A mid-career NYC HS Teacher:This proposal is fucked. This is insane. Mulgrew wants to take our health plan, totally deregulate it, and hand huge chunks of it over to the worst actor (United Healthcare) in the entire industry.I read through that FAQ with a very qualified expert (who is not in a position to put their name out publicly). They are of the same opinion. Very, VERy bad idea.The self-insured plan would not be subject to regulation from NY State Insurance Commissioner (Department of Financial Services). Nor would it be subject to Federal ERISA rules.The alarm bells need to be ringing. We are sleep walking into a huge set up.NY State DFS is one of the most powerful regulators in the country (next to California). We should most definitely not remove our plan from their oversight.
If you have a vote, you need to vote no. Start making some noise on this. I am telling you it is time to wake up and get LOUD!I don’t know what else to say to motivate people. People are sleepwalking like confused robots into very bad situation.Like lambs to the slaughter.UFT Retiree, ABC candidate for Ex Bd. :I am a retiree and I was lied to about my healthcare. I will never again believe what Unity has to sell me. This is the “little boy who cried WOLF” syndrome. The way I see this we should all be voting NO on proposed city healthcare until we are given the contract and adequate time to read/digest it. I certainly could not approve of something that I have not read/researched....
HS teacher: Happy school year 2025-26! Our members are already expressing concern about United health care's terrible record when it comes to pre-authorizations and denial of claims.
Is this something we need to be concerned about ?
comment on chat: RA And NAC’s delegates have to show some spine. Someone needs to rally the half of the RTC delegates not caucus bound. The 300 delegates in RTC should be demanding answers. ....
Tuesday, Sept. 16, 2025
I know this after decades of watching Unity Caucus leadership of the UFT operate: LOOK PAST THE SALES JOB AND BE SUSPICIOUS and OPPOSE even not knowing the details because there will be things you are not being told. I will be posting some more details on reasons to say NO in the next few days. But here is some history of where we are today. And let's point out -- the new healthcare plan affects working members and retirees not on medicare (under 65).
As people examine the proposed changes in healthcare, after a sense of initial acceptance by some associated with the opposition, there is a growing sense of opposition. While not public, I'm proud to say that on internal ABC chats there was immediate push back and analysis of the flaws in the plan, while the rest of the non-Unity world seemed to be in the dark, with all members of the healthcare committee, including reps from non-Unity caucuses, actually voting to agree, which, given their experience with Unity, they bought the bill of goods at the Aug. 28th Mulgrew presentation - the equivalent of a used car salesman. (I'm bringing the Brooklyn Bridge to hawk at the next meeting.)
Now we are seeing posts from New Action (Some Initial Thoughts and Questions About the New Healthcare Proposal) and MORE (Why are UFT Chapter Leaders and Delegates in the Delegate Assembly Voting No on the Proposed Changes to Our Healthcare? doing some deeper analysis, with MORE calling for a NO Votes while NAC fears to go that far, not unusual given the NAC history of caution when it comes to challenge Unity. Since NAC has so much influence in RA Org, expect RA to echo NAC in its caution.
ABC has also been doing internal analysis with some ABC affiliated people raising public issues since the first days of the plan.
NAC co-leader and ARISE steering committee member Nick Bacon (congrats on the new baby) made his usual attack on ABC people who raised questions about the healthcare plan and branding them as seeing things through "conspiracy colored glasses" and promoted the more cautious NAC approach.
Well, get me more pairs of those glasses. Would he brand fellow ARISE member MORE's call for a NO Votes the same way and threaten the bonds formed in the ARISE alliance? In this situation MORE and ABC seem to be more in synch.
While ABC has not put out a formal position, the ABC chats were rife with criticisms immediately after some details of the Mulgrew-led Aug. 28 healthcare committee meeting, focusing on the self-funding issue (see below), hospital tiers and other issues that my brain is too simple to absorb.
In my internal debates with RA/RTC leaders I have pulled whatever hair I have left over their sense of "We can't automatically oppose anything Unity proposes, Unity is not the enemy but fellow unionists." My response has been - you mean the very people who tried to sell retirees on how great a Medicare Adv would be -- twice - until they lost the big RTC election? And you are giving them a benefit of the doubt an yet another healthcare plan being presented as saving the city money? With United fucking Health yet? And how about that 60 year reign with the current edition holding 100% of elected position despite getting only 54% of the vote, a state of disunion?
I say automatically oppose anything this big they propose. I don't even need to see any stinkn details to smell a rat - especially when they say they are both saving the city money and giving us a better healthcare plan.
Where do I begin to talk about the brand new healthcare proposal which will be voted on at the special Sept. 29 Delegate Assembly. Maybe at the beginning.
Way back then -- at a DA last fall or winter (excuse the memory issue - I was in the midst of chemo) - the newly empowered Retired Teacher Chapter, for the first time no longer controlled by Unity Caucus, passed a resolution calling for a vote by the Delegate Assembly for any changes in healthcare.
Now understand, this was occurring in the midst of a UFT election campaign where there was a growing differential between the newly emerging A Better Contract and the ARISE coalition of 3 legacy caucuses comprising New Action, MORE and Retiree Advocate. The latter had won the June 2024 RTC chapter election and elected the entire 10 officer, 15 exec bd and 300 delegates. MORE claimed to have 100 chapter leaders and delegates and New Action had a few. ABC, still in formation, had no clear number of delegates and chapter leaders at that point, but had a bunch. If they all packed the DA, there was potential to exert an unprecedented level of control over the DA.
It didn't happen.
What began the year as a nervous Unity, turned into more and more dominance as the opposition seemed to fade away. At that point, Unity was still figuring things out and decided to support the reso from RTC on the DA voting for any healthcare changes.
UFT Secretary LeRoy Barr amended the reso to declare the UFT would never advocate for MediCare Adv - the leadership response to the RTC election loss - to many of us words only because they would oppose city council bill 1096 which would codify protections for retirees.
And then Mike Sill, part of the 3 man triumvirate, added another amendment calling for the creation of a UFT Healthcare Committee that turned out to be totally controlled by the leadership. Some say hand-picked, including some members of RA and New Action - it is not clear if any from MORE joined the committee -- but one thing was clear - anyone associated with ABC who tried to join was rejected.
I want to point out that some of us associated with ABC were not happy with a reso calling for the DA, controlled by Unity, to vote on healthcare changes since a few of us had put out a petition back in April-June 2023 calling for the entire membership to vote on healthcare changes, a petition that garnered over 12,000 signatures of in-service and retirees. (Yes, we dropped the ball in not continuing with it in the 23-24 school year.
The late James Eterno was instrumental in formulating the petition which
needed 10% of the membership (20K) to sign to force a referendum. James' stroke and total incapacity affected us so deeply, the momentum was lost on the petition and we never reached 20k but it was clear we had a shot at it.
This was one of James' final posts on the ICE blog on April 18, 2023:
HEALTHCARE REFERENDUM ORGANIZING ZOOM
We can convince 10 percent of UFTers to sign our petition so we can get a full membership vote on significant changes to our healthcare if everyone climbs on board the petition express.
At that point we had 400 sigs. Over the next 8 weeks it grew to over 12K: James and I posted progress on our blogs:
Strong & growing. -Petition for UFT Healthcare Vote: Sign now - hcpetition.educators.nyc
The abandonment by the RTC leadership of the call for a member referendum and lodging the vote in the DA was viewed as a betrayal of sorts, given that the original reso from 2023 had a chance of passing this DA, if RA and MORE had gotten most of their delegates to show up and actually coordinated with each other- which they did not do, which is surprising given they were allied in the election as ARISE. (At no point through the 6-month election process did we see signs of the ARISE delegates from all 3 groups working together at the DA, except for a few rare moments.) At that point ABC had. not yet consolidated a delegate group to act at the DA except in a few instances.
The chickens of that decision to make the DA and not the membership vote will come home to roost when a Unity controlled DA is favored to pass the new healthcare plan at the special Sept. 29 DA.
That abandonment was a sign of weakness in the RTC leadership -- a fear and failure to confront the leadership when it should have capitalized on the strength of having won 63% of the RTC vote in June, 2024. I and other retirees have been increasingly frustrated by a sense that the RTC leadership values being civil and seeking bipartisanship over confronting the leadership. Arthur and I are part of that leadership but have disagreed with that direction.
On August 28, Mulgrew called a healthcare committee meeting. RTC Bennett Fischer, who was in Maine on vacation and also recovering from a serious operation, had scheduled a remote RTC Exec Bd meeting, postponed it so 4 RTC officers who are all on the Retiree Advocate Organizing committee and ran on the ARISE slate, could attend the healthcare meeting.
What was clear to many of us who have dealt with the Unity machine over decades was that this would be a selling job, not a fair presentation. They needed to go into that meeting prepared to say no or at least abstain.
Mulgrew announced after the meeting there was a unanimous vote to support the new agreement, news that astonished me and others. I emailed the RA Organizers listserve and asked if the 4 attendees had voted for the plan but received no response. One member told me that there was a lot of confusion and no formal vote but that Mulgrew ended the meeting by saying "if there are no objections." At the next RA meeting I asked again and heard a variety of responses, but also a sense that Mulgrew's selling job worked on the whole. Our reps told us they did raise questions but without an independent analysis, had no way of knowing what the flaws were. As I said -- they should have said no and not let Mulgrew claim bipartisan unanimous support as part of his selling job to the DA and members.
What I did see on ABC chats was an immediate reaction questioning many aspects of the plan. I mean immediate.
The New Plan is self-funded - a major flaw according to the ABC crew - as per the opening comment, does self-funding remove state protections?
In a self-funded ERISA-governed plan, New York state mandates—including protections for gender-affirming care, fertility treatments, and mental health parity are not automatically enforceable, unless federal law requires it.
Here are some notes from the ABC chat:
But aren’t they legally required to provide coverage like gender-affirming care in NY State?
Legally, yes. However, one of the loopholes United Healthcare has is that under the new plan, it will be self-funded, which means you cannot appeal externally to New York State if you are denied coverage, which is an important tool for many members of our communities who are denied care. This doesn’t just apply for gender-affirming care, but cancer treatments and other life-saving treatments as well. If you wish to receive care outside of the Downstate 13, you are essentially at the mercy of United’s system. Union leaders will respond that Emblem is administering parts of the plan.The have to follow the law they don’t have to cover any explicitly NYS health mandatesPer Marianne they could follow idahos state regulations on coverage if they choose to.This is a major issue. The oversight is very loosely goosey on self funded plansEspecially for left leaning states healthcare mandates
This self funding is the primary reason to vote NOYes absolutelyYes the STRIKE HOT (MORE) post simply mentioned it’s self funded. Unless that’s explained how that works and why it could easily collapse the system, most will NOT have any clue what that means.I’ve spoken to a lot of cl and delegate teachers in Staten Island who have staff who want this because they live in NJ and emblem was garbage there for years. So this is an improvement to them.
Selling point 1 is that they claim there are 50% less preauthorizations. This conflates preauthorizations with denials. They are not the same … and no matter who has more or less preauthorizations… United healthcare’s percentage is still 1 out 3. Even if I drive in less traffic every day, follow all traffic rules and don’t putz around in strip mall parking lots … if my accident rate is still 1 out of 3 … it’s still a fkn nightmareSelling point 2 … they say “medical claims” will be handled by Emblem’s new downtstate 13 plan. First we don’t know it to be true since we don’t have a contract to analyze. Emblem’s plan never handled hospital care before. And is medical claims same as hospital claims?Nj, ct, and everyone else is ruled by unitedUnited is covering outside the downstate 13Hospital is health and hospital then tier 2 is a crapshoot
The Cons of Self-Funded Insurance Plans: A Comprehensive List
Cost Uncertainty and Budgeting
One of the biggest disadvantages of self-funded insurance plans is cost uncertainty.
Variable Costs and Unpredictable Expenses
Unlike fully-insured plans with fixed premiums, self-funded plans have variable costs. This means the amount you pay depends on the actual medical claims of your employees. One month, you might pay very little, but the next month, you could face multiple high-cost claims. This unpredictability can make it hard to plan and budget for healthcare expenses.
“In a self-funded plan, budgeting becomes extremely important,” says Les Perlson, a veteran in the health insurance industry. “You need to anticipate the number and amount of claims you may receive.”
Budgeting Challenges
Planning for healthcare costs year over year can be stressful. Self-funded plans require careful budgeting based on employee demographics such as age, region, and the number of dependents. It’s crucial to have sufficient reserves and risk mitigation strategies like stop-loss insurance to manage potential financial risks.
These are just a few issues on self-funding. Read more: https://npabenefits.com/disadvantages-of-self-funded-insurance-plans/
More analysis from the ABC crew to come.
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