Say What? NYS Court of Appeals Rules Retirees Fighting Medicare Advantage ‘Failed to Establish the Existence of a Clear and Unambiguous Promise’

Advocates for New York City municipal retirees are vowing to press the fight against Medicare Advantage following a serious setback at the NYS Court of Appeals on June 18.

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By Joe Maniscalco

“Oh, you silly civil servants…your big mistake was believing what you were reading and what you were told throughout your whole career working for the City of New York—thanks, though, for helping out during 9/11, Hurricane Sandy, Covid, and all the rest of it. You’re the best, God bless!

The above might as well be the New York State Court of Appeals’ decision delivered today in the Bentkowski, or so-called “nuclear option” Medicare Advantage case, described in a nutshell.

After deliberating since May 15, the seven court justices released a ruling on June 18, shutting down claims from the New York City Organization of Public Service Retirees [NYCOPSR] that the Traditional Medicare and MediGap benefits they earned from their City jobs were guaranteed and sacrosanct.

You can practically hear Mayor Eric Adams and the heads of the Municipal Labor Committee kicking up their heels as their scheme to strip all current and future municipals retirees of their Traditional Medicare health insurance benefits and herd them all into a profit-driven, scandal-plagued Medicare Advantage plan just got a lot easier.

NYCOPSR released a statement immediately after the Court of Appeals decision saying, “While we are disappointed in the ruling by the Court of Appeals, the solution to protecting seniors’ healthcare has always been with the City Council and the Mayor. The next Council and Mayor need to do the right thing and codify protections for seniors in City law.”

New York City Council Member Chris Marte [D-1st District], sponsor of Intro. 1096—pending legislation aimed at doing just that—issued a statement also calling the ruling “disappointing,” but saying that it “doesn’t change what we know to be true.”

“The responsibility for protecting retiree healthcare lies with the City Council,” Council Member Marte said in a statement. “For decades, the Council has legislated on retiree health benefits—not the courts, not the unions, and certainly not the Mayor. Now, more than ever, we must pass Intro 1096. This is our clearest and most urgent mechanism to stop the administration from forcing retirees onto Medicare Advantage—a privatized plan that has been repeatedly exposed as dangerous, restrictive, and profit-driven.”

The Manhattan lawmaker further stated, a “forced switch to Medicare Advantage—where their providers may no longer be in-network—can be a literal death sentence.”

“I call on my colleagues in the City Council to not continue to kick the can down the road and take definitive action protecting retiree healthcare by signing onto Intro 1096 today,” he added.

Retires who have been fighting the privatized Medicare push over the last four years—a scheme that was actually hatched a decade ago in the aftermath of the Mayor Mike Bloomberg years—feared the Court of Appeals might ultimately rule against them when they travelled to Albany to hear closing arguments in the Bentkowski case on May 15.

“This was the jewel. This was the carrot. This is why you kept working for 30-something years to get your health benefits, to get your Social Security, to get your pension,” retired special education teacher Suzanne Knabe told Work-Bites immediately after the 45-minute proceedings concluded in Albany last month. “That was the motivation right there. Nobody’s going to want this job without decent healthcare. The Medicare Advantage plan is a joke. It’s a joke.”

Some of the “highlights” of the Court of Appeals June 18 decision include the judges finding that, “Here, we need not decide whether to recognize a promissory estoppel cause of action, either generally or in this particular context, because petitioners have failed to establish the existence of a clear and unambiguous promise.”

“Promissory estoppel” is a legal principle involving the enforcement of promises without a formal contract. In another part of the 12-page decision, the court determined, “Petitioners rely heavily on the phrase ‘and thereafter’ in the [Summary Program Descriptions] as conclusive evidence of a continuing promise, but read in context this language is used only to explain when someone is eligible for Medicare and not in reference to any promise of future benefits.”

Intro. 1096 still only has 16 cosponsors in the New York City Council at the time of this writing. Speaker Adrienne Adams has steadfastly opposed advancing the legislation alternatively arguing that the matter is the subject of collective bargaining, City Council involvement only “complicates” the issue, and/or that the case must be fully adjudicated in the courts.

A spokesperson for Adams said the Council is now reviewing the Court of Appeals’ ruling.

“The mayoral administration holds the authority over healthcare decisions for municipal employees and retirees and should bring all parties together to reach a resolution that protects adequate healthcare choices for them,” the spokesperson told Work-Bites in an email.

Marte concluded his statement on Wednesday saying, “We will continue to stand and fight alongside our retirees—every step of the way, tooth and nail—until the healthcare they earn is protected by law.”

Editor’s Note: This is a developing story, and Work-Bites will have more on it shortly.