Advocacy

We believe that access to quality healthcare should never be compromised by excessive prices. Our mission is to unite labor, community, employers, and healthcare advocates to challenge anti-competitive practices and demand transparency and fairness in hospital pricing. We are committed to ensuring that working families can afford the care they need without financial hardship. Together, we are building a healthcare system that puts people before profits.

NewYork-Presbyterian

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As the Coalition for Affordable Hospitals, we believe that every New Yorker deserves access to high-quality, affordable care — not a system where massive hospital conglomerates dictate prices and limit competition. We stand with organizations like the Building Service 32BJ Health Fund, which provides health benefits to more than 200,000 working-class members and their families. Their fight has exposed a troubling reality about hospital pricing in New York: costs have continued to soar at an exponential rate, far outpacing inflation, and hospitals like NewYork-Presbyterian (NYP) are using anti-competitive contracting practices to keep it that way.

For years, healthcare costs for 32BJ members have risen sharply, from 17% to 37% of total compensation in just over a decade. After analyzing claims data, the 32BJ Health Fund found that some of the city’s wealthiest hospitals were charging significantly more than equally rated systems, with no difference in quality or outcomes. To control costs while maintaining quality, the 32BJ Health Fund began steering patients toward hospitals that deliver quality care at fair prices. When NYP pushed back against other cost saving measures, the 32J Health Fund removed the hospital system from its network.

 

In just one year, this decision saved members and the Fund over $35 million without sacrificing care quality or access.

The 32BJ Health Fund’s experience shows that NYP utilizes multiple anti-competitive terms in its contracts with insurance carriers, such as “all-or-nothing” provisions, “anti-steering” provisions, and “gag” clauses.

“All-or-Nothing” Clauses

Hospitals like NYP have required insurance carriers to include all of their facilities and physicians in a network even if only one location or provider is needed. This forces carriers and employers to pay higher prices across the entire system, eliminating the ability to negotiate or exclude overpriced facilities.

“Anti-Steering” Clauses

This practice restricts payors from incentivizing patients to seek quality care at lower-cost options. The 32BJ Health Fund repeatedly faced pushback when it attempted to place NYP in a non-preferred tier with higher co-pays, ultimately leading to the 32BJ Health Fund removing NYP from its network in order to maintain its tiered structure and continue to provide access to high quality affordable care.

“Gag” Clauses

For years, NYP has used “gag” clauses to prevent insurance carriers from disclosing hospital prices, both before and after patients received care. This lack of transparency means patients, employers, and policymakers are left in the dark about what’s driving high healthcare costs.

Anti-competitive contracting don’t just impact union members, it affects every New Yorker:

  • Patients face higher bills and fewer choices.
  • Employers struggle to keep up with rising healthcare costs.
  • Taxpayers see more public dollars go toward inflated hospital spending.

When hospitals can demand whatever prices they want, without oversight or competition, everyone pays more, and healthcare becomes a privilege instead of a right. This is not a problem of individual behavior; it’s a systemic failure of accountability and transparency. Massive hospital systems have been allowed to consolidate power, using their market dominance to command excessively high prices and stifle competition. We know that high-quality, affordable healthcare is possible, but only if we hold powerful hospital systems accountable.


That means:

  • Ending anti-competitive contracting practices that block transparency and restrict choice.
  • Enforcing existing transparency laws so patients and payors can compare prices and outcomes.
  • Supporting legislation that caps excessive pricing and promotes fair market competition.

New Yorkers deserve a healthcare system that rewards value, quality, and fairness. We invite you to learn more about the advocacy of The 32BJ Labor Industry Cooperation Trust Fund below:

32BJ LICF