UFT Healthcare Vote at the DA: Lots of Reasons to Vote NO or Table Till We Get Further Info - Role of United Health's 32% Denial Rate
A Better Contract on the Proposed UFT Healthcare Deal - UFT Members Need Transparency On Healthcare
Monday, Sept. 29, 2025
People who registered early for in person have been turned down, so expect the place to be lined with staffers and school-based caucus 
members. Expect the total Unity Ex Bd, which includes 7 HS reps who got 35% of the HS vote -- call them the 35 per centers -- and includes full time staffers making believe they teach in high schools. In fact I'd bet much of the exec bd are not school based, so expect the heavy duty rubber stamp in their pre-DA meeting. Some Unityites, one of the most virulent and nasty Unity voices out there, have been encouraging Mulgrew to call on certain oppo people who are sure bets to support the plan.
What a spirit of bipartisanship! I find more and more Unity people saying positive things about their fave oppo people.
The scattered opposition groups are all doing their own thing, another gift to Unity.
What happened to the ARISE Coalition: Of all issues they should have united on this one - but you will find no hint of an ARISE coalition at this point.
I have pointed out that MORE has taken a VOTE NO position. Now if their supposed 100 delegates and chapter leaders actually show up---MORE has held meetings and has a plan - I think a reso of some sort. But as usual, MORE did not collaborate with others - they don't want to contaminate their pure sandbox. Think of it -- they say they have 100 delegates and RA has 300 - and NAC has some and even the dreaded ABC have a batch. These non-Unity groups should theoretically have enough delegates to put up a fight - if they could agree. Last year the oppo at the DA was a descending disaster at the year went on.
The 12 member Retiree Advocate Organizing Group, with 300 delegates, who seemed to show up less and less as the past year went on, has not made an attempt to organize this group since there are divisions over how to vote within the group - I'm one of the TABLE /VOTE NO Group.
Why should NYC workers have the responsibility to save NYC billions in healthcare costs?
MLC leaders claim that the new health plan will save the city billions. Will it? And what will happen if it doesn’t?
City retired workers successfully challenged the Municipal Labor Council (MLC) when they wanted to save the city $600 million in health care costs by giving them Medicare Advantage instead of traditional Medicare. Now the UFT leadership wants the in-service workers to provide these savings to the city.
In 2014 Mulgrew negotiated a contract with Del Blasio to insure billions of dollars in health care savings to the city in exchange for raises to city workers. Mulgrew didn’t want to organize workers to strike for wages they had been denied for years. In reality city workers didn’t receive a pay raise: they paid for their own raises with health insurance cutbacks.
The MLC leadership has made unsubstantiated claims that they can save the city $1 billion per year through the following measures:
1. They claim $400 million will be saved through improved networks and contracts but there is no proof that that will happen. The justification for this is that we will have one card. Emblem will manage doctors and hospitals in downstate NY and United will manage the plan outside of the NY downstate area.
2. The plan is self-insured. While NYC city will still be paying for our benefits, the plan will be completely administered by insurance companies. All claims will still go through United Healthcare which denied 20% of claims in 2023.
3. The welfare funds will sell their drug data to United Healthcare for $100 million. If 75% of city workers don’t agree to sharing their data the MLC will lose this savings. The proposed plan for instance doesn’t cover GLP-1’s for all medical conditions.
4. Supposedly, an additional $50 million in administrative costs will be saved by having one card and one insurer. This is unsubstantiated.
5. Emblem and United Healthcare will negotiate better contracts with hospitals to save $200 million. This savings of $200 million has no basis in current reality. One of the leaders of DC37 admitted that this savings was not an absolute because we’re just initiating it. Hospitals are currently stressed with overcrowding and Trump’s cutbacks to Medicaid.
A DC37 leader admitted that the city can come back at any time to renegotiate the plan.
This healthcare agreement may be beneficial to some workers for a very short time.
But the overall problem is that in the current healthcare system New York city workers should never be responsible for achieving impossible savings in healthcare.
Healthcare costs for NYC employees have increased from $5.1 billion in 2015 to $9.3 billion in 2024.
The city should take responsibility to see that insurance carriers, pharmaceutical companies and hospitals and health systems which are reporting record profits are complying with the law.
Workers should not have their wages stolen from them to pay for health care costs. Over the past 25 years increases in the out-of-pocket costs borne by workers in employer sponsored insurance have outpaced any increases in wages and inflation.
WE MUST VOTE NO ON THE CURRENT RESOLUTION WHICH CONTINUES A PATTERN OF WORKERS PAYING FOR THEIR OWN HEALTHCARE.
We need to pass a resolution in the delegate assembly to prohibit the inclusion of any UFT responsibility for cost savings for health care in future negotiations.
By Deborah Poleshuck, Retired Teacher Delegate
1. We need to be able to see what doctors and hospitals are in the networks. Don’t post “you can visit any doctor” - sure you can, but we need to know if we “visit” what, if anything, are we paying? (If my baby is delivered at NYU where my doctor is associated, how much will it cost me?)
2. Has the City provided the commitment in writing to the MLC that there is a five-year no-premium guarantee?
3. Is there a similar five-year cap on out-of-pocket costs (copays, deductibles, coinsurance, and out-of-pocket maximums)? If not, what triggers increases, and are there limits on raising any of these elements?
4. Since the provider tiers are defined only as Preferred (Emblem Health network (ACPNY) and NYC public hospitals (H+H) and Standard. Is the membership of the Standard network guaranteed for five years? If not, under what circumstances could a hospital be removed and deemed out-of- network? Could additional tiers be created with different copays, deductibles, or coinsurance?
5. What hospitals are in Emblem’s Network since they are handling hospitalization for the Downstate 13 Counties? Is Northwell, which holds the largest CBP utilization, in the network?
6. 7. What is the new full drug formulary, and what is the appeal process if a prescription is denied? What is the full list of prior authorizations, will they be determined by physicians or computer AI’s, what is the appeal process for denials, and what is the turnaround time? How often can these be renegotiated and by whom?
8. Since this plan is now “self-funded” and no longer under the oversight of the NYS Department of Financial Services (DFS). How is oversight going to be handled? Since a self-funded public plan does not have to cover the state mandates, will this new plan cover ALL the treatments currently covered, and is that promise in writing? What ensures the plan will cover those mandates during the 5-year term?
9. Is the equalization agreement and stabilization fund still in place? If not, what governs? What changed? What is the future of the stabilization fund once the Core Fund of the current CBP insurance carriers are paid out? Is restoration of payments to the union welfare funds from the stabilization fund likely in the future? What is happening with the $35 million annually that was supposed to go into the Stabilization fund?
10. What happens to the Medicare eligible retirees’ optional rider drug plan since the rider plan will be different? What is the new vendor and what is the new vendor’s formulary?
11. What rules will be governing the committee reviewing this plan monthly? Who exactly is on it? Since this is a self-funded plan will these meeting be open to the public?
12. What is happening with all the other 11 plans offered by the City? And does the HIP HMO continue as the benchmark?
13. What is the Administrative Services Only (ASO) fee to be paid to the insurance companies, and does it change annually? Are there separate ASO fees for UnitedHealthcare and Emblem Health? If so, what are they?
14. If the City doesn’t see the savings of the $1 billion you promised, what is the penalty? When does that start and in what forms will we be paying? Is there any “blow up clause” language in any agreement in case the insurance companies can’t provide the savings you promised? If costs rise above the established trend or benchmarks, what penalties will UnitedHealthcare and/or Emblem Health incur? Will the City be required to increase participant out-of-pocket payments?
• UFT Retirees learned the hard way that you
had better read the whole contract -
including any side agreements - before you
approve it.
• We have had to fight our own union for
three years to stop the privatized Medicare
Advantage deal that we would have been
forced into, designed to save the city money.
• This new deal before us today aims to save
the city $1 billion a year. How exactly will
that work?
• We should vote to table approving this
agreement until we can read the whole
contract.
• If a vote to table is not adopted, then we
need to vote NO on this new agreement.
No comments:
Post a Comment