Why UFT Chapter Leaders and Delegates Must Vote “NO” on the NYC Employees PPO Plan
Taken together, these three reasons — the missing contracts, the reckless self-funded gamble, and Mulgrew’s record of betrayal — all point to one unavoidable conclusion: this plan cannot be trusted.
Healthcare is not an abstract policy issue or some political football. It is not a bargaining chip. It is not a spreadsheet of “savings.”
It is life and death for us, for our families, for our dependents.
The upcoming vote before UFT chapter leaders and delegates on the newly proposed NYC PPO Employees healthcare plan is not just another union decision — it is one of the most consequential votes you will ever take.
The plan being pushed by the Municipal Labor Committee (MLC), Michael Mulgrew, and the City would throw us into uncharted waters, handing our health and futures to corporate insurers and a self-funded structure that has never been tested in this city. Worse, this entire scheme is being rushed forward without transparency, without accountability, and without the trust of the rank and file.
In a true member-driven union where all members vote on things like major political endorsements and ratifying major healthcare agreements, every member would need to take heed.
But here we are. Delegates and chapter leaders, you are the last line of defense.
You must vote “NO.”
Here are three big reasons why:
We cannot trust anyone who refuses to show us the full contract with Emblem Health and United Healthcare, or the MLC’s agreement with the City that underpins this change.
We cannot trust the City and MLC to run a self-funded plan when they’ve bankrupted the Healthcare Stabilization Fund and have no history of running such a system.
We cannot trust Michael Mulgrew with our healthcare after his disastrous and dishonest attempt to force retirees into Medicare Advantage.
1. No Contract, No Trust. No Trust, Vote No.
Transparency is the foundation of trust. Yet as chapter leaders and delegates are being asked to cast this historic vote, we have not been given the actual contract with Emblem Health, with United Healthcare (UHC), or the labor agreement between the City and the MLC that cements this arrangement.
Think about that. We are being asked to make a life-or-death decision without the actual documents that spell out what this plan will mean in practice.
Instead of contracts, we’ve been handed glossy FAQs, talking points, and vague assurances with no contractual documents to back up their claims.
The UFT’s FAQ claims that prior authorizations will be reduced by 50%. That sounds promising — until you realize the union has not actually shown us a list of which services will require prior authorization.
We’re asked to “take their word for it,” while ignoring United Healthcare’s long and well-documented record of denials and delays. It leads private Big Healthcare insurers in denials — with a 32% denial rate. To make matters worse, United Healthcare is under multiple investigations for fraud.
One might also be led to believe this is 50% less pre-authorizations than we had under our old Emblem/Anthem plan. However, leaked MLC minutes from a September 10th meeting adds more questions about this propaganda talking point.
Here, Chris Caller, Segal healthcare consultant, tells MLC union leaders that they cut down the list given to them by Emblem and UHC at the beginning of the summer to “about half”.
Does “about half” mean — 50%, 55%, 65% or even 70%? Is this “about half” of 10k, 20k, or 30k proposed preauthorizations? He maintains there is a list but not even the union leaders in the MLC are privy to hold on to it.
And what does pre-authorizations are “much more intelligently designed” mean? Does this mean they will be relying even more on AI and algorithms to make life and death decisions?
Without the contracts and documents, it’s all really hard to tell. And, of course, the number of preauthorizations doesn’t change UHC’s high denial rate.
This is not an oversight. It is a strategy. They want you to vote first and learn the details later. But once we hand over our healthcare, there is no going back.
We need to read the language and guarantees of the contract before voting on whether to approve it. Without that, every promise is just a shell game.
Here are some things that they’ve failed to show us that you should be able to peruse and analyze: the unredacted contract with Emblem and United Healthcare, the new MLC agreement with the City, all appendices, the list of network providers, formularies, a full list of prior authorizations, the disruption of care impact study, and the comprehensive plan details regarding how the self-funding oversight will be structured and its processes.
Would you buy a home without reading the deed? Would you sign a mortgage without seeing the terms? Of course not. Yet that is exactly what Mulgrew and the MLC are asking you to do with your health and your family’s future.
To be honest, this is the type of grift and shady dealing we see from time-share salespeople in Orlando as they hand the unsuspecting funky tickets to Disney World and a lifetime of inescapable debt.
The bottom line must be: No contract, no trust. No trust, vote no.
2. A Self-Funded Gamble We Can’t Afford
The second red flag is likely even bigger in scope: the City and the MLC are proposing a self-funded plan. That means instead of a traditional insurance model, where risk is spread and the insurer assumes financial liability, the City itself will assume the risk — using member and taxpayer healthcare dollars to pay claims directly.
On paper, self-funding sounds attractive: no/low premiums, more control, supposed “savings.” In reality, it’s a gamble with our lives. And the City and MLC have already proven they cannot be trusted with healthcare finances.
Consider the recent history. The City’s Healthcare Stabilization Fund — once meant to stabilize costs for workers — has been effectively bankrupted by the same people now promising they can responsibly run a self-funded plan. Billions drained. No replenishment. And no accountability.
On paper, this looks like a “cost-saving” idea despite having zero experience in managing this type of plan. In reality, it is a reckless gamble with our lives. And the track record of the City, the MLC, and Mulgrew’s Unity caucus proves they cannot be trusted to manage it.
They Already Bankrupted the Healthcare Stabilization Fund
The City and MLC once had a tool to stabilize rising costs: the Healthcare Stabilization Fund. It was expressly designed to offset the rising costs of healthcare. That fund is now admittedly bankrupt. Why? Because instead of protecting healthcare, city and union boss leadership used it recklessly as a self-serving slush fund.
Raided in 2014 for retro raises: Hundreds of millions were drained from the Stabilization Fund to cover contractual raises for City workers, leaving healthcare vulnerable.
Siphoned into reserves, not members: Tens of millions were shifted into the UFT’s Welfare Fund from the 2014 and 2018 healthcare agreements, where the bulk of the money, nearly a billion dollars now sits in reserve— even as members face higher copays, more out of pocket expenses and limited welfare fund benefits.
No accountability: Decisions were made behind closed doors, with no member input and no transparent accounting — no publicly accessible minutes or financials. The City comptroller, Brad Lander, has been asked to audit the HSF but has yet to do so.
And now, when the fund is broke and unable to meet even its most basic obligations, we are being told to trust these same leaders with a much larger, riskier pool of healthcare dollars.
HSF: A Fund That Can’t Pay 9/11 Widows and Orphans
The consequences of this financial mismanagement are not abstract. As the New York Daily News recently reported, the collapse of the Stabilization Fund has left even 9/11 widows and orphans without critical medical payments. If the City and union leadership cannot protect the most vulnerable victims of the worst terrorist attack in our city’s history, why should we believe they will protect us?
The Stabilization Fund also pays for PICA drugs. PICA covers self-administered injectable medications and chemotherapy medications, including those for treating cancer and its side effects.
This is not about ideology. It is about survival. A self-funded plan means that every unexpected spike in costs, every bad year of claims, every legal liability, every miscalculation — will land directly on our shoulders and New York City taxpayers.
When the money runs short, and it will, the City will not dig deeper. They will slash. They will deny. They will use it as a bargaining chip for more contractual givebacks. They will push costs back onto us.
This is not speculation. It is exactly what has already happened.
This is not theoretical. If the self funded plan runs short — if costs exceed projections, if claims pile up, if the City mismanages funds — what happens?
Cuts. Denials. Higher copays. More prior authorizations. Services delayed or eliminated.
Self funding by a public employer also lacks several state and federal legal protections afforded to fully funded and minimum premium plans. State healthcare mandates regarding plans and procedures like in-vitro fertilization, gender-affirming care, and reproductive rights do not apply to self-funded plans. Certain state oversight also doesn’t apply to self-funded plans.
The UFT FAQ now indicates that a handful of bureaucrats on the oversight board of this new plan would continue to implement these protections but without seeing any solid details on how oversight will work or contractual assurances — how do we know? If something goes wrong, who do we appeal to and how?
And let’s be honest: the City is not interested in “savings” for our benefit. They are interested in cutting their costs. Every dollar they “save” is a dollar less of care for us.
You wouldn’t let someone who crashed and totaled your car take the wheel again. Why would we let the same City and MLC officials who bankrupted the stabilization fund run a self-funded healthcare plan for hundreds of thousands city union members and our families?
3. Mulgrew’s Record: Medicare Advantage Betrayal
Finally, we must confront the elephant in the room: UFT President Michael Mulgrew.
This is the same Michael Mulgrew who orchestrated and pushed the disastrous scheme to force NYC retirees into Medicare Advantage — a privatized system riddled with prior authorizations, delays, and denials. Retirees fought back, crowdfunded millions of dollars to face the giants like the City of New York and the MLC, went to court, and exposed the truth: Mulgrew and the MLC had made a backroom deal to trade away healthcare in exchange for “savings” that thus far has never materialized.
The retirees’ lawsuits revealed something damning: Mulgrew and the MLC were willing to gamble with the health of our most vulnerable members in order to free up money for the City. And when confronted at first, Mulgrew didn’t apologize or course-correct — he doubled down. Mulgrew finally backed off his Mulgrewcare plan after his political caucus suffered a historic loss in the Retired Teachers chapter.
Why should we believe that this new PPO scheme is any different? The fingerprints are the same: secrecy, backroom deals, empty assurances, and an obsession with negotiating our labor for “cost savings” at the expense of care.
Mulgrew has not earned the trust to negotiate our healthcare in good faith. Quite the opposite: he has shown a pattern of deception and betrayal.
Do not forget: retirees were told Medicare Advantage would be “just as good” as traditional Medicare. That turned out to be a lie. Active members are now being told the new PPO will be “just as good” as GHI — and that lie is already falling apart before our eyes. Retirees were told they could “see any doctor they wanted”. And, that was true but only if they wanted to pay for it. Retirees were told all doctors that accepted Medicare would accept Medicare Advantage. That was a proven lie, too. They told retirees the plan would cost less than they were paying. That was another lie — as they implemented copays for the first time in 60 years and in the RFP told the insurance companies not to disclose this initially.
All while corralling and steering many of our lowest paid city workers, such as paraprofessionals and low income retirees, into the false security of zero dollar co-pays if they use a city hospital facility in the plan’s newly designated hospital tier — In-Network Preferred.
Let’s be clear. Our city hospitals have made some improvements over the years and there are hardworking doctors, nurses and staff working for them but we know that the quality of care is still very much an issue. Most of these hospitals remain critically understaffed, under-resourced and among the lowest performing nationally according to federal ratings. Many NYC hospitals are also facing a maternal health crisis – with a series of alarming and tragic deaths of black mothers at Brooklyn’s Woodhull Hospital.
And yes, one of the biggest lies in the leadership’s marketing propaganda campaign is that there are no hospital tiers. But our eyes don’t lie.
A third option has been added, creating a tiered structure that can and will be used to penalize hospitals acting in “bad faith” by requiring higher copays at some of the area’s more elite hospitals — like New York Presbyterian and NYU Langone.
Ultimately, we bear the costs while continuity of care is delayed and/or disrupted when the out of pocket costs become too prohibitive to use these hospital facilities and the medical providers affiliated with them.
In 2018, UFT leadership failed to divulge a negotiated side letter, Appendix B, that spelled out “cost savings” schemes like Medicare Advantage before the Delegate Assembly voted to recommend the contract. Now, we are poised with a similar fate because they refuse to give us full disclosure.
Fool us once, shame on you. Fool us twice, shame on us.
Healthcare Is Not a Bargaining Chip
Taken together, these three reasons — the missing contracts, the reckless self-funded gamble, and Mulgrew’s record of betrayal — all point to one unavoidable conclusion: this plan cannot be trusted.
And when we are talking about healthcare, lack of trust can be fatal.
This is not just about doctor’s visits. It is about cancer screenings. Surgeries. Life-saving medications and procedures. The mental health care we need because others depend on us to be well enough to provide and support. The specialists our children need. The hospital care our spouses, partners and little ones might need tomorrow.
Once you vote “yes,” the damage cannot be undone. You cannot go back to your members and say, “I didn’t realize.” You cannot tell a colleague fighting cancer that you thought it would all work out. You cannot tell a parent whose child was denied care that you didn’t ask to see the contract.
Your vote is the shield between your members and imminent disaster.
Delegates: The Responsibility Is Yours.
This is a moment of truth for the UFT.
The City and Mulgrew want chapter leaders and delegates to rubber-stamp this plan so they can claim “union approval” while stripping us of our most fundamental security. They want to say we consented. They want our signatures to legitimize their betrayal.
Do not give it to them.
You were elected by your chapters to represent them, not to rubber-stamp Mulgrew’s deals. Your members did not elect you to gamble with their lives. They elected you to stand up, to ask hard questions, and to defend them.
And right now, defending them means voting NO.
The Bigger Picture
If we approve this PPO plan, it will not be the end. It will be a turning point and will accelerate the erosion of our healthcare. Once the City sees it can get away with a self-funded scheme, with no transparency and no pushback, it will only embolden them to demand more cuts, more concessions, and more privatization.
The retirees were the test balloon. We are the next step. And if we allow this to pass, the future of union healthcare in New York City will be one of endless cuts and corporate control.
But if we vote it down? We send a clear, united message that UFT delegates will not rubber-stamp secret deals. Then we begin to shift the balance of power. We show the City and Mulgrew that our health is not for sale.
Other city unions are beginning to also see that the lack of full disclosure means we all must vote no. The PSC delegate assembly has voted not to approve this plan.
Bottom Line: No Trust, Vote No.
Delegates, the decision before you is clear:
No contract, no trust. We cannot vote on what we cannot see.
No faith in oversight of self-funding. The City and MLC have already bankrupted one healthcare fund — we cannot hand them another.
No confidence in Mulgrew messing with our healthcare. His Medicare Advantage betrayal proves he will trade our health for savings every time.
To reiterate, this is not about politics. It is not about factions and caucuses within the UFT. It is not even about Michael Mulgrew personally. It is about whether you will protect the lives of your members and their families.
Healthcare is not a bargaining chip. It is not a budget line. It is life and death.
Vote “NO” at the Monday, September 29th Special DA.
“I want to be able to trust Michael Mulgrew and the Unity leadership of our UFT. But the reality is they weren’t transparent with us regarding Appendix B in our 2018 contract, or with the Medicare Advantage plan they tried to force onto all retired city workers. This time around, we get a healthcare FAQ on the UFT website and a couple UFT town halls that were run as sales pitches from Michael Mulgrew. Mulgrew and Unity won’t let us see the actual contract, even in a redacted form. This forces me to vote NO.” -
Chad Hamilton, Brooklyn Chapter Leader
Learn more:
NYC Organization of Public Service Retirees - Email to City Union Leaders
UFT - UFT Healthcare Negotiations and FAQs
PSC - What’s Happening to Our Healthcare
New York Focus - NYC’s Employee Health Fund Has Hit Zero — What It Means for Public Workers
Daily News, Wanda Williams - A Risky City Hall Healthcare Change
New Action - Some Initial Thoughts and Questions About the New Healthcare Proposal
You have experience with a self-funded plan, the UFT Dental plan is a self-funded plan administered by Cigna. What did they do to save money, they kept the reimbursement rate so low that dentists dropped out. How do you get a 10% savings when health care inflation is going up; by paying your providers less than the usual, customary and reasonable rates. That is their plan.
Voting NO places our health care into Adams hands, a mayoral candidate we did not endorse, our colleagues have one plan, threatening to strike, planning to strike and going on strike.
It’s reckless.
Remember the opposition caucuses supported Medicare For All, run by a 30 member board it trustees selected by the governor and the electeds, and we would pay for it through a graduated health tax, how much? To be determined by the trustees.
Vote YES, as we move deeper into Trumpland it’s critical that we lockdown our healthcare, not going on strike