On Monday, September 29, the United Federation of Teachers (UFT) Delegate Assembly voted overwhelmingly to support the city’s proposed health care plan, the New York City Employees PPO (NYCE PPO).
The next morning, September 30, the Municipal Labor Committee (MLC)—the umbrella body of New York City’s public sector unions—also approved the plan, with the UFT casting its decisive block of votes in alignment with its delegates’ decision.
After hours of debate, the vote tallies in the MLC were as follows:
Yes - 1263, 87.6%
No - 178, 12.35%
Abstain and No Shows - about .5%
Votes in the MLC are weighted — with the two largest unions, DC37 and the UFT carrying over 60% of the total “yes” vote.
Unions that voted against this new healthcare plan include several of the uniformed unions: (DEA) Detectives’ Endowment Association, (SBA) Sergeants Benevolent Association, (PBA)The Patrolmen’s Benevolent Association, (UFA)The Uniformed Firefighters and (UFOA)The Uniformed Fire Officers Association.
Two locals from DC37 voted against the plan, also. They are: Local 2054 and Local 3005.
Union leadership and City Hall tout the measure as a necessary step to contain spiraling health care costs. But the move has ignited protests, deep unease among retirees, and sharp criticism from rank-and-file unionists who say they were excluded from the process.
Union Leaders Defend the Deal: Cost Control and Stability
UFT and other MLC leaders have framed the deal as essential to preserve premium-free health coverage for active employees and retirees alike. They argue the plan maintains broad provider access, while also giving the city greater leverage to negotiate with providers and contain costs.
In messaging to members, UFT leaders described the shift as the only way to prevent escalating expenses from eating into future raises and collective bargaining gains.
“This is about ensuring the long-term sustainability of benefits,” one leader said about the Delegate Assembly debate. “If we don’t act now, we risk losing what we’ve built over decades.”
Protest Outside DC 37 Headquarters
Not all union members are convinced. Hours before the MLC convened to vote, active and retired city workers rallied outside DC 37 headquarters in Manhattan, demanding transparency and a halt to what they described as a rushed, secretive process.
The protest included active union members, retirees, and leaders from HandsOffNYCare and New York City Organization of Public Service Retirees.
Demonstrators carried signs accusing City Hall and union leaders of “selling out” workers’ health to balance the budget.
HandsOffNYCare issued a statement blasting the process:
“City Hall is gambling with our health to balance their budget without giving us a seat at the table. The claim that this new plan will deliver $1 billion in savings has not been backed up with any proof, and the municipal employees and pre-Medicare retirees who will be directly affected were shut out of the negotiating process. If the MLC votes to approve this rushed contract today, they will have betrayed the hundreds of thousands of municipal workers who have dedicated their lives to public service and deserve the health care they currently have.”
The group further criticized the release of only heavily redacted versions of the contract to MLC leadership, leaving rank-and-file members in the dark.
Voices of Dissent
Retirees and union members have been outspoken about what they see as a betrayal of trust.
Marianne Pizzitola, President of the NYC Organization of Public Service Retirees, told us here at The Wire:
“New York City Retirees have repeatedly been betrayed by their former union leadership, and this decision is no different. This decision was done in darkness and not shared with members when healthcare is a mandatory subject of bargaining.
Yesterday’s admission by Alan Klinger and Henry Garrido that the tripartite committee intentionally imploded the stabilization fund rocked us to our core. Henry Garrido of DC37 stated the stabilization fund had been used like a piggy bank. The irony is he and Michael Mulgrew allowed that to happen.
Even more disturbing if you could imagine that being possible, was that in doing so and choosing this plan, they left behind the widows and children, whose welfare fund benefits are funded by the stabilization fund they destroyed. The only ones who defended them were the UFA, UFOA, PBA, SBA and DEA.
Unions are supposed to protect their members, their retirees, and their line of duty spouses on their families. The Municipal Labor Committee left them on the floor.
The United Federation of Teachers’ health committee anonymously supported this plan without ever seeing the contract first, nor having considered the financial implications of not meeting the billion dollar savings they have promised. One month later, after recommending the contract, they reviewed a redacted contract.
They better hope that everything they promised comes to fruition or we will hold each and every one of them accountable.
In amNewYork, Wanda Williams, a retired DC 37 member and board member of HandsOffNYCare, denounced the lack of consultation:
“We were not allowed to see the contract. Even the people who did see it saw only redacted versions. This is being done without a vote of the membership and without any consultation, and it is anti-union.”
She added:
“You’re putting us in a risky proposition. You cannot disengage your membership and tell them that what you’re doing on their behalf is good without sharing the information with them.”
From amNewYork, more dissenting voices surfaced. Migdalia Acevedo, president of Chapter 3 of the NYC Health & Hospitals division of Local 375, said:
“Our union leadership has excluded the rank and file from these negotiations, which are mandatory subjects of bargaining.” (amNewYork)
She warned that what’s being sold as savings will in fact shift costs and risks to workers:
“What they call cost savings is really profit at the expense of denied care.” (amNewYork)
Acevedo also cautioned that limits to out-of-network benefits could harm members seeking second or third opinions:
“Out-of-network is our most precious resource for getting second and third opinions.” (amNewYork)
Mary Kanigher, 68, a retired municipal worker, told amNewYork:
“I retired about two years ago. I had worked for the city for a total of nearly 47 years. This is not what was promised to me after all these years, and it infuriates me.”
She added:
“The pay is lousy, but at the end you’ll be taken care of. This is not what was promised.” (amNewYork)
Longtime UFT delegate Arthur Goldstein also spoke out after the Delegate Assembly vote:
“What we did last night was take a step backward. We handed our health care over to UnitedHealthcare, a company notorious for denying claims. Members deserve better than cost-cutting schemes dressed up as ‘savings.’”
In his Substack, Union Matters, Goldstein added:
“As educators, we’ve failed egregiously. We’ve not only failed to learn, but we’ve also failed to set an example. That’s tragic and shameful, because the beating heart of our job is acting as role models.”
In TheCity, James Davis, president of the Professional Staff Congress-CUNY, whose union abstained, said:
"My members are concerned with what might not be there because of redactions that we don’t have access to, about what the conditions would be under which we do end up back at the table.” (The City)
Concerns About AI and Denials
Another issue fueling anxiety is the plan’s reliance on AI-driven utilization management and preauthorization protocols under UnitedHealthcare’s standards.
Critics fear these automated systems could generate more automatic denials, especially for complex or out-of-network care.
The American Medical Association (AMA) has cautioned against insurers’ growing use of AI in claims processing, warning that such tools risk “inappropriately restricting or delaying medically necessary care.”
For retirees living outside the NYC metro area—where in-network access is less robust—these denials could pose especially harsh barriers.
The City has released the redacted contract after the MLC vote. It is available here.
Editor’s note: In the coming days, The Wire will share its analysis of the administrative service contract. Our reporting this past week regarding what was not openly shared with union members has been precise and target — especially surrounding the role of United Healthcare and its subsidiary, United Medical Resources (UMR), will play in being the key player and interface for nearly all preauthorizations, claims and denials — including its use of AI with limited safeguards.
Legislative and Legal Fronts
With both the UFT and MLC votes completed, the NYCE PPO is slated for implementation in 2026. But opponents are not backing down.
Retiree advocates, including Pizzitola, have already called for legislation codifying retiree healthcare protections into city law. Others are preparing legal challenges to the contract and exploring whether the city’s obligations to retirees and active union members have been undermined.
“This fight isn’t over,” one retiree said outside the MLC vote. “We’re not going to stand by while they gamble with our health.”
The Bottom Line
The approval of the NYCE PPO plan marks a pivotal moment in New York City labor politics. For union leadership, it represents a pragmatic step to rein in costs and safeguard premium-free coverage. For critics, it symbolizes a dangerous retreat—one that jeopardizes the very promises that unions and the city made to generations of workers.
With lawsuits, legislation, and continued protests looming, the battle over the future of municipal health care is only just beginning.
The New York City Employees PPO (NYCE PPO) plan is subject to finalization and approval through the city’s contracting process.
You can visit the NYCPPO mini-site, here: https://go.tpa.com/nyceppo
In the media:
City’s public sector unions approve sweeping healthcare shift for 750,000 workers amid secrecy criticism — amNY: https://www.amny.com/news/public-sector-unions-approve-health-care-shift/
MLC Approves Contentious Healthcare Agreement — The Chief Leader: https://thechiefleader.com/stories/mlc-approves-contentious-healthcare-agreement,55185
Municipal Unions, EmblemHealth, UnitedHealthcare — The City (NYC): https://www.thecity.nyc/2025/09/30/municipal-unions-emblemhealth-unitedhealthcare
And those of us who are retired are at the mercy of….?..???
After hours of debate both the UFT Delegates and the MLC overwhelmingly approved the plan, called union democracy, and in the era of Trump locking down our health plan was extremely important…