Portside

Editor’s Note: This is the first installment of a two-part report on TWU Local 100 Retirees and their fight to stop Medicare Advantage from replacing their traditional Medicare coverage.

TWU Local 100 retiree Patricia Jewett put more than 30 years into the MTA New York City Transit. Now at 67, her knees are shot and bronchial asthma makes it hard to breathe. 

But Jewett says she remains proud of being the first woman to ever work in the East New York Bus Depot’s Maintenance Division — and she doesn’t understand why she and her fellow retirees are now being stripped of their traditional Medicare coverage and pushed into a profit-driven Medicare Advantage plan. 

“I spent years being the only woman in an all male atmosphere,” Jewett told Work-Bites this past Friday outside the Downtown Marriott in Brooklyn. “It wasn't easy, but I stuck it out. My concern is that when I need my knee surgery — what I should get, I won’t get.”

The union representing New York City Transit workers is planning on dumping traditional Medicare as an option for its members in favor of a Medicare Advantage plan with Aetna following the ratification of a new contract agreement with the MTA in July.

“I don't understand, we worked for years paying into a system and now they're changing it,” Jewett continued. “It’s like pulling the rug from under you at a time when we need more [health care]. Our bodies have worn down — we need everything we can get. And now they're going to change the script? That's just not fair.”

Jewett and TWU Local 100 retirees opposed to the Medicare Advantage contract the union signed with Aetna are dreading January when their new privatized health insurance is slated to kick in. They were at the Marriott on Oct. 6 for a retirees meeting held at the hotel to further challenge the pact they say is being foisted on them with little or no transparency.

“All of us feel very much betrayed,” retired bus operator Lloyd Archer told Work-Bites on Friday. “We worked 26…30 years paying into Medicare and FICA out of our checks — and now you're gonna put us in private medical coverage. No, it's not right.”

Former MTA track worker Eric Josephson expressed his fear to Work-Bites way back in March that, like New York City municipal retirees fighting Mayor Eric Adams’ ongoing campaign to push them into a profit-driven Medicare Advantage plan, he and his fellow TWU Local 100 retirees would also be herded into an Aetna Medicare Advantage plan as well. 

“I don’t have a lot of confidence in TWU Local 100’s desire to fight something off,” the Bronx retiree said. “Especially, our brothers and sisters in the other municipal unions, if they get put into this terrible Medicare Advantage program.”

But TWU Local 100 retirees aren’t going quietly into that good night. Instead, they are coalescing and fighting back — following in the footsteps and largely inspired by the successful battle New York City municipal retirees are waging against the forces of privatization. 

The cosponsors of bills in the New York City Council, New York State Legislatureand the U.S. Congress aimed at safeguarding traditional Medicare coverage for public sector workers — as well as a State Supreme Court judge who has repeatedly ruled in favor of NYC municipal retirees fighting Medicare Advantage — are in align with them.

But the drive to push public sector workers in New York into profit-driven Medicare Advantage plans mirrors similar privatization campaigns also taking place across the country — all with the backing and blessing of some of the most powerful union leaders in the nation. 

New York City municipal retirees from the New York City Organization of Public Service Retirees, Cross-Union Retirees Organizing Committee, Council of Municipal Retiree Organizations and other groups, have long maintained that subjecting lifelong trade unionists to the preauthorizations, delays and outright denials of care associated with privatized Medicare Advantage Plans not only hurts them — it undermines the entire labor movement.

TWU Local 100 spokesperson Pete Donohue, however, told Work-Bites this week the union’s “number one mission is to provide the best plan for our retirees — and if that’s Medicare Advantage then it’s Medicare Advantage — but a specifically tailored Medicare Advantage plan for transit workers.”

“We’re going from what people like to call traditional Medicare — which is kind of like doesn't really exist anymore,” he continued. “Medicare for years has used outside contractors to basically screen and pre-authorize things. It's not like anything that you request gets done for Medicare either. So, that's the starting point. It's not like it's a completely wide open system without any kind of screenings for what's covered and what’s not.”

Marianne Pizzitola, former FDNY EMT and president of the New York City Organization Public Service Retirees, calls that assessment of traditional medicare “egregiously incorrect.”

“Traditional Medicare, the Federal Public Health Benefit, is an open plan with no networks and few prior authorization for things like transplants — and in this plan 97% of providers in America accept it,” she told Work-Bites. “Unlike Medicare Dis-Advantage — which has a narrow network in comparison and prior authorization for services most senior citizens need like hospitalization, rehab, and skilled nursing.”

Pizzitola further stated, "Right now, in traditional Medicare — which surely does exist and is funded by a Medicare Tax in every worker's paycheck — if a doctor orders a test or procedure — the patient gets it. In Medicare Dis-Advantage, Aetna determines if it is medically necessary. The doctor you see must agree to be in the network or accept the plan for payment. If they don’t, you have to call for ‘pre-visit confirmation’ which is like preauthorization. And even if Aetna agrees to it initially, they have a review process that can later deny it and the retiree is on the hook.”

Preauthorizations often overwhelm unsupported and elderly retirees seeking care — many simply give up rather than trying to cut through all the red tape.

A few years ago, the U.S. Department of Health and Human Services Office of the Inspector General issued a full report detailing how only one percent of Medicare Advantage denials between 2014 and 2016 were actually appealed. 

“I believe that we made the first steps forward for universal health care with Medicare — but now there's a push back and they want to privatize,” TWU Local 100 retiree Anita Clinton told Work-Bites on Friday. “Slowly, but surely they're chipping away at traditional Medicare to privatize it — and I think it's a shame.”

Clinton began her NYC Transit career in 1983 as a car cleaner at the graffiti-strewn train yard in Coney Island, and later became an air break maintainer — “one of only three females in the history of TWU Local 100” doing the job.

“[TWU Local 100] talks about enhancements and how, when you retire, you could add traditional Medicare, Aetna Medicare Advantage 1 and 2 — but now, they eliminated traditional Medicare. I don't call that an enhancement,” she said. “That’s not an enhancement by any means whatsoever.”

According to Donohue, TWU Local 100 eliminated traditional Medicare as an option for retirees “because traditional Medicare is not eligible for the federal subsidies.”

“And what we're seeing is through the Medicare Advantage we can provide a better plan and better service,” he said. “We're pumping millions and millions of dollars into this to improve and provide better care at lower costs.”

Just how much money in federal subsidies is involved remains unclear. 

In January, Dr. Leonard Rodberg, professor emeritus of Urban Studies at Queens College, testified before the New York City Council Committee on Civil Service and Labor saying that the federal subsidies the Adams administration was anticipating by instituting Medicare Advantage was actually drying up — fast. 

"The City is currently contributing 20% of our healthcare costs; the federal subsidy to Medicare Advantage for the past few years has been just 4%, and this year it is reported to be just two percent,” Dr. Rodberg said. 

The heads of the Municipal Labor Committee partnering with Mayor Adams in the drive towards privatization also assert the uniqueness of their specific Medicare Advantage Plan. 

Last month, UFT President Michael Mulgrew told Work-Bites, he is "fully confident” the Medicare Advantage Program the MLC negotiated with Aetna is “unprecedented” and that there’s “nothing like it in the country.”

Donohue, meanwhile, stresses TWU Local 100 Medicare Advantage plan “is not the same as the city plan.”

Retirees opposed to the privatization of their health care aren’t buying any of it, however, citing Medicare Advantage’s long and well-documented track record of not only the aforementioned preauthorizations, delays, and denial of care — but also fraudulent overcharging or “upcoding” and extensive use of inhuman AI algorithms to determine care.

“This is the very, very beginning of our fight,” Clinton told Work-Bites. “We started out as friends and coworkers who just wanted to stay in touch. We started meeting in person and when the pandemic came we started Zooming. We’re new and we're struggling — we just have passion on our side and the idea that this is the right thing to do."