After years of legal battles, Mayor Adams’ administration got a green light from New York’s highest court Wednesday to shift hundreds of thousands of retired municipal workers into a controversial, cost-cutting Medicare Advantage plan.
The ruling marks the conclusion of a legal battle that started shortly after Adams became mayor in January 2022, when a group of retired city workers sued his administration over its effort to eliminate their traditional Medicare coverage and shift them into an Advantage plan.
The retirees, concerned the Advantage plan would diminish the quality of their coverage, alleged in their suit the switch violates local administrative law they say requires the city to provide them with traditional Medicare, consisting of the federal program paired with a city-subsidized supplement.
Lower courts have repeatedly sided with the retirees, barring Adams’ administration from moving forward with the plan.
But Adams’ administration, adamant the Advantage plan would continue adequate coverage for retirees and save the city hundreds of millions in health care costs annually, has appealed the lower rulings, culminating in Wednesday’s decision from the State Court of Appeals, the top jurisdiction in New York.
In a unanimous 12-page ruling, the top court’s seven judges wrote the retirees were actually mistaken in alleging city administrative law prohibits Adams’ administration from moving them into an Advantage plan.
It was not immediately clear how quickly the city would be able to move on the change or if the plan could fall to the wayside should a new administration be elected in November. Some members of the City Council are also fighting the Advantage push.
Adams’ term is up Jan. 1, 2026, and he’s facing a difficult path to reelection running as an independent in November’s general election amid continued fallout from his federal corruption indictment.
Ex-Gov. Andrew Cuomo, who’s polling as the favorite to replace Adams, recently committed to killing the Advantage plan and let retirees stay on traditional Medicare should he be elected mayor.
Spokespeople for Adams and Cuomo didn’t immediately return requests for comment on Wednesday’s ruling from the State Court of Appeals.
As they pursued their case, the retirees argued the shift would violate the law because health insurance documents provided to them by the city formed a “promise” of lifelong traditional Medicare coverage in retirement.
But the judges found the paperwork didn’t actually make such a promise.
“It does not rise to the level of a clear and unambiguous promise that the city would pay for Medigap coverage, as opposed to some other form of health insurance coverage, for the rest of every retiree’s life,” they wrote, referring to traditional Medicare.
To that end, the top court reasoned Adams’ administration can move forward with moving the retirees into the Advantage plan, which will be fully subsidized by the city, but administered by a private insurance provider, Aetna.
The retirees opposed to Advantage have raised concern the private administration of the plan subjects them to serious risk. They have pointed to federal studies finding Advantage plans can result in beneficiaries being denied “medically necessary” care due to the convoluted pre-authorization protocols used by private insurers.
“While we are disappointed in the ruling by the Court of Appeals decision, the solution to protecting seniors’ healthcare has always been with the City Council and the mayor,” said Marianne Pizzitola, a retired FDNY EMT who runs the retiree group that first brought the suit against Adams’ administration.
“The next Council and mayor need to do the right thing and codify protections for seniors in city law.”
Pizzitola was referring to a bill introduced in the Council that would enshrine in local law that retired municipal workers like cops, firefighters and teachers are entitled to traditional Medicare coverage fully subsidized by the city.
The bill currently has 16 co-sponsors. To pass, the bill would need support from at least half of the Council’s 51 members, and for movement to happen, it would likely also need sign-off from Council Speaker Adrienne Adams.
“The mayor needs to do right by the retirees,” Speaker Adams said walking out of City Hall on Wednesday, adding the incumbent should reconsider and allow retirees to continue their current health insurance. “All of this is the mayor’s job, and he needs to be responsible for what’s going on with our retirees.”
Like Cuomo, the speaker is running in Tuesday’s Democratic mayoral primary.
Brooklyn Councilman Justin Brannan, one of the anti-Advantage bill’s co-sponsors who’s running for city comptroller in next week’s Democratic primaries, said the State Court of Appeals ruling means the need to pass the legislation “is more urgent than ever.”
“Let’s be clear: this isn’t just about health care. It’s about whether the city keeps its word to the people who built this city,” Brannan said. “I’m not going to shrug and treat this ruling as the end of the story just because a court said it’s legal. Legal doesn’t mean right. I didn’t get into this work to break promises and I sure as hell won’t stop fighting.”
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