Tuesday, March 28, 2023

WE ARE NOT FOOLS, MAYOR ADAMS!: Pre-April Fools Rally Friday March 31, noon, at City Hall

Media Advisory for March 31, 2023

FOR IMMEDIATE RELEASE

For Planning Purposes: Friday, March 31st , 2023

Contacts: Lauren Parker, lauren.parker@berlinrosen.com

                     Sarah Shapiro, sarahmorah@gmail.com


Municipal Workers to Hold Emergency Rally to Express outrage at Mayor Adams’ decision to force

250,000 Retirees into Medicare Advantage

The rally is April Fools Day-themed: “Mayor Adams, Don’t Try to Fool Municipal Retirees”

What: Municipal workers from across the city will rally at City Hall the day after Mayor Adams’ signed a contract that sold out 250,000 retired city employees and their dependents by forcing them into an inferior Medicare Advantage Plan. Retirees are here to tell Mayor Adams that they want Medicare Not Profitcare.

The theme of the rally, which takes place the day before April Fool’s Day, is “Mayor Adams, don’t try to fool municipal retirees!" The rally is organized by the Cross-Union Retirees Organizing Committee (CROC) and the Professional Staff Congress, the union representing active and retired faculty and professional staff at CUNY.

Visuals Will Include:

  • Speaking program of retirees, municipal workers, union leaders and elected city officials including Council Members Christopher Marte, Alexa Aviles, Kristin Richardson Jordan.

  • A chanting crowd of retired and active workers with music, noise makers, signs, crutches, walkers, and canes.

  • April Fool’s Day themed signage, “We’re Not Fools” hats, and slogans.

When: Friday, March 31st at 12pm

Where: Outside City Hall Park on Broadway and Murray Street

 


 

Rally at City Hall

WE ARE NOT FOOLS, MAYOR ADAMS!
          We Want Medicare, Not Money Care!
                      Friday, March 31, 12 Noon -  Broadway & Murray St.

No to Medicare Advantage
NYC retirees do not want to be forced onto Aetna’s for-profit Medicare Advantage plan! NYC retirees demand to keep our traditional Medicare & premium free Medi-gap insurance.

Yes to “Option C”
The Mayor has a choice to make by April 1st. Tell the Mayor to Choose “Option C” in the Aetna contract which would let us keep what we already have. Retirees & Active Municipal Workers: We Need You There

Bring your signs, noise makers, wheelchairs, crutches, walkers, canes, your sense of humor and sense of outrage!
 
For More Info Contact:



Here is the article that was behind a Paywall.  Please come to tomorrows Rally at city Hall at 12 Noon to tell the Mayorf Not to Try to Fool Municipal Retirees.
 
Retirees are here to tell Mayor Adams that they want Medicare Not Profitcare.The fight will continue.



Mayor Adams signs controversial contract that eliminates traditional Medicare for retired NYC workers

By Chris Sommerfeldt

New York Daily News

Mar 30, 2023 at 12:22 pm

Mayor Adams signed off on a contract Thursday that will eliminate traditional Medicare coverage for retired city government workers and shift them into a privatized version of the program instead — a highly controversial move that immediately drew a lawsuit threat from a grassroots retiree group.

The contract with private health insurance giant Aetna is the culmination of a years-long effort by the city to enroll its roughly 250,000 municipal retirees in a Medicare Advantage Plan.

Under the deal inked by Adams, the city’s retirees — most of whom are on a traditional Medicare benefits structure that includes a Senior Care supplement — will lose their current coverage and be automatically enrolled in an Advantage plan administered by Aetna, effective Sept. 1.

The Advantage setup will save the city some $600 million annually thanks to increased federal subsidies, an allocation Adams described as critical at a time that the municipal government is staring down a $10 billion budget deficit by 2026. In a statement, Adams also argued the Advantage plan will improve health care coverage for city retirees.

“This plan improves upon retirees’ current plans, including offering a lower deductible, a cap on out-of-pocket expenses, and new benefits, like transportation, fitness programs, and wellness incentives,” said the mayor. “This Medicare Advantage plan is in the best interests of both our city’s retirees and its taxpayers.”

Tens of thousands of retired teachers, cops, firefighters and other city workers say Adams is wrong.

Citing federal studies that show Advantage plans can deny beneficiaries “medically necessary” care, retirees have called on Adams since he took office to let them stay on traditional Medicare, contending that the switch would put them at risk of losing access to certain doctors, medical procedures and drugs.

A group called the NYC Organization of Public Service Retirees successfully convinced courts last year to block the first iteration of the Adams administration’s Advantage plan — and Jake Gardener, a lawyer for the group, told the Daily News on Thursday that they will file another lawsuit in hopes of derailing the new plan as well.

“We will be challenging this violation of the retirees’ health care rights in court,” Gardener said. “This is just the latest example of the city trying to save money on the backs of retired and disabled city workers. What this would do is to jeopardize the health of a quarter million elderly and disabled city workers.”

Retirees are resisting the Advantage switch, in part, because Aetna will require pre-authorizations for some forms of care, a protocol that does not exist under traditional Medicare. They fear this will result in diluted coverage, and have depicted it as a life and death issue.

“Retired firefighters, police, EMT workers and teachers will be forced into a privatized, managed care plan that has strict in-network, pre-authorization and referral requirements that will cause potentially life-threatening delays and denials of care,” said Marianne Pizzitola, a retired FDNY EMT who leads the NYC Organization of Public Service Retirees.

“Many of the quarter-million respected public servants, and all the current NYC public employees, will be harmed by this damaging decision by Mayor Adams.”

In his statement, Adams said he sympathizes with the angry retirees.

“We also heard the concerns of retirees and worked to significantly limit the number of procedures subject to prior authorization under this plan,” he said.

The reason courts blocked Adams’ first plan was because it would’ve levied a $191 monthly premium on retirees who wanted to opt out of Advantage and stay on traditional Medicare. The courts found that penalty violated a local law requiring the city to provide its retirees with premium-free coverage for life.

Adams’ administration, with support from the city’s Municipal Labor Committee, says the new plan structure complies with the court rulings because there will no longer be a $191 penalty on the table as the premium-free Advantage coverage is the only insurance option available to retirees.

Gardener disagreed and claimed the new plan is also illegal.

“Forcing them into Medicare Advantage by not even giving them the option of keeping their existing health insurance is far more damning and just as illegal,” he said.

Gardener declined to say exactly on what grounds his group will challenge the new plan, but added: “We have a number of grounds that we will be relying on to ensure that the savings the city is looking to achieve is not obtained solely on the backs of retirees.”

Sunday, March 26, 2023

Is the UFT a company union? UFT/Unity act like Republicans: Anti-Strike, Anti-Public Healthcare; Becoming a Laughing stock of the union movement

There is still time to register for tonight's Retiree Advocate-UFT's meeting at 7pm on Zoom.  Register Here: https://bit.ly/3yr6M8K (Close to 250 people are already registered.)

DONATE TO THE UFT PETITION CAMPAIGN FOR A HEALTHCARE VOTE  - IT IS COSTING MONEY TO MAKE SURE EACH ELECTRONIC SIGNATURE WILL NOT BE TOSSED OUT BY THE UFT LEADERSHIP.

A Tale of 3 city teacher unions - and UFT/Unity are the losers


 

Sunday, March 26, 2023 - This  post is loaded, so sit back or just ignore and go out and get some sun

No matter the liberal blather from the UFT (we support the LA teachers for not crossing picket line but would jump off the roof of 52 Broadway of NYC did the same), we have an ineffective right-center UFT leadership compared to the left wing leadership in Chicago and Los Angeles and the compilation I've gathered below proves it, not only ideologically, but in terms of actual political and economic accomplishments. My comment above about changing the leadership does not mean dumping Mulgrew for another Unity Caucus hack but removing Unity from leadership. Note these articles.

In the UFT we have decreased militancy - actually no militancy. Well, if you  consider "wear certain colors certain days" as militancy. 

The increasingly militant autoworkers had their first direct election of a national president and an insurgent won - barely. He said:

“This is the end of company unionism, where the companies and the union work together in a friendly way, because it hasn’t been good for our members ---- President Is Ousted in United Auto Workers Election --

"Company union" increasingly strikes a chord when talking about the Unity crowd. When Marianne appeared on Brian Lehrer the other day, his first comment was how surprised he was that the UFT was teaming up with the Adams administration against its own members. 

We are not surprised.

A long-time UFT activist asked: What would happen if we had direct elections for presidents of the AFT and NYSUT? Right now only winner take all Unity delegates (750) vote in those elections. 

There is actually a new petition campaign in the UFT to bring a level of democracy with a petition campaign based on the UFT constitution calling for a member vote on healthcare changes (as opposed to Mulgrew backroom deals through the MLC).

Saturday, March 25, 2023

CSA President Explains Why He Voted NO on Aetna (Dis)Advantage Plan; Retirees Fighting Own Unions’ Health Cuts - Labor Notes

Sign the petition for a democratic vote on healthcare.

 

Attend the Retiree Advocate Zoom Sunday, March 26 at 7PM. Register: https://bit.ly/3yr6M8K

Are you fed up with our union leadership making bad decisions for us without our input? We never got a chance to vote about our Medicare with Seniorcare being taken away from us. RA has no representation in the DA, ExBd or RTC despite receiving 30% of vote in last Chapter election. Time to build our caucus and get ready for next year's Chapter Election. Find out how by coming to the Retiree Advocate's meeting on March 26 at 7pm on Zoom.

In case you didn't hear Marianne on Lehrer:

 https://www.wnyc.org/story/nyc-

retirees-speak-out-about-health-plan-changes/

 

 

CSA President Explains Why He Voted NO on Aetna (Dis)Advantage Plan

Who would have thunk that the CSA is more responsive to its members than the UFT? !

 

Retiree Message From CSA President Henry Rubio on MLC Vote

Posted on March 9, 2023 at 8:05 pm by

Brothers and Sisters,

This morning, the Municipal Labor Committee, a group of approximately 100 NYC public sector unions, voted to ratify an agreement with the city and Aetna to transition Medicare-eligible retirees to a Medicare Advantage plan.

CSA voted “no” on behalf of our membership.

Throughout this entire process, we have been committed to fighting for the highest quality of healthcare possible for every retiree. Our retiree members have consistently asked that we advocate for an option for Medicare-eligible retirees to keep their current plan. For a variety of reasons, city retirees will not be allowed that choice at this time, and too many retirees have limited options.

To be clear, our vote was not a referendum on the process nor the Aetna proposal itself. The MLC has been diligent in fighting to protect Medicare-eligible NYC retirees during these complex negotiations, and Aetna has customized their proposal to try and mirror our current Senior Care plan. Aetna representatives have been collaborative and responsive; we greatly appreciate that they addressed our members directly on a Zoom yesterday afternoon. They have committed to returning to speak with our members again now that the agreement has been ratified. Thankfully, many CSA members have had their most critical questions and concerns addressed, and we are pleased that we were able to support these retirees and advocate on their behalf.

However, there are currently too many CSA retirees who still believe this plan is not right for them and their families. In January, I took an oath to represent all CSA members to the best of my ability, and it is my belief, along with our leadership team, that voting “no” today was the right decision for our union.

Other union leaders within the MLC also did what they felt was right for their members, resulting in enough votes to ratify the agreement. Aetna has pledged to begin communicating immediately providing further details and answering your questions. The MLC and the city will work to ensure that the plan is implemented as promised. The dedicated staff and leadership of the CSA Welfare Fund will begin to immerse themselves in the new plan which include many additional, unique benefits.

We will continue to communicate regularly with you in the coming weeks and months. Please be reminded to contact CSA Headquarters or the Retiree Chapter with any questions or feedback about the negotiation process. If you have specific questions regarding the transition to the Aetna plan, please contact the CSA Welfare Fund directly.

As always, I thank you for your honest feedback, patience, and support.

In Solidarity,

Henry Rubio

CSA President

Retirees Fighting Own Unions’ Health Cuts

 

Jenny Brown reports on the vote by New York City’s Municipal Labor Committee to  scrap some of the best retiree health care coverage in the country and push retirees onto the for-profit Medicare Advantage plan. 

Protesters in New York City against the mayor’s and the 

Municipal Labor Committee’s effort to change a city law protecting 

their health care benefits, photo undated.  (Cross-Union Retirees Organizing Committee)

By Jenny Brown
Labor Notes

Defying two years of protests and lawsuits by union retirees, New York City’s Municipal Labor Committee voted March 9 to scrap some of the best retiree health care coverage in the country. The change would put 250,000 city retirees into a for-profit Medicare Advantage plan run by Aetna. 

Twenty-six unions in the MLC voted no, while others abstained. But their votes were swamped by the votes of the largest unions on the committee, AFSCME District Council 37 and the New York United Federation of Teachers. 

Retirees and active members protested during the MLC vote and marched to City Hall. They are asking the city council to strengthen the law protecting retiree health care. The NYC Organization of Public Service Retirees promises to sue. 

The New York City fight has wider implications as for-profit Medicare Advantage insurance companies come under fire for second-guessing doctorsblocking patient care, and ripping off the public while they reel in record profits.

What is Medicare Advantage? 

In traditional Medicare, available when you turn 65, you present your card, get care, and the government pays for it.

With Medicare Advantage, a for-profit insurance company gets money from the government to cover you. But they get to take a fat cut — Medicare Advantage is now the most lucrative sector of an already-lucrative health insurance industry. And they get to say what care you can get.

Medicare Advantage plans negotiated by employers and unions provide worse coverage than traditional Medicare. But they are generally better than the individual Medicare Advantage plans that seniors may sign up for themselves and which are advertised on late-night TV. 

Medicare Advantage plans that individuals buy on the private insurance market may work out to have cheaper premiums than traditional Medicare because they wrap in a drug benefit and may cap out-of-pocket expenses. But they are notorious for denying expensive care, imposing narrow networks of doctors and hospitals and ripping off the government. 

On the other hand, union-negotiated Medicare Advantage plans are the result of insurance companies having to negotiate with unions and employers to sign up large groups of retirees, and that may restrain the most egregious abuses. Still, some retirees in negotiated plans report that they were denied care at the most difficult time in their lives. 

Department of Health & Human Services, Washington, D.C. (Sarah Stierch, CC BY 4.0, Wikimedia Commons)

In both cases, the for-profit insurance companies that run the plans have a strong incentive to deny care. Every dollar they don’t pay for your care is a dollar earned by shareholders and CEOs, who often take most of their compensation in stock. Stock prices are based on how little care the company can pay for.

Traditional Medicare (part A & B) costs $164.90 a month and covers hospital costs and 80 percent of non-hospital costs. But medical costs are such that the 20 percent gap in coverage can quickly become ruinous. So, the government set up a regulated market of Medigap supplements. Retirees can pay additional premiums to private insurance companies to cover the final 20 percent, and cap out-of-pocket costs.

Medigap plans can cost as little as $75 a month, but can cost hundreds more, depending on the plan, your age, gender and whether you smoke. Unlike Medicare Advantage, however, these Medigap plans are heavily regulated.

It is this gap for which New York City union retirees over age 65 are covered by the city’s Senior Care plan. The city also pays the monthly premiums for traditional Medicare, so retirees get premium-free coverage.

Numbers Don’t Add Up

States and municipalities have increasingly tried to put retirees into Medicare Advantage plans once they reach age 65. Where unions have fought the change, as in Washington state and Vermont, they have been able to prevent the switch. But in New York City, retirees have been fighting not just the city but also their own unions to keep from being shunted into a for-profit plan.

Public employees in New York City have given up a lot over the years to keep their ironclad retiree health care coverage and it paid off until now. Along with paying traditional Medicare premiums, the city pays for Senior Care, the wrap-around supplement that picks up nearly all costs not covered by Medicare, along with drug benefits.

Rally in Washington, D.C., February 2013. (Djembayz, CC BY-SA 3.0, Wikimedia Commons)

Leaders of District Council 37 and the UFT claim the Medicare Advantage plan will save money and provide the same coverage. But the numbers don’t add up, said Len Rodberg, a retired City University of New York health policy expert who will be affected by the change. “Medicare Advantage starts out 20 percent below what Medicare does, in terms of actual money available to spend on health care,” Rodberg said. 

Traditional Medicare pays 3 percent overhead. By contrast, Medicare Advantage plans have to make a profit for shareholders, and they also pay huge executive salaries and maintain enormous staffs to protect their profit margins by delaying and denying care. In these for-profit plans, Rodberg said, “basically anything that costs money would need pre-approval.”

Municipal Labor Committee leaders said their consultants told them the difference would be picked up by the federal government, Rodberg said. But while the federal government used to subsidize for-profit Medicare Advantage plans 20 percent over what they paid out for traditional Medicare patients, that subsidy is now down to 2 percent. 

Medicare Advantage plans also cut costs by contracting with certain providers. This means the insurance company will only pay for care provided by certain doctors or hospitals. For retirees who move to states with spotty coverage, Rodberg said, “suddenly their Medicare card won’t work, cause they’re in Medicare Advantage, not Medicare.” 

Quick Reaction

Retired teacher Gloria Brandman heard about the change in 2021 from friends in PSC-CUNY, the union of faculty and staff at the City University of New York. She and other teacher retirees swung into action, holding a webinar that drew 400 people. The recording of the webinar circulated widely, leading to a whirlwind of protest which forced UFT’s president, Michael Mulgrew, to hold a town hall where he tried to sell the change.

Retirees from the teachers, AFSCME and several uniformed service unions formed a Cross-Union Retirees Organizing Committee to fight. Brandman and other CROC activists hounded newly elected Mayor Eric Adams at every opportunity.

New YorkCity Mayor Eric Adams February, 2022. (Marc A. Hermann / MTA, CC BY 2.0, Wikimedia Commons)

They rallied when the MLC met: “We marched on the hottest day of the year,” Brandman recalled. They held a Valentine’s Day “Don’t Break Our Hearts, Mayor Adams” event.

In October they held a “Halloween Horror” press conference, saying “Mayor Adams, You’re Scaring Us to Death.” (“Death masks optional,” said the invitation flier).

A city law requires that all the health care options the city provides be premium-free. That law turned out to be an important backstop and the NYC Organization of Public Service Retirees sued to get it enforced. A judge agreed that it was against the law for the city to charge seniors an extra $191 per month to stay in original Medicare.

So Adams and the MLC leadership asked the City Council to change the law. They walked into a buzz saw. After vigorous protests and reams of testimony from retirees and active union members objecting to the change — which could have undermined active members’ health care as well — the City Council declined to alter the law.

In her testimony before the council, Jen Gaboury, PSC chapter chair at Hunter College said, “We know these ‘savings’ don’t come from some brand of private business magic. If you get this money, you’ll be denying care and/or delaying treatment to your own people, older city workers.”

Contracts Held Hostage

Part of the problem is that the unions created a $600 million hole in the last round of contracts and they’re trying to plug it now. They negotiated to use a health care stabilization fund, designed to equalize costs between health plans for active members, to bolster wage increases. Now the fund is broke and that threatens to raise health care costs for active members.

At the City Council hearings, PSC-CUNY proposed a way out of this mess. Retired professor James Perlstein described it in his testimony:

“(a) Redirect funds the City holds in reserve to bridge the Municipal Labor Committee Stabilization Fund for three years, (b) Create a stakeholders commission charged with finding a path to control health care spending, with hospital pricing as a priority, and (c) Develop a sustainable mechanism for funding City health insurance.”

PSC also suggested that New York City’s very profitable non-profit hospitals contribute, since they don’t pay taxes.

None of these steps have been taken, so far. Instead, city administrators continue to push Medicare Advantage. “The city’s taken a hardball position that it won’t negotiate new contracts until the unions save them $600 million by moving forward with Medicare Advantage plan,” said Rodberg in February. The city promises to replenish the stabilization fund with the estimated $600 million it will save from the switch.

AFSCME DC 37 members have been working for 18 months without a contract. Recently the city and the union inked a tentative agreement with raises that don’t even keep up with inflation. Other city unions object that this low bar will harm their negotiations, since the city expects the first agreement settled by a major city union to set a pattern which the other municipal unions will largely follow.

And while members will get to vote on the agreement, they won’t be able to vote on the retiree health care concession their union agreed to behind closed doors. It seems that as a condition for settling, the dominant MLC unions agreed to impose what the retirees call “the nuclear option,” deliberately misreading the city law they tried to change, and making Medicare Advantage the only option for retirees. 

Any retiree who wants to stay in traditional Medicare would have to pay for all of their coverage, as if they had no union at all.

Jenny Brown is an assistant editor at Labor Notes.

This article is from Labor Notes.

The views expressed in this article may or may not reflect those of Consortium News.


Friday, March 24, 2023

Marianne on Brian Lehrer show, Mulgrew/UnityCaucusCare will Raise, Not Lower Costs - 25 billion in overpayment, Lobbying Frenzy to Stop Plan to Cut Billions in Medicare Fraud


The showdown underscores just how important — and lucrative — Medicare Advantage has become to insurers and doctors’ groups that are paid by the federal government to care for older Americans. Roughly $400 billion in taxpayer money went to these private plans last year. Profits on Medicare Advantage plans are at least double what insurers earn from other kinds of policies, according to a recent analysis by the Kaiser Family Foundation.

Without reforms, taxpayers will spend about $25 billion next year in “excess” payments to the private plans, according to the Medicare Payment Advisory Commission, a nonpartisan research group that advises Congress.... NYT

Friday, March 25, 2023

First let's post the link Marianne's appearance on Brian Lehrer show Thursday morning - she took everything thrown at her and educated Brian and the listeners. A transcript may be available. Must listen - https://www.wnyc.org/story/nyc-retirees-speak-out-about-health-plan-changes.

One thing has become increasingly care - switching us out of traditional medicare to MedAdv will raise healthcare costs by billions. Thursday's NYT has an explosive article in the print section which I am reproducing below, with the charts that show how they make money by upcoding. Like my blood tests show some sugar escalation - they will take that and get more money from medicare by classifying me as pre-diabetic.

Some hints on enormous profits for MedAdv plans -- fraud, upcoding ----- How our union's move to MedAadv will raise not cut costs while reducing service for the sick.
It would significantly lower payments — by billions of dollars a year — to Medicare Advantage, the private plans that now cover about half of the government’s health program for older Americans. The change in payment formulas is an effort, Biden administration officials say, to tackle widespread abuses and fraud in the increasingly popular private program. In the last decade, reams of evidence uncovered in lawsuits and audits revealed systematic overbilling of the government. A final decision on the payments is expected shortly, and is one of a series of tough new rules aimed at reining in the industry. The changes fit into a broader effort by the White House to shore up the Medicare trust fund..  NYT March 23, 2023
 
UNITYCAUCUS-CARE 
Mulgrewcare does the opposite - weakens the Medicare trust fund. This was my theme when I spoke at the UFT Ex Bd on Monday, to mostly deaf Unity Caucus ears. I think we need to make it clear - this is a Unity Caucus, not a Mulgrew operation. Do we think if Mulgrew left Unity would not support this move? 
 
UFT is acting like Republicans
Nick had a summary of my comments (which if not  for him I wouldn't remember):
Norm Scott: UFT member since 67. Wearing a UFT logo and hope no lawyers contact me. Healthcare: MAP isn’t Medicare. If I were to pay someone to go to the grocery store for me, that’s kind of like what Aetna is going to do with our healthcare. If you don’t understand that healthcare hasn’t increased in cost because of profits and denial of benefits…I hear some people say I don’t really care about it – it’s just politics. I’m really disturbed by the fact that I may not have access to my doctors. I’ve got doctors for every part of my body. I’m getting calls from all over the country by people saying they might not get access to doctors. 60% of people are now on MAP. But what happens when it’s 80 and 90%? I’m sorry to say but this union is acting like the Republicans – the Republicans will end up killing Medicare. Mulgrew talks about representational voting at MLC, but not in the UFT. Even though Retiree Advocate got about 1/3 of the vote in the retiree chapter election, we get no say at all – not a single delegate. We think there should be a vote on questions of healthcare. We are starting a petition campaign, where if we get 1/3 of this body, we can get a referendum to vote on any healthcare changes. You might win that vote  anyways – why not support it. Give members a choice to vote.
I also said that Aetna is not doing this for charity but for enormous profits -- that is the cause of healthcare rise from insurance companies, hospitals, and doctor practice corporations. By joining in with MedAdv company lines, the UFT is helping undermine and bankrupt traditional medicare which is the only publicly run healthcare agency and instrumental in keeping healthcare costs down.
 
Another example of the UFT leadership Scam from Nick:
 A few more highlights if you don't have time to read the whole thing:
  • The showdown underscores just how important — and lucrative — Medicare Advantage has become to insurers and doctors’ groups that are paid by the federal government to care for older Americans. Roughly $400 billion in taxpayer money went to these private plans last year. Profits on Medicare Advantage plans are at least double what insurers earn from other kinds of policies, according to a recent analysis by the Kaiser Family Foundation.
  • Older Americans have flocked to Medicare Advantage, finding that many policies offer lower premiums and more benefits than the traditional government program. The insurers receive a flat rate for every person they sign up — and get bonuses for those with serious health conditions, because their medical care typically costs more. But numerous studies from academic researchers, government watchdog agencies and federal fraud prosecutions underscore how the insurers have manipulated the system by attaching as many diagnosis codes as possible to their patients’ records to harvest these bonus payments. Four of the largest five insurers have either settled or are currently facing lawsuits claiming fraudulent coding. Similar lawsuits have also been brought against an array of smaller health plans.

https://www.nytimes.com/2023/03/22/health/medicare-insurance-fraud.html 

The Biden administration has proposed changes to how it would pay private Medicare Advantage plans, setting off a lobbying frenzy.

Tuesday, March 21, 2023

NYC Municipal Retirees Crash Aetna Meeting!, L.A. school employees will begin a three-day strike on Tuesday, as UFT Leaders Disparage Strikes

In 1975 the overwhelming majority of teachers (I was one of them) were willing to accept two for one Taylor Law penalties to stand up for their 15,000 laid off colleagues. The UFT is a very different union from those days.

Are Teacher Strikes Antiquated? How Should Teachers/Teacher Unions Respond to the Current Attacks on Teachers and Public Education? -- Peter Goodman, long-time Unity Caucus apologist


The contrast between the NYC UFT and the LA UTLA teacher unions is beyond astounding. Our leaders emphasize our right not to strike and use their shills to claim we are in a post-teacher strike phase.

Nick has a blog on that -

Why doesn’t UFT leadership want us to have the right to strike?

while the teacher union in Los Angelos is refusing to cross the picket lines for the next three days of the lowest paid school workers.

Note how our UFT leadership begged the city council (unsuccesfully) to create a two-tier healthcare system by allowing the wealthiest members to buy their way out of Medicare Advantage.

View in browser | nytimes.com
The New York Times
 

BREAKING NEWS

L.A. school employees will begin a three-day strike on Tuesday, canceling classes for more than 400,000 students as workers demand higher pay.

Monday, March 20, 2023 11:39 PM ET

The union that represents 30,000 support workers in the Los Angeles Unified School District is seeking a 30 percent pay increase, saying that many employees make little more than the minimum wage and are struggling to afford the cost of living in Southern California.

Read more


And out warrior retirees were risking arrest -- 

Here's a little video about the Action at the Aetna Mock Retire Training.


NYC Municipal Retirees Crash Aetna Meeting!

Security attempts to corral Medicare Advantage protesters inside the Conrad Hotel in New York City. Photos by Steve Wishnia

By Steve Wishnia

A group of seven New York City municipal retirees protesting NYC’s plan to privatize their Medicare coverage slipped into the Conrad Hilton hotel today in Battery Park City where the Aetna insurance company was about to hold a session to prepare union staff on how to tell retirees about the company’s Medicare Advantage plan.

“We want to keep the care we have!” retired music teacher Trudy Silver called out from one side of the room, where attendees were finishing their lunches and mingling before the session. “We don’t want your Aetna plan!” her compatriots — all of them women — responded from the other side of the space. 

Silver then swiveled through the crowd, around the small barstool-style tables, and past the buffet, as men in purple Aetna-logo T-shirts tried to push her out. One tried to block a news photographer’s camera angles. Eventually, all seven women were herded out by security guards.

Members of the Cross-Union Retirees Organizing Committee deliver their message despite attempts to shut them out.

“They’re preparing the propaganda,” Sarah Shapiro of the Cross-Union Retirees Organizing Committee [CROC] said before the March 20 action.

Earlier this month, the Municipal Labor Committee [MLC], which includes 102 unions representing civil service workers, approved the city’s agreement with Aetna to provide a privatized, profit-driven Medicare Advantage plan for retirees, who now have traditional Medicare with city-funded supplemental coverage. Mayor Eric Adams’ administration then announced its intention to make the Aetna plan the only premium-free health coverage available to retirees.

“We want to keep the health care we have, and we’re not going to give up,” Silver told Work-Bites afterwards. “Forty percent of the nation has been boondoggled into accepting privatized Medicare. We’re not going to in New York.”

Retired United Federation of Teachers member and former special-education teacher Denise Rickles said that she opposes the privatization of Medicare and that “Aetna is a disreputable insurance company” that’s under federal investigation.

In 2021, CVS Health, which acquired Aetna three years prior, revealed in a financial filing that it was being audited by federal Department of Health and Human Services inspectors to check for “diagnostic upcoding,” in which patients’ diagnoses are written to list more serious conditions than they actually have. Medicare pays insurers at a higher rate if the people they cover are sicker.

These NYC municipal retirees successfully slipped into the Conrad Hotel on March 20, to protest the ongoing campaign to privatize traditional Medicare coverage.

Last year, a Kaiser Health News review of 90 audits of Medicare Advantage plans done by the Centers for Medicare & Medicaid Services between 2011 and 2013 — the most recent available, obtained after litigation — found upcoding a common practice in the industry. The overpayments averaged more than $1,000 per person at 23 plans, including 10 owned by Humana. Overall, the companies had claimed excess payments for 20 percent of the patients in the audits.

In October 2021, the Justice Department sued Kaiser Permanente, the fifth-largest insurer in the Medicare Advantage market, charging that it used algorithms to find ailments it could then pressure doctors to add to diagnoses. It sought reimbursement and triple damages for more than 350 allegedly fraudulent diagnoses.

CVS Health has 3.1 million people enrolled in its Medicare Advantage plans, according to a study last year by the Kaiser Family Foundation. That gave it 11 percent of the market, ranking fourth among U.S. health-insurance companies after United Health, Humana, and Blue Cross Blue Shield. New York City imposing Medicare Advantage on retirees would add as many as 250,000 more enrollees.

“People put their trust in unions,” Rickles added. “But for the past few decades, unions have not really represented their membership.”

The UFT and District Council 37, the two largest unions in the Municipal Labor Committee, have actively pushed for the switch to Medicare Advantage, as has the Uniformed Sanitationmen’s Association. The Professional Staff Congress [PSC], which represents City University of New York faculty and staff, has opposed it. A PSC staffer attending the session said he was sympathetic to the protesters, but wasn’t the right person to comment.

“I’m on your side,” another union official told the protesters after they’d left the building. She quickly rushed inside.

Silver, a jazz singer, said she knew the attendees had heard their message.

“I know how to throw my voice,” she said.