The Elders Strike Back

By Nijmie Zakkiyyah Dzurinko

The following article draws heavily from an interview I conducted with Martha Cameron (activist and member of the Steering Committee of the Cross-union Retirees Organizing Committee) and Judith Feldman, who has been involved with the single payer movement. 

It’s not often that a conversation about a powerful organizing campaign begins with “Two of us are in our 90s, one is 88, one is 84, a few are 82, we have one person still in her 60s – she’s the baby.” But it’s also not every day you get to talk to a group of elders like those in the Cross-union Retirees Organizing Committee (CROC). These elders aren’t reminiscing about organizing “back in the day” but about a current campaign pitting a gritty group of leaders fighting on behalf of a quarter million retired New York City municipal workers against an unholy alliance between labor leaders, state government and Wall Street.

In 2018, New York City Mayor Bill DeBlasio’s Office of Labor Relations started to negotiate with the Municipal Labor Committee – a consortium of over 100 unions representing city workers – to replenish the city’s Health Insurance Stabilization Fund. This fund is set aside to help pay for municipal union members’ healthcare premiums. The fund had been emptied in 2014, since the United Federation of Teachers (UFT) borrowed from it to provide raises to teachers with the promise that it would be renewed through savings at a later date.

In order to replenish the fund, the assembled players went for the “low-hanging fruit”: retirees’ healthcare. In 2021, NYC municipal union retiree associations began to spread the word that secret negotiations were happening that would impact their negotiated excellent healthcare benefits – which consisted of Medicare along with a Medigap plan. Retirees got word that their coverage would be replaced with privatized Medicare Advantage plans, which would be much worse. Medicare Advantage is administered by Wall Street insurance corporations who make their profits from denying necessary care. Medicare Advantage uses “prior authorization” as a mechanism for this denial of care – something which traditional Medicare rarely does. The more treatment is denied, the more money the profiteers can keep.  

At the time, most retirees didn’t know what this would mean because they had never had to think too hard about their healthcare coverage. But soon, alarm bells started to ring and word began to spread among various retiree associations, including the Council of Municipal Retiree Organizations (COMRO), District Council 37 Retirees Association, Retiree Advocate-UFT and others. Julie Schwartzberg, a DC 37 retiree and long-time activist and member of Good Neighbors of Park Slope (GNPS), an aging in place organization in Brooklyn, NY, put a notice in the GNPS online bulletin. Martha and a few others responded. They met on May 26, 2021, pulled in more folks who were also becoming active, and that became the nucleus of CROC.

We figured we needed to inform people. We didn’t know what was happening to us. It was being dropped from above, with all kinds of false narratives and promises. You’re going to have dental care, they said. We already have that. Lots of questions started to emerge. We were up against the City of New York – and our own unions. That was the tough part. If it was the unions against the city, we would have had major allies, and it would have been game over for the city. But instead, it was the unions collaborating with the city of New York, with City Hall.– Martha Cameron

Medicare Advantage would serve no benefit to the retirees and instead would usher in networks, prior authorization, and more roadblocks to essential care. The two biggest public-sector unions in New York City, United Federation of Teachers (UFT) and AFSCME District Council 37 carry any vote within the Municipal Labor Committee. Their leadership, together with the DeBlasio administration, claimed the move to Medicare Advantage, which is entirely subsidized by the Centers for Medicare and Medicaid Services (CMS) would save $600 million a year, as the city would shed its financial and contractual obligation to pay for retirees’ Medicare premiums and Medigap insurance. The “savings” would then be used to replenish the Health Insurance Stabilization Fund. It should be noted that some locals and smaller unions did push back against the move, to no avail since the vote within the Municipal Labor Committee is weighted.

The “deal” – which primarily benefited Wall Street – gave retirees the ability to “opt-out” of Medicare Advantage, which they would automatically be placed in. A quarter of a million people who once worked and lived in New York City but were now far flung across the country, would potentially have their contractual healthcare benefits severely worsened without even knowing about it until they went to the doctor. If it weren’t for organized retirees, that is. Thanks to the combined efforts of CROC, COMRO, DC 37 Retirees, Retiree Advocate-UFT, the New York City Organization of Public Service Retirees (NYC OPSR) and others, the retirees won the right to “opt in,” requiring a change to the city charter and a major pressure campaign on City Council to split them from the Mayor. Soon after, 65,000 retirees “opted out,” prompting Emblem, the Medicare Advantage insurer, to walk away from the deal. The city then pulled in healthcare giant Aetna to take Emblem’s place. 

When he was running, current Mayor Eric Adams said “this is a terrible thing for the retirees.” As soon as he got elected, he changed his mind. – Martha Cameron

Faced with an uphill organizing battle, CROC assembled a Steering Committee and working groups for outreach, local and national politicians, and communications. To avoid being isolated in their fight, CROC’s talking points emphasized that the retirees were simply the first to be affected. All existing union members, as they retired, were going to lose the benefits that they once had – therefore – this was everyone’s fight. They educated the existing workforce to understand “you’re next.” 

They quickly learned that the Wall Street companies behind Medicare Advantage had them out-moneyed. On January 26, 2024 dozens of Senators from both parties signed a letter of support for Medicare Advantage addressed to the federal Centers for Medicare and Medicaid Services and the Department of Human Services. As a result of the cumulative organizing efforts, 3,000 retirees called into Senator Kristen Gillibrand’s office demanding that she remove her name from the letter. She eventually did. Chuck Schumer did not. 

Physicians for a National Health Program estimated, based on 2022 spending, that Medicare Advantage overcharges taxpayers by a minimum of 22% or $88 billion per year, and potentially by up to 35% or $140 billion. By comparison, Part B premiums in 2022 totaled approximately $131 billion, and overall federal spending on Part D drug benefits cost approximately $126 billion. Either of these — or other crucial aspects of Medicare and Medicaid—could be funded entirely by eliminating overcharges in the Medicare Advantage program Judith Feldman

The NYC Organization of Public Services Retirees took the City and the Mayor to court. Other retiree groups, including CROC, supported these lawsuits by encouraging donations, participating in submitting affidavits and providing evidence. Retirees pooled their limited resources to hire lawyers, while the City used the people’s money, paid in taxes, to try to defeat the seniors’ fight for healthcare and instead serve Wall Street. The first lawsuit was about whether retirees would have to pay for their own Medicare and Medigap upon opting out. They won, but the city appealed. The second lawsuit was about co-pays. The retirees won that suit, too, and the city appealed again. 

We went to city hall hearings. Went on for 5 hours, had people waiting so they could have 2 minutes. They hung on to the bitter end. When it came to hear from the insurance companies, City Council was more than willing to give them more than two minutes. – Martha Cameron

CROC began to make links with organizing groups like Make the Road NY, the Poor People’s Campaign, No More 24, PNHP, and others impacted by the healthcare crisis. They started to understand the significance of their fight as a bellwether for moves in Congress to privatize Medicare. CROC went beyond its original mandate – to guarantee healthcare benefits for NYC municipal retirees – as they started learning about similar fights across the country, and linking up with retiree groups nationwide that are fighting back (in most cases, with the support of their unions).  This past fall, CROC joined with the Poor People’s Campaign and the Nonviolent Medicaid Army at an action focused on Medicaid cut-offs at Lincoln Hospital in the Bronx. 

Just days before this writing, the retirees experienced another victory – the Appellate Division, First Department, of the New York State Supreme Court unanimously affirmed the retirees’ victory in the class action case of Bentkowski et al. v. City of New York. This ruling settles the City’s appeal in favor of the retirees and affirms Judge Lyle Frank’s ruling from July 6, 2023 that NYC municipal retirees are entitled to Medicare and supplemental Medigap coverage, fully paid for by the City of New York. The two aforementioned cases are still going through the appeals process – and the City may still seek permission to appeal the state Supreme Court’s decision to the Court of Appeals, so this fight isn’t over. 

What can we in the University of the Poor network learn from this struggle? We can take some insights from the hard-won lessons that leaders in CROC have lifted up in the course of this interview. The healthcare crisis objectively unites large sections of our country – and all segments of the working class – unionized and non-union workers, employed and unemployed workers. The retirees’ struggle amplifies the importance of our political independence as we unite and organize the 140 million poor and dispossessed people in this nation today. The struggle reveals yet again that our healthcare system is owned and controlled by Wall Street, which also controls our political system. And nothing less than a mass movement of the exploited and oppressed, united across lines of division, will be capable of re-organizing our society in our own interests.

Right now the UPoor is engaged in a study of the Communist Manifesto. In it, Marx and Engels say: “Now and then the workers are victorious, but only for a time. The real fruit of their battles lies, not in the immediate result, but in the ever expanding union of the workers.” In addition to winning the hearts and minds of the retirees and current municipal workers, and winning in the courts, perhaps one of the biggest victories of the Cross-union Retirees Organizing Committee is the ever expanding union of those in this country who are hurt and killed by the social murder of our for-profit healthcare system.

Nijmie Zakkiyyah Dzurinko (she or they) grew up poor in a steel town in western Pennsylvania as the industry was closing down and the town began to hollow out with no other economy to take its place. Her path in the movement has focused on developing youth, building working class organizations from the ground up, uniting the poor and dispossessed across all lines of division and working to master the unity of theory and practice. They are a co-founder of Put People First! PA and the Nonviolent Medicaid Army and their movement commitments also include the Poor People’s Campaign and the National Union of the Homeless. 

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