STOP Medicare Advantage! NYC Lawsuit Filed

New York City Retirees Fight Against Medicare Coverage Changes

An important development regarding retirees' access to health insurance is the class-action lawsuit that has been brought against the City of New York. The complaint, which was filed on May 31, 2023, contests the City's intention to convert almost a quarter million retirees who are aged and disabled from their current Medicare coverage to “Medicare Advantage,” a less comprehensive form of coverage.

In contrast to the government-run Medicare program that has protected City retirees for more than 50 years, the new insurance policy, known as the Aetna Medicare Advantage plan, is a private, for-profit venture. The lawsuit asserts that the new policy exposes retirees to debilitating healthcare expenditures, has a small network of medical providers, and does not cover a wide range of medical services unless certified “medically necessary” by Aetna.[source]

The action also asks for a preliminary injunction to prevent the City's plan from being executed and to stop the forced move to Medicare Advantage immediately. They include causing risky denials of and delays in medical care, requiring senior adults on limited incomes to forgo medical care and other requirements, and prohibiting retirees from visiting their preferred doctors and staying in their continuing care homes.[source]

The lawsuit alleges that the City has promised every active and retired City worker since the 1960s that they would be entitled to City-funded healthcare through a combination of Medicare and Medicare “supplemental” insurance, which covers healthcare expenses that Medicare does not. The retirees argue that they reasonably relied on this promise and insist that the City must continue to honor it. The lawsuit alleges eleven other ways that the City’s new healthcare policy violates the rights of retirees, including violations of the New York State Constitution, the Retiree Health Insurance Moratorium Act, the New York State and New York City Human Rights Laws, the City Administrative Procedure Act, and the Donnelly Act.[source]

The legal filings include hundreds of affidavits from retirees, experts, and former high-ranking City officials supporting the allegations in the complaint.[source] Jake Gardener, a partner at Walden Macht & Haran LLP and counsel to the retirees, criticized the City’s new healthcare policy, saying, “The City’s new healthcare policy imperils the health of hundreds of thousands of senior citizens and disabled first responders and flagrantly violates their rights. To deprive them of those benefits now“`html
, in their old age, is an unconscionable bait-and-switch.”[source]

Marianne Pizzitola, President of the New York City Organization of Public Service Retirees, expressed her disappointment, stating, “As a former EMT who became sick working at Ground Zero, I feel disgusted and betrayed by the Mayor and union leaders, who chose to enrich themselves at the expense of elderly and disabled retirees. Retired municipal workers devoted themselves to this city for little pay. We were guaranteed certain healthcare benefits in return. To deny us that after a lifetime of service is outrageous and immoral.”[source]

The class-action lawsuit, a hybrid of a class action and Article 78 proceeding, was filed in the New York State Supreme Court. The retiree plaintiffs are being represented by Walden Macht & Haran LLP, with assistance from co-counsel at Pollock Cohen LLP.[source] As the case proceeds, the implications for the future of healthcare coverage for retirees in New York City remain to be seen.

The Senior Savings Network is a broker specializing in Medicare benefits throughout the United States. We are continuing to monitor this situation and provide help for alternative solutions for those who need it.  The Senior Savings Network can be reached at 1-800-729-9590.

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