A New York judge has temporarily blocked New York City's plan to switch 250,000 retired city employees from traditional Medicare to an Aetna Medicare Advantage plan.
Judge Lyle Frank sided with a group of retirees challenging the plan, issuing a temporary injunction on July 6 that prevents the city from requiring retirees to switch from their current insurance to Medicare Advantage.
In a lawsuit filed May 31, nine retirees and the NYC Organization of Public Service Retirees alleged providing Medicare Advantage as the only option for retirees violates the city's obligation to provide health benefits to its retired workers. Under the city's plan, retirees who opted out of the Aetna MA plan would have to pay for any supplemental coverage out of their own pockets.
In court documents, Mr. Frank said it is "likely that this court will ultimately find" the city cannot require retirees to switch to a Medicare Advantage plan.
"As this matter deals with health decisions of an aging and a potentially vulnerable population, mostly on fixed incomes, any lapse in care for these people could lead to deleterious impacts," Mr. Frank wrote in the decision.
In the lawsuit, retirees alleged they could face coverage denials and out-of-pocket costs and lose their current providers if they are not in Aetna's Medicare Advantage network.
Marianne Pizzitola, president of the New York City Organization of Public Service Retirees and a plaintiff in the lawsuit, said the decision is the third time in two years courts have blocked the city from implementing a Medicare Advantage plan.
"We call on the city and the Municipal Labor Committee to end their ruthless and unlawful campaign to deprive retired municipal workers of the healthcare benefits they earned," Ms. Pizzitola said in a news release.
New York City Mayor Eric Adams has said the Medicare Advantage plan could save the city $600 million annually.
In a statement to Gothamist, a spokesperson for Mr. Adams said the city is "extremely disappointed by this misguided ruling."
"As we've said repeatedly, this Medicare Advantage plan improves 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," Mr. Adams said in a June 15 statement.
Mr. Frank also denied Aetna's petition to intervene in the case.
"We look forward to the next steps in the legal proceedings and continue to stand ready to serve the City of New York, the [Municipal Labor Committee] and, most importantly, the city's retirees," an Aetna spokesperson said in a statement shared with Becker's.