Approximately 40,000 New York City public employees, retirees, and their dependents could lose in-network coverage as early as next week in a long-running dispute with insurance company Emblem Health over premiums at the NewYork-Presbyterian Hospital Network.
The United Federation of Teachers, the city’s second-largest public sector union, accused the hospital of making a “power play” by demanding “exorbitant” reimbursement rates to renew its contract.
The union sent a notice Thursday to members enrolled in EmblemHealth plans warning that they could lose access by April 10.
“NewYork-Presbyterian is trying to increase profits without considering how price gouging is hurting working families,” UFT President Michael Mulgrew said in a statement Thursday.
The coverage dispute comes days after the U.S. Department of Justice sued NewYork-Presbyterian, accusing it of using its influence to “stifle” competition among health insurance companies to keep premiums high.
If Emblem and NewYork-Presbyterian are unable to reach an agreement, tens of thousands of city employees and their families enrolled in the city’s HIP-VIP, HIP-HMO and NYCE PPO health plans will lose access to coverage across the giant hospital’s downstate health system. UFT said members enrolled in the city’s GHI Senior Care program are not affected.
NewYork-Presbyterian and Emblem Health emphasized that discussions are ongoing.
“NewYork-Presbyterian is currently in network with Emblem Health and is negotiating to reach an agreement,” hospital spokeswoman Angela Karafazuli said in a statement. “We believe New York City employees covered by Emblem Health have a right to access the hospital of their choice.”
“We work hard to protect and maintain affordable coverage for New York City workers,” said Alex Gomez, a spokesperson for Emblem Health.
Antitrust lawsuit targets major hospitals
The Trump Justice Department alleged in a March 26 lawsuit that NewYork-Presbyterian uses leverage to prevent health insurance companies from selling plans at lower prices, keeping costs artificially high.
The lawsuit is the result of an antitrust investigation that began in 2025. The UFT says NewYork-Presbyterian charges 77% more for medical services than other hospital systems in New York. (Mr. Karafazli said the Justice Department’s claims are baseless.)
The dispute between Emblem and NewYork-Presbyterian also comes on the heels of a violent nurses’ strike at three of the hospital’s campuses in upper Manhattan, which ended in late February after more than five weeks. It is the longest and largest strike of its kind in the city’s history.
First Deputy Mayor Dean Freihan noted that Emblem and NewYork-Presbyterian had agreed to a short-term extension from the previous April 7 deadline to April 10, but added that “a stop-gap measure is no substitute for a fair and lasting agreement.”
Then-Mayor Eric Adams’ administration announced last summer that it had reached an agreement on a new cost-saving health care plan for 750,000 city employees and pre-Medicare retirees to be jointly managed by UnitedHealthcare and Emblem Health.
Emblem Health and NewYork-Presbyterian began negotiating a new contract later that year. The plan goes into effect on January 1, despite a lawsuit seeking to block the switch, and is expected to save taxpayers an estimated $1 billion a year.
Union health care commitments threatened
When a consortium of public sector union leaders approved the plan in September, it said it would save money while preserving existing insurance. The plan was ultimately approved by 88% of the city’s Labor Board members, despite the concerns of many unions, including the Police Benevolent Association, which voted down the plan.
“We were able to improve benefits and expand our network of providers while allowing members to keep their existing doctors and maintain premium-free care without increasing out-of-pocket costs. This is especially important in an economic climate where every penny counts for members,” the City Labor Board said in a statement at the time.
Now, these promises are threatened by conflict between New York Presbyterian and Emblem.
A spokesperson for Henry Garrido, executive director of District 37 Council and labor committee co-chair, did not immediately respond to a request for comment. Mulgrew, who also co-chairs the labor committee, could not be reached for comment Friday.
“Our standard has always been high-quality, premium-free health care for city employees and retirees,” Mulgrew said in a statement Thursday. “Other hospitals are working with New York City to protect this benefit. NewYork-Presbyterian should do the same.”
Marianne Pizzitola, president of the New York City Public Employees Retirees Organization, said the controversy is a “great concern” to members who have been operating under the assumption that care would not be interrupted under the new health care plan.
“You have been on this health plan for three months and now you [the agreement between Emblem and NewYork-Presbyterian] It expires in seven days,” Pizzitla said.
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