicare!

Despite pending charges of fraud, AETNA, the health care insurance company of choice by the MLC and the OLR, will benefit from enrollment of DC37 members and those of other municipal unions for which it sets the standard.  Today, in 2023, almost 50% of seniors over 65 are members of Medicare Advantage Programs.  Aetna has promised to grow its enrollee list by 100,000 in 2023.  Capturing NYC retirees will make that promise a reality.

The fifth word of The Seven Last Words of Christ is, believably, “I thirst.”   For many of us this statement conjures up a scarcity of life’s basic– water.  We extend the idea of lacking this basic to equate with austerity.  A basic ingredient in our struggle is the initial lack of adequate funding !  NY City, operating in a framework of economic austerity, continues to lack the money it needs to provide the services it must deliver to its people.  It refuses to raise taxes on those who can best afford it, often declaring that those taxpayers will abandon the City for Florida or South Carolina or Arizona.  Our response is that they should pay their fair share!

What’s next? 

 The sixth word of Hayden’s sonata is “It is finished.”  Countless thousands of retirees know that it is NOT finished! DC37 members are among the lowest paid municipal employees and thus retirees who need access to the best care available without hassle.    Current DC 37 members are many of the essential workers who kept the City going throughout the pandemic.  DC37 members have been without a contract for a long time. A vote on the contract which includes the proposed AETNA Plan is scheduled for March 9, 2023.  Too many DC 37 members may well accept the Proposed Agreement because on the surface it looks good. It is not! 

 The Aetna Plan would not only require that City retirees, if we choose to remain in traditional Medicare, purchase and pay for our own Supplemental Plan, but it would also require that we waive all other City health benefits. No longer would the City reimburse us for our Medicare Part B (Medical) premiums, nor would retirees be eligible for IRMMA (for those who qualify). The cost to every retiree would be $5,000 to $6,000 each year. No wonder many retirees refer to this as the “nuclear option.” The majority of retirees would be unable to afford this, and thus, by design, would be forced into the Medicare Advantage plan provided by Aetna. Retirees will fight back!

We reject the Proposed Agreement for still more reasons.  What we have been presented with is a SUMMARY. We are entitled to receive and review the entire Plan.  All too often the devil is in the details.  We do not believe that it will save the City money and, finally, we reject the underlying idea that we live in an environment where we have to choose between quality health care and increased wages.  The MLC’s continued opposition to revision and passage of the New York Health Act is an affront to all workers.  Acceptance of the AETNA plan betrays the promise of public, premium-free, affordable, quality, comprehensive, health care.

The road  ahead includes additional law suits, demonstrations, rallies, newspaper articles, and other resistance moves as retirees show that we have not given up on a system which appears to have forsaken us (like the fourth word  of Hayden’s sonata.)  

The seventh and final word of  The Seven Last Words of Christ is “Father, into thy hands I commend my spirit.”  Finally, and luckily for us, we still have lots of SPIRIT!  

  1. Write your City Councilperson.  Seek out your NY State Assemblyperson and State Senator and ask each to reach out to your Councilperson.  (You can get all these names by calling 911 or emailing at 
  2. Call MLC leaders daily:   DC37: Henry Garrido 212-815-1500, 212-815-1511
    UFT: Michael Mulgrew or Tom Murphy 212-777-7500
    Sanitation Local 831: Harry Nespoli 212-964-8900
    Sanitation Local 444 Officers Joe Mannion 718 837-9832
    Local 237 Greg Floyd (212) 924-1989
    CSA: Henry Rubio 212-823-2020
  3. Call Elected Officials
    NYC Mayor – In NYC 311; if calling from outside NYC 212-639-9675 (not a bad man but misled and lacking vision and creativity)
    Jumaane Williams – 212-669-7250
    Email your Union President 
  4. Educate your friends: at the grocery store; in church; at the hairdresser or barber; in your coffee klatches and at your board games; relentlessly. 

We retirees see this struggle as the fight of our lives; a war against aging; a war against commitment; a war against right and justice.  Join us in our struggle in this environment of rebirth and renewal.  We are not giving in and we are not giving up! Join us! We love this City! So do you!  Help us redeem it!