I am a firm believer that when your government does something good, it should be disclosed to the public and when it does something bad, there is an equal obligation to let it be out there for everybody to know about.

The bail reform agreement that the governor fought for is a big winner. Quietly cutting health care benefits for 1.2 million state employees and retirees is a loser.

The state’s bail laws were the hottest issue in last year’s governor’s race. Candidate Lee Zeldin hammered away on the crime issue and he ran a close contest with Gov. Kathy Hochul.

The bail issue resonated up and down the ticket and the loss of four congressional seats to the Republicans was in part due to an aroused public’s unhappiness with the current bail law. Having learned the lesson of the 2022 campaign, Gov. Hochul insisted that the changes be made part of the new budget deal and she emerged a winner.

The issue that irks me terribly is the quiet backroom deal with United Healthcare and the Civil Service Department to cut out-of-network coverage for Empire Plan reimbursements for over one million state employees and retirees, effective July 1, 2023.

Instead of following the provisions of the state Surprise Billing law, which would have required review by another state agency, the administration decided to follow the federal law, which doesn’t need approval of the agency responsible for reviewing changes.

By and large most of us get our medical care under the in-network part of our health policy. In-network has many doctors who provide us with good quality care.

But from time to time, patients need certain types of care from a particular specialty practice such as neurology or mental health, which is rarely in-network. In many cases, depending on how much the out-of-network doctor charges, the patient has to pay something out of pocket. As a result of the arrangement between United Healthcare and the state, patients will probably be paying much more out-of-pocket costs, which is grossly unfair.

There is another way to explain how the cuts in coverage work. Up to the present, out-of-network doctors were reimbursed at a rate that was created by the insurance industry titled “Fair Health.”

Effective July 1 of this year, out-of-network doctors will get the equivalent of what Medicare pays for claims, which is ridiculously low. I know that for a fact as I am in the Medicare program and I know that my doctors get next to nothing for their services. I am a former state employee, so my out-of-network benefits will be slashed, along with many other state employees and retirees.

The state has an agency called the Department of Financial Services. Its job is to review any healthcare benefit changes. Instead of giving the new rate schedule to that agency, the administration bypassed them and had the Department of Civil Service sign off on the deal.

Was the state Legislature consulted about the reimbursement rate cuts? No, because they would have turned down the proposal on arrival.  Come July 1, their benefits will be cut as well, so the Legislature was left out of the discussions. Many members of the Legislature have protested these changes, but to date their pleas have fallen on deaf ears.

Will anyone be able to stop these cuts? The leaders of the Public Employees Federation and the United University Professions will be seeking a new contract this year and they could tell the governor that they will not accept the cuts.

There are a number of bills that have been introduced in Albany that would stop this insurance industry power grab, but the governor might choose to veto them.

I will be continuing this fight in behalf of the Quality Care Council to alert as many people as possible to this terrible government action.

I don’t know what it will take to get the administration to stop their plans to take away this important health coverage for state employee groups, but this fight will continue throughout the year.  The new bail reform law is a winner. The cut in out-of-network care is a big-time loser.