The state Court of Appeals on Wednesday finally decided against retired municipal employees who for years have agitated to keep New York City from forcing a change in the terms of their health care coverage. Coming on the cusp of Tuesday’s city primary elections, reaction to the top court’s ruling could shift a potentially crucial number of votes, in an 11-way mayoral race with ranked choice voting.

Small margins are expected to prove crucial in that scenario — and the affected retirees who live in the city and vote could number in the tens of thousands.

Continuing resistance to a Medicare Advantage Plan for retirees will depend on how the next mayor and the next City Council proceed. The NYC Organization of Public Service Retirees, or NYCOPSR, which brought the matter to court, has already made clear which candidates it deems acceptable, and which it does not.

Ex-Gov. Andrew Cuomo, the presumed front-runner, is touted as a supporter of retirees on the group’s website; Assemb. Zohran Mamdani, who’s polling right behind him, is not. Other "mayoral candidates who support retirees" include Brad Lander, Scott Stringer, Whitney Tilson and Michael Blake in the Democratic scrum, and Curtis Sliwa, the Republican candidate in the November general election.

Those "supporters" pledged to oppose retirees being "forced into Medicare Advantage — preserving our promised paid-for supplement to Traditional Medicare & not permitting backdoor premiums onto us in the form of copays and deductibles." Opponents of Medicare Advantage plans fear they would face higher out-of-pocket costs, limited physician networks, and pre-authorizations for certain procedures.

Marianne Pizzitola, who heads the NYCOPSR and has been pushing the issue for four years, is a retired employee of FDNY’s Emergency Medical Service, a Georgia resident who hailed from West Babylon. The organization has not issued preferred rankings for the candidates. Last year, it first endorsed Jim Walden, an independent candidate.

A unique twist here is that the city’s biggest labor union, District Council 37, was part of the wage negotiation years ago that allowed the city to save costs by introducing a Medicare Advantage Plan for retirees. DC 37 has withdrawn support for at least one candidate who backed legislation pushed by retirees barring any change in their longtime free-Medicare deal.

DC 37 urges its members to support term-limited Council Speaker Adrienne Adams as their first ballot choice for mayor, Mamdani second, and Assemb. Zellnor Myrie third.

As reported by The City news site, Mamdani tried to flip-flop earlier this month — quietly changing his campaign website to suddenly add a pledge to "reject Medicare Advantage." Pizzitola, however, noted to The Point Thursday that the text of Mamdani’s statement cautiously covers only active employees and union members, which her members are not.

Last-minute news of interest to one constituency always has the potential to influence big elections. It remains to be seen whether this will be one of them.