MORE OF MULGREW’S HEALTHCARE MESS: MLC now opting to impose much higher tiered copays on city workers and their families.
With looming tiered copays for select hospitals and providers -- we can’t afford Mulgrew anymore! In this UFT election, we must vote for A Better Contract slate.
By now, many New York City public employees have experienced the steady erosion of their healthcare benefits over the last decade. We’re becoming more aware of the warning signs, buried in memos and sugar-coated with euphemisms like “cost-savings” and “choice.” But the implications of the Municipal Labor Committee’s (MLC) latest health care strategy — quietly outlined in an April 28, 2025 letter to union leaders — are anything but modern or liberating. Instead, they foreshadow a healthcare crisis for municipal workers and retirees, spearheaded by UFT President Michael Mulgrew and the MLC’s pursuit of permanent cost-cutting mandates. Deals that sold out our hard-earned healthcare benefits for mediocre, sub-inflation wage increases.
The Tiered Copay Trap
According to internal documents, the proposed plan includes tiered copays that could see union members paying up to $2,500 out-of-pocket if they choose providers deemed “irresponsible” or “too expensive” — namely elite hospitals like NYU Langone and NewYork-Presbyterian. The idea, initially floated before 2018, is now a cornerstone of the MLC’s response to the City’s demand for permanent annual healthcare savings of $600 million — a commitment made in deeply flawed deals struck by Mulgrew and the MLC in 2014 and 2018.
The recent MLC letter affirms this is very much the path they are pursuing.
A False Choice
Proponents claim this system will empower members with more “choice.” But in reality, it’s a cost-shifting mechanism. It penalizes anyone who seeks care at top-tier facilities — some of which provide specialized services unavailable elsewhere. Patients won’t be choosing freely; they’ll be choosing between affordable care and the care they actually need.
This echoes concerns raised when Mulgrew and the MLC tried to force retirees into the Aetna Medicare Advantage plan — also dubbed “MulgrewCare”. That plan was ultimately blocked by the courts after massive outcry and litigation (source: The City, Aug 11, 2023).
The pattern is clear: shift costs to us, limit options, then rebrand it as innovation.
Why This Is Happening
The backdrop is an RFP (Request for Proposals) process initiated by the City to find a new group health insurance plan that can meet these aggressive cost-saving targets. According to Geoff Sorkin’s recent email update to union members, the process is ongoing — but notably absent from his message was any mention of these potential tiered copays or their long-term implications. Transparency remains elusive because most of this happens and remains in back-room deals.
What Sorkin didn’t say is just as important as what he did: without substantial member pushback, the MLC will likely greenlight a plan that locks us into these even higher and limiting copay structures in perpetuity.
The public notice for the initial RFP in 2022 explicitly tells us that the City and MLC are looking for a new comprehensive benefits healthcare provider for city workers that will direct patients to certain providers and networks while managing “bad actors”.
It calls for:
“ … effective management of chronic conditions, anticipation and management of high-cost claimants, and focus on directing membership to most cost-effective providers through education and plan design (using centers of excellence and/or high-performing networks with benefit design differentials and a focus on positive health outcomes)”
In plain English, they are asking bidders to contain costs for them by tiering hospitals and providers by limiting our healthcare choices and reining in our behaviors.
Ask yourself: How does Big Healthcare manage chronic conditions? Seriously.
All of this is on the heels of the MLC, comprised of New York City’s major public sector unions, filing a lawsuit against City Hall challenging the administration’s attempt to compel them to cover up to $4 billion in health care savings. It that failed to materialize after a proposed switch to Medicare Advantage for retirees was blocked in court.
The unions argue that the city is unfairly holding them accountable for the collapse of the Medicare Advantage plan, which was intended to generate $600 million annually in savings but faced strong opposition from retirees and was ultimately rejected by a state Supreme Court judge. The Adams administration plans to appeal the court’s decision later this year, while the unions seek to prevent the city from pursuing arbitration over the disputed savings.
The Path Forward
This isn’t fear-mongering. It’s a reckoning. The tiered copay system isn’t hypothetical anymore — it’s a real and looming threat to the quality and accessibility of care for hundreds of thousands of municipal workers, retirees, and their families.
Union members must demand better. Leadership must be held accountable — not just for these decisions, but for the secrecy and spin used to sell them. They gaslight us saying they’ve averted healthcare premiums while slamming us with more out-of-pocket costs and “backdoor premiums”.
As the UFT election is now in full swing, the choice is clearer than ever: continue down this never-ending path of false “savings” that shifts costs to all of us or vote for leadership that truly values the health, dignity and pockets of its members and families.
Step 1: Stand up. Speak out. Say no to Mulgrew’s healthcare cuts. Vote for A Better Contract.
A Better Contract (ABC-UFT) is committed to fighting for a better labor contract with the City of New York and a better social contract with our union leadership.
We are member-led, member-centered and members FIRST!
Our focus is simple. Better pay that outpaces the cost of living. Protect and improve our healthcare, pensions and benefits. Improve our working conditions so we are respected as professionals — free to be the experts we are. And a union that answers to its members.
quick question Daniel... do you know why copays for city md were raised to 100 dollars? just curious