In 2014, New York City Mayor Bill de Blasio reached a deal with public sector unions that was projected to save $3.4 billion through changes that included eliminating copays for preventive services and tripling copays for emergency room visits. Beyond helping the city’s bottom line, the deal also helped the mayor politically as he renewed a long list of expired labor contracts. The city said it has achieved its goals so far, and officials are optimistic the trend will continue as the plan is fully phased in for fiscal year 2018. But while it could help the city weather an economic downturn, some say the city still needs to save even more.