Tuesday, April 16, 2024

NYC Retirees: Defeat Privatization; Take Back Your Unions From ‘Sell Out’ Leaders!! - Work-Bites



NYC Retirees: Defeat Privatization; Take Back Your Unions From ‘Sell Out’ Leaders!!

NYC municipal retiree Julie Schwartzberg and fellow members of the National Alliance of Retiree Health Care confront security outside the Centers for Medicare & Medicaid Services’ offices on Broadway.

By Joe Maniscalco

In the span of two days, New York City retirees battling to save Medicare from extinction have called out corrupt union misleaders willing to sell out the entire labor movement for Medicare Advantage; challenged President Joe Biden to finally get real about what needs to be done to rescue Medicare; and provided a game plan on how to win back rank and file control from the misleadership class.

It began on Friday afternoon outside Federal Plaza on Broadway where building security refused to allow retirees in coalition with the National Alliance of Retiree Healthcare to deliver a letter to the Centers for Medicare & Medicaid Services, calling on Biden and the agency to “make Medicare whole.”

“Take that money that the insurance companies are robbing — and there’s an estimate that it’s up to $140 billion a year — and put into Medicare,” New York City municipal retiree and Cross-Union Retirees Organizing Committee member [CROC] Julie Schwartzberg said. “Why does Medicare make us pay 20 percent? Why don’t they have dental? Why don’t they have optical? We can take the money from the fraud — and put it in and make Medicare whole.”

Stu Eber, head of the Council of Municipal Retiree Organizations [COMRO], recalled how working class people used to have a pretty good bead on who was gunning for them — but not anymore. 

“Through the years, we always thought the enemy was the Republicans who were against Social Security like Barry Goldwater…and Ronald Reagan against Medicare,” Eber said. “Then we wake up in the 21st century and we have Democrats and Republicans who are forcing Medicare Advantage on us.”

Eber also noted how more than half the Medicare-eligible people in the United States today are now enrolled in a profit-driven Medicare Advantage plan.

They have lost their Medicare,” Eber said. “They’re on Medicare Advantage. And why? Because of [the 20 percent] Medigap. Because they have to pay for their Medicap insurance — unlike city employees. It was cheaper for them to say, ‘I’ll give my Part B to an insurance company, and they’ll take care of me for everything else.’ Unfortunately, they have found out the hard way that it doesn’t work that well. That they aren’t getting better healthcare — they’re getting worse health care.”

The following day, 90-year-old municipal retiree Evie Jones-Rich lambasted the heads of New York City’s shadowy Municipal Labor Committee [MLC] — the same labor leaders bent on driving 250,000 municipal retirees into a profit-driven Medicare Advantage plan — and who Jones-Rich says is using the MLC as “cover” for refusing to “carry out their mandate.”

“The first thing I want you to remember is that most of the union movement today is corrupt,” Jones-Rich said at a special town hall about the MLC held inside the People’s Forum on W. 37th Street. “It is corrupt. The leaders have no vision. They have lost their way. They are not doing their job. And one of the things you're going to walk away with [today] is the feeling that is going to change.”

Originally created back in 1966 as a way of leveraging the power of New York City’s public sector unions against the political bosses — the MLC, through a heavily weighted voting structure that rests all of the controlling power in the hands of the three largest unions in the organization — has devolved into a different kind of undemocratic beast altogether.

“They need a two-thirds vote to pass a motion, and it doesn’t matter if most of the other unions behind them want the opposite,” Marianne Pizzitola, president of the New York City Organization of Public Services Retirees and the FDNY EMS Retirees Association, said. “Whatever those large unions want — that’s what ends up happening.”

District Council 37 Progressive Caucus member Robert Cuffy jeered his own union VP Anthony Wells for supporting AFSCME’s takeover of the DC37 Retirees Association, as well as the organization’s overall lack of transparency.

“This is the position we're at — at least at the Administration for Children's Services — people who work as child protective specialists and supervisors are beaten down on such a daily basis just doing the work — we barely have time to raise our head above the water to participate in the union,” Cuffy said. “And those of us who do participate in the union face a very opaque bureaucracy.”

Pizzitola criticized the MLC leadership with not "recognizing their own value” and “trauma-bonding” with the mayoral bosses following more than a decade of former Mayor Mike Bloomberg’s anti-union tyranny. 

“Everything around us goes up in value,” Pizzitola said. “So, if that’s the case — then how come labor, our value diminishes, and we have to give up something in order to get something back? The rest of the world, your big unions — [United Auto Workers] — they’re noticing that. They’re making strides removing tiering and improving their healthcare. We shouldn’t be giving ours back.”

Last week, Association of Flight Attendants President Sara Nelson also called out those labor leaders embracing profit-driven Medicare Advantage plans and selling out the rank & file. 

“I’ll say it right here and right now, unions have lost their way,” Nelson said at a Medicare for All forum on April 10. “I don't agree with it. I completely disagree with it. I'm opposed to that position. I think it hurts our solidarity. It hurts care for ourselves in our communities — and it sells out the people that we are here for, and charged to protect.”

Just a couple of weeks prior, the NYC Chapter of the Democratic Socialists of America received flak after they invited TWU Local 100 officer JP Patafio to another town hall on public sector organizing also held inside the People’s Forum — because Patafio is part of a leadership team at TWU Local 100 that’s also attempting to push its retirees into a profit-driven Medicare Advantage plan.

CROC member Gloria Brandman, meanwhile, is running on the Retiree Advocate-UFT ticket in the UFT’s upcoming chapter elections in May. The Retiree Advocate-UFT ticket is a direct challenge to UFT President and Medicare Advantage proponent Michael Mulgrew’s entrenched hold on the teachers union.

“We are running a full slate against the UFT Unity leaders of our union,” Brandman said. “Our union has sold us out.”

Pizzitola urged more rank & file members everywhere to “take back” their unions.

“This is where that trauma-bonding comes back…you are conditioned to thinking you have no value, [and] you have to accept the measly pittance that they have to give you,” she said. “Your value is not in a box — and the only way to get that [power] back is you have to take back your leadership. Don’t let them stay in power. Get your friends, make a coalition, take back your local — they’re trying to take back their retiree chapter — you have to make noise.”

Fellow CROC member Sarah Shapiro urged retirees to continue coalition-building with others throughout the country.

“The more I get into this fight, the more I believe that coalition building is the way to go,” Shapiro said. “It’s not only municipal retirees that are being screwed over — it’s the home care attendants who are being forced to work 24 hours, and being paid for 13 hours, and the City Council saying they’re the most progressive in this city’s history, [but also] ‘We can’t do anything for you.’ We are working hard with other groups — [like the] Poor People’s Campaign — it’s not only us…we need to keep growing, expanding because when we get right down to it — we need to fight the system.”

Saturday, April 13, 2024

Assured and intent, Pizzitola battles the city and a few unions too - The Chief

Assured and intent, Pizzitola battles the city and a few unions too

On behalf of promises made to 250,000 city retirees


Marianne Pizzitola has run a bakery out of her home kitchen, filling orders for custom-baked cakes, cookies and breads. She has also single-handedly rebuilt the motor on her 1971 white VW bus. That effort took two years, but the thing’s been purring ever since. 

Her most recent endeavor, as anyone who follows municipal goings-on surely knows, has been to advocate — and battle, and argue, and cajole — on behalf of city retirees. And she and her allies have so far prevailed, beating back attempts by successive mayoral administrations to shift the city’s roughly 250,000 retirees to a private, for-profit health plan against their wishes by arguing that the city’s cost-saving move would break promises made decades ago. 

“I have a very strong sense of right and wrong, and I sense that what they’re doing is wrong,” Pizzitola said during a long conversation a few weeks ago. 

Up to now, judges have agreed with Pizzitola and her colleagues, concluding that city officials had in fact dangled the assurance of lifelong government-administered Medicare and city-paid supplemental coverage as an “essential recruiting and retention tool,” as a former city official put it in an affidavit. 

Both sides now await a decision from a State Supreme Court Appellate Division panel that last month considered the city’s appeal of a court decision blocking the proposed switch. 

Pandemic start

Pizzitola’s enterprise began on Aug. 13, 2021, a Friday, the city still under a Covid cloud, when 17 of the 40 people she had invited to hone opposition to the city’s proposed plan joined a Zoom call. Five would volunteer to mount a challenge to the city’s proposal. At the conclusion of the two-hour call, the New York City Organization of Public Service Retirees was launched, and Pizzitola was chosen to lead it as president. 

“In a few hours, we had a name, a mission, an attorney, a bank. And then that weekend, I started a PayPal, a YouTube, a Facebook, and I drafted our first website,” she said. 

The organization, funded by donations, most of $25, has since grown to include a board of directors and an administrative board along with advisors and volunteers, some of them former city and union officials.  

Since that August day, over hundreds of emails, at rallies, on YouTube, Threads, Twitter and TikTok, in strategy sessions with attorneys, at gatherings with retirees, and during court hearings, Pizzitola has parlayed her passion, belief and deep knowledge of sometimes opaque policy points and obscure legislation to, so far, preserve what she adamantly believes the retirees, herself among them, are due.

Pizzitola, 55, became an expert in all things pension- and benefit-related while working as an FDNY emergency medical technician starting in the mid-1990s and into the early 2000s, during which she served a tenure as a delegate with Local 2507, the District Council 37 local that represents EMTs and paramedics. 

She helped her colleagues in that union and also those in Local 3621, the officer’s union, navigate the arcana of their pension and benefit plans, as well as their disability and or injury claims, often during sessions at the Elk’s Club on Queens Boulevard, which the local rented for that purpose. 

She did so, she said, because DC 37 officials charged with informing their members on those matters were not. “And people were suffering because of that and that angered me because now you have a person who's trying to retire on disability and you have a narrow window to do that,” Pizzitola said. 

1/2 union household

Pizzitola spent her childhood first in Queens and in Brooklyn before her parents moved her and her twin sisters, a year younger, to Long Island. She was a good student, particularly adept at music and science, and graduated from Longwood High School in Middle Island. 

Her mother, a teacher, was a chapter leader PS 165 in Queens. But her father, a construction project manager, was anti-union, which confounded his wife and daughter. 

“And we would always turn into fights between me and my mom and my father. We saw the abuses of management from our perspective and knew that you needed good, strong unions to be able to protect workers’ rights and safety and benefits and whatever. So there were a lot of differences of opinion there,” Pizzitola said. “My mom and I were on the same wavelength.”

After graduating and through her early 20s, Pizzitola prepared for a future in restaurants. Her grandparents — her mother's family is from the Italian port city of Bari, and her father’s hails from Sicily — owned and ran eateries and bars along Queens Boulevard. “I wanted to continue my grandfather’s legacy,” Pizzitola said. 

But by the time she graduated with an associate’s degree in restaurant and hotel management, from Johnson and Wales in Providence, Rhode Island, the family had sold its last establishment.

Pizzitola started working in hotels, first interning as a purchasing manager with the Marriott chain before moving closer to the culinary team. But it was during her stint as a sales manager at the Omni Berkshire on East 52nd Street in Manhattan in the early 1990s that she began a slow but steady conversion to an EMT. 

Serendipity — and someone’s misfortune —  got her into the field. Pizzitola was having drinks at a Bell Boulevard bar in Queens’ Bayside neighborhood near her home when a person was hit by a car. “And I ended up tending to that person and I was like, wow, this is really cool,” she said. 

Making a difference
Pizzitola was making a good living at the Omni, and she joined the Bayside Volunteer Ambulance Corps to, she said, “pay it forward.” But the economy went into a tailspin soon after, and she lost her hotel job. “I just ended up hanging out at Bayside Volunteer Ambulance all the time. And then when that happened that made me want to do this,” she said of losing her job and joining an ambulance crew full time. Needing to pay her mortgage on her recently purchased Bayside condo, Pizzitola, now in her mid-20s, landed a paid position as an EMT with St. John’s Queens Hospital. 

Enticed by the prospect of a pension and a lifetime of quality health care, she eventually took the city’s EMT exam. She was hired in 1996, and initially based with Bronx EMS Station 23 Jacobi, now known as Battalion 20. 

Although she thought she would eventually return to a hotel job once the economy regained strength, the FDNY would prove too compelling for her to leave. “I liked it too much. It was uniforms and sirens and lights, and every day was something different,” she said. “And I wasn't wearing high heels and stockings.” 

But there was a not-insignificant tradeoff: “Privates make more than the city,” she said. “I took a $10,000 pay cut to work for the city,” which, accounting for inflation, would be about twice that much today. 

Still, she was making a difference. “It was exciting,” said Pizzitola, who was briefly married around this time, but she and her husband were not a match and divorced in 1999. “Our job was going into chaos and making organization out of it and having an impact on people's lives.”

Every day brought some new adventure, she said, the job reflecting all of the city’s character. “You're going to see your friends and your peers, but you're going out into the city, and every day you will meet other people, and they need you to help them solve whatever crisis that they're having. You meet people at their worst, and you meet people at their best.”

A few years later, on a job with EMS Station 49 in Astoria, she stepped into a pothole while transporting a patient to her rig and tore the ligaments in her right ankle. The fallout from that injury, as well as respiratory difficulties from working the bucket brigade at the World Trade Center pile, would eventually convince her and the FDNY that she could no longer be out on the job. She left the department in 2004. 

“I was really frustrated with that because I loved what I did, really genuinely loved. My father was always of the type that work isn't something you love. Work is something you have to do to make a living and raise a family. And I never understood that mindset,” she said.

‘I see my grandpa’

Pizzitola spends part of the year in Georgia’s warmer weather to alleviate her health issues. When she’s not parsing through the minutiae of municipal health plans and associated statutes, she tends to her garden and dotes on her two rescue dogs, Jewels, a pomeranian eskimo, and Sugar, an eskimo. 

But you’re very likely to find her back in the city when the Medicare issue crops back up, as it has every few weeks for the last three years or so. She’ll also make the trip to rally support for former municipal workers generally, as she did earlier last month on behalf of the DC 37 Retirees Association, which has been put into administratorship by its parent union, ostensibly for its failure to file tax returns for several year, but also for what some believe was the the group’s support, financial and otherwise, of Pizzitola’s effort. 

“I don't sleep. I know. My attorney yells at me all the time,” she said. “But this mission is a constant. And being first responders, being EMS people, we take care of everybody else before we take care of ourselves. So my team is starting to feel the brunt of that.” 

Still, Pizzitola added, the mission has forged them into comrades with a common cause. “I have a new family because of this and I would never trade that for anything in the world,” she said. 

The high-profile nature of Pizzitola’s endeavor has, if by default, cast her into something of a fixer for and a counselor to the retirees. “You kind of become that liaison in between to help them figure all of this out,” she said of the Medicare imbroglio. “So you want to help them because they're confused and they're scared. They're worried they're going to lose a coverage or welfare-fund benefit that they've had forever. They don't know what to do. They don't understand it.”

And just as much as city officials, Pizzitola and her organization are battling big players among the city’s public-sector unions, among them DC 37 and the United Federation of Teachers, which along with a majority of the Municipal Labor Council, the umbrella organization of municipal unions, sanctioned the planned switch to Medicare Advantage.

Union officials, Pizzitola has argued, on occasion with disdain but nearly always with frustration, are indifferent to the retirees. And few current workers can fully comprehend how different their lives will be in a few decades. “They're not seeing themselves as older, having health issues, trouble getting around, loss of a spouse, disabled spouse, disabled children that they still have to take care of even though they're 70 and 80 and 90 years old and half the income that they are making today,” Pizzitola said, her voice rising with frustration. 

Earlier in the day, she had discussed the potential fallout from a switch to Medicare Advantage with about 80 retired FDNY firefighters. “How do you look at these gentlemen, knowing their service to the city? And you're OK with stripping away their health care?… You look at them, I see my grandpa,” Pizzitola said. “This is why I take this personally.”


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Monday, March 25, 2024

City attorney, judge joust on Medicare matter - The Chief - March 22, 2024



City attorney, judge joust on Medicare matter


A state appellate judge and a city attorney sparred Thursday about whether assurances made to city workers decades ago regarding their health care were essentially lifelong, unbreakable promises. 

The exchange took place during a hearing by a State Supreme Court Appellate Division panel considering the city’s appeal of a court decision blocking the Adams administration from switching municipal retirees to a private health plan from their government-administered Medicare. 

Just as the city attorney, Richard Dearing, began his statement, Associate Justice Ellen Gesmer interrupted him to ask whether the city disagreed with a former municipal official’s affidavit that the city’s promise of Medicare and a city-paid supplemental plan was an “‘essential recruiting and retention tool.’”

“I didn't see anything in your papers that disputed that that was an essential recruiting and retention tool. Could you show me where, if anywhere, in the record, you refuted that,” Gesmer said to Dearing

“We refute, I think, the premise that that promise was made,” Dearing, the executive assistant corporation counsel for appeals, replied. He suggested that the affidavit, submitted by Lilliam Barrios-Paoli, herself a retired longtime city official who headed several departments, including that charged with personnel, “hinges on a passage” from a summary program description of health benefits offered to municipal employees. 

That did not satisfy Gesmer, who along with three colleagues from the State Supreme Court’s Appellate Division, First Department, are considering the city’s appeal of a Manhattan Supreme Court justice’s decision that blocked the Adams administration’s plan to usher the retirees into a Medicare Advantage plan. 

“I understood her affidavit to rely on her statement of the city policy with regard to recruiting and retaining employees, not limited to what was in the [summary program description], but rather limited to what it was her policy as director of HRA, among other things, to convey to new employees,” the justice said. 

Dearing said he did not dispute that the city’s promise of free health care into retirement was intended as a recruiting tool. The issue, he said, was whether those assurances met a legal standard. He argued that the city’s guarantees to its employees as outlined in the summary plan description “do not equate to any such promise or to any such clear and unambiguous promise under the court's precedents.” 

Taking up his court colleague’s line of questioning, Justice John R. Higgitt asked Dearing why there was no evidence in the record, such as an affidavit, refuting the promises of lifetime benefits alleged by the retirees and Barrios-Paoli. “There wasn't one individual in city government over that course of 57 years who could say such a promise was not made?” Higgitt asked. 

“I don't think there's not such a person,” the city’s attorney replied. “I think we looked at the record and we concluded that the evidence of that promise, under the standard of New York law, was not sufficient.” 

But the attorney representing the retirees, Jake Gardener, said there was “a very simple answer” to the justice’s question, namely “because no one would say, under penalty of perjury, that there was no promise made, nor would they say that any promise made was unauthorized.” 

Conversely, Gardener said, the hundreds of affidavits from city retirees and others, attest to “the clear and unambiguous promise delivered by city officials in virtually every setting, verbally, in person, and then also in HR documents and [summary program description].”

Adams had disapproved

Gardener also noted that Mayor Eric Adams himself had disapproved of the proposed switch when he was running for office, calling the plan, first put into motion during the de Blasio administration, as a bait-and-switch tactic.

Shifting the retirees to the privately run plan would save the city anywhere from $500 million to $600 million annually, which the retirees have argued would be equal to less than 1 percent of the city’s $107 billion budget this fiscal year.

The city would derive the savings through federal subsidies available to Medicare Advantage plans. The savings would help replenish the city’s Health Stabilization Fund, which supplements employee welfare funds.

The hearing, lasting just under 25 minutes, followed Justice Lyle Frank’s finding last August that switching the retirees to a private plan and stripping them of their no-cost supplemental coverage would in fact break long-ago guarantees the city made to employees.

“The petitioners have shown that numerous promises were made by the City to then New York City employees and future retirees that they would receive a Medicare supplemental plan when they retired, and that their first level of coverage once that retired would [be] Medicare,” he wrote in his five-page decision

Frank dismissed the city’s arguments that the promises “were not definite and were not forward looking,” by noting that “[w]hen words such as ‘will’ are used, that is to this Court a promise that is future looking.”

The decision marked the third time in two years the courts sided with the retirees. Soon afterward, the city said it would appeal his ruling. A decision from the Appellate Division could take anywhere from a few days to as long as several months. 

Marianne Pizzitola, the president of the New York City Organization of Public Service Retirees, one of the lead plaintiffs in the lawsuit that led to Frank’s decision, called out the city’s tactics. 

“Retirees know what we were promised and that was Medicare and a city supplemental plan when we became Medicare eligible," she said in a statement following the hearing. "A promise made should be a promise kept, and we relied on that when choosing to spend our lifetime working for the city. It is shameful that the mayor’s Office of Labor Relations would encourage unions to sell off retirees for their raises."


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The Next Step: UFT Paras for A Fair Contract launches campaign for A LIVING WAGE and FAIR CONTRACT; seeking paras to run on its election slate



The following is an update from the newly announce UFT Paras For A Fair Contract website: http://fixparapay.org


We want to thank you for supporting the Fix Para Pay petition. The calls for a living wage and fair contract for New York City paras have resonated and they are earth-shattering.

In less than a week, we have surpassed over 1700k signatures — and the totals are still growing strong! Over 65% who have signed on are NYC paras who are struggling to survive in the NYC area without a living wage. Almost every signature is a UFT member who stands with paras in this fight. The others are stakeholders in our public schools.


We need our leadership to hear our voices!

That is why UFT Paras for A Fair Contract will be running a slate of representatives for the citywide UFT Paraprofessional functional chapter election that will be held from May 9th to June 13th.

Our union proud and union strong community of paras and UFT members believes that it’s time to organize for a meaningful change by pressing the issues of a living wage and a fair contract at the collective bargaining table. With rising inflation, skyrocketing costs, and Mulgrew making us pay more for our healthcare plans, we are left no choice.

We are also are committing to further mobilize to ensure the para chapter and our school chapters are strong.

We are resolute in our mission: Fighting for respect and dignity for paras by achieving a living wage and a fair contract for NYC paras.

Lip service, empty promises, political grandstanding, symbolic gestures, luncheons, certificates, digital handbooks, more PDs and CTLE opportunities, will not do.


Are you ready to take back our union? If you are a UFT para and want to run with us in this election, we want to connect with you. There are over 250 para delegate representative seats within the UFT para functional chapter that are open in this election. Learn more here: https://www.uft.org/your-union/chapter-elections-2024/chapter-election-faq

We intend to run as many qualified candidates who want to join us in solidarity to organize and bring about the change we sorely need in our beloved union.

We must become the change we all seek by filling those seats with rank and file, hard working members like you.

Our existing team of para leaders and UFT activists is experienced and ready to help. Please submit this form no later than April 2, 2024.

If you interested in joining this slate for meaningful change for paras, complete the form below to connect with us. If you are interested in joining this slate for meaningful change for paras, go to: http://joinslate.fixparapay.org

Join Our Election Slate


Mulgrew’s Unity caucus, the entrenched, stagnant and establishment union leadership that has had sole control of our union for over 60 years, has rejected our calls for a comprehensive bargaining plan for a living wage and a fair para contract.

They failed to pass all of our proposed resolution, only acknowledging to educate members about pending legislation. They gutted the heart of it at the UFT executive board and delegate assembly by not including the provision to create a comprehensive and robust plan.


We organize, mobilize and educate members. And, we vote them out!

We relentlessly march forward as a member-driven labor movement, together.

As union proud and union strong community of paras and UFT members, we assert that it’s time to organize for a meaningful change by pressing the issue at the collective bargaining table. We also believe we must organize to ensure our para chapter and local school chapters are strong.

We will not stand for the status quo. We soundly reject: sub-inflation pay raises, the further erosion of our healthcare and pension benefits, our rights being trampled, and a tone deaf, current leadership stifling our individual and collective voices.

Let’s stand as ONE to join together to be heard even as those we entrusted at 52 Broadway, UFT headquarters, have become more and more disconnected from those of us working hard in the classroom and school communities.

Get involved, now.

We’re here for you!

Have a question or concern? Email us at info@fixparapay.org



Medicare Advantage gets walloped in the press as the federal government's rate notice looms - Mar. 25, 2024



Medicare Advantage gets walloped in the press as the federal government's rate notice looms

In the next week or so, the federal government will announce a decision that will clue us in on whether big health insurers that run the private Medicare Advantage program will have once again succeeded in browbeating regulators into giving them billions more of our money than they’re lawfully entitled to. 

This is the time of year when the Center for Medicare and Medicaid Services makes a final decision on how much of an increase to send to private insurers that now control access to care for more than half of all Medicare beneficiaries. In past years, private insurers’ intense lobbying and intimidation have paid off–to Wall Street’s delight.

HEALTH CARE un-covered is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

That’s largely because consumer and patient advocacy groups and the media have not paid close enough attention to what has become the biggest source of revenue and profits for many of the country's biggest corporations.

But this year is different, and you’ll see some of the evidence below. 

Here’s what’s happening:

At the end of January, CMS released its “Advance Notice” of proposed payment rates and policy changes for health plans that participate in Medicare Advantage in 2025. The calculations CMS uses are complicated but the bottom line is that the agency proposed a 3.7% average expected increase in revenue for MA plans next year. You can find a good analysis of what’s going on and what’s at stake in last Wednesday’s edition of Health Affairs, written by a team of researchers at Brown University and Georgia State. 

Health plans are insisting, as they did last year and in years past, that what CMS is proposing would actually result in a pay cut, and they warn that it would force them to increase premiums, cut benefits, or both. Usually, the back and forth stays inside the beltway, but last year the fight spilled over into prime time when the industry-funded Better Medicare Alliance spent a fortune on a Super Bowl ad that asked viewers to “tell the White House” not to “cut” Medicare Advantage. 

The Brown and Georgia State researchers set the record straight and, in somewhat restrained academic prose, called BS on the industry:

Indeed, although MA plans and their lobbying organizations have portrayed these proposed payment updates as major cuts, this is not true. To put the 2025 MA rate changes in perspective, the 3.7% increase in revenue is larger than last year’s 1% predicted increase but smaller than previous years’ increases exceeding 7% annually. The extremely high margins made by MA plans will barely be touched by provisions in the Advance Notice. (Emphasis added.)

STAT News’ Bob Herman, was more direct in his reliably engaging newsletter this morning:

Within the next week, we will know how the Biden Administration is approaching next year’s Medicare Advantage plans–and whether it is willing to meet the health insurance industry’s demands and deposit more money into the bank accounts of insurers…Billions of dollars are on the line for a program that still has not saved a dime for taxpayers, despite promises that it would. 

Having been a part of the industry’s propaganda machine, I know how insurers swing into action at the slightest perceived threat to Medicare Advantage profit margins. For years, we organized and financed what we called “granny fly-ins” to Washington to get “regular seniors” to fan out across Capitol Hill to deliver the industry’s talking points directly to members of Congress. We helped thousands of others who couldn’t make the trip to write letters to the President and lawmakers expressing outrage at the very notion of putting insurers’ fattest cash cow on a diet. 

As Herman noted this morning, 42,000 comments have flooded into the federal government on this issue in the weeks since CMS released its Advance Notice.

What has changed this year, though, is that many of those comments are from real people and real organizations representing them, like Public Citizen, the Center for Medicare Advocacy, People’s Action, Be a Hero and many others that have come together to push back against the industry’s tactics and lies. In recent weeks, they’ve landed high-level meetings with Biden Administration officials and members of Congress and have made it clear that they won’t be happy if CMS caves once again to industry pressure. 

In addition, the media is waking up and calling foul on Medicare Advantage. I wouldn’t think of writing this without giving a big shout-out to Fred Schulte at KFF News (and previously at the Center for Public Integrity, where Fred and I were colleagues a decade ago). Fred was among the few in the media at the time whose investigative reporting laid bare the industry’s blatant “money grab.” If you care about how your tax dollars have been used to enrich a few executives and shareholders, you should check out Fred’s series of reports from 2014 to 2017.  

But it would take The New York Times’ Reed Abelson and Margo Sanger-Katz to make the money grab a hot topic in DC and the rest of the media. The headline of their October 22, 2022, front-page story was compelling, to say the least: 

‘The Cash Monster Was Insatiable’” How Insurers Exploited Medicare for Billions. By next year, half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers in the program have been accused in court of fraud.

In the months after that seminal story, dozens of reporters have turned their attention to Medicare Advantage. My team and I have seen most of them and have brought many of them to your attention. But in case you might have missed them, we’ve provided links to a few we think you ought to see. After you read them, we encourage you to “call the White House.”

Here’s a small sampling of some of the stories and commentaries you might have missed:

March 2023

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Subscribe to HEALTH CARE un-covered

By Wendell Potter · Hundreds of paid subscribers

Pulling back the curtains on how Big Health is hurting Americans and how we got to this point.