Delaware State News | by Joseph Edelen
In a letter released to the public Thursday, 27 former Delaware lawmakers urged Gov. John Carney not to adopt a Medicare Advantage plan for state pensioner health care coverage.
The communication advises the governor and his administration that the state’s $8.8 billion underfunded liability for retiree health care “should not be the only consideration in your decision-making.”
Gov. Carney’s recommended budget for fiscal year 2024 features a one-time appropriation of $51 million to address that liability.
The former legislators who signed the letter include Retirees Investing in Social Equity Delaware members John Kowalko, a one-time representative, and Karen Peterson, an ex-senator. RISE Delaware was successful in stopping the implementation of Medicare Advantage last October, after a judge ruled in favor of retirees in a lawsuit filed in Delaware Superior Court.
Nine former senators and 18 former representatives were included in the letter, including Sens. Bruce Ennis, Harris McDowell, George Bunting and Margaret Rose Henry; and Reps. Nancy Wagner, Harvey Kenton, Robert Valihura and Donald Blakey.
They petitioned that the plan would result in delays and denial of medically necessary care; pre-authorization for 2,030 procedures and medications; charges for deductibles, copays, coinsurance and “cost-sharing” fees; mandatory use of in-network doctors instead of their primary care physicians; and the inability to get treatment at specialty hospitals that do not accept Medicare Advantage.
“Even in the worst of times, we kept our promises to our retirees and made sure that their excellent healthcare benefits were secure. Now it is your turn to do the same for those who went before you,” the letter stated.
On Monday, RISE Delaware members released a statement warning retirees and lawmakers of a “sneak attack” provision within the governor’s recommended budget bill.
The language within that bill states, “Section 101. Notwithstanding any provisions of law to the contrary, the Department of Human Resources will continue its efforts towards implementing 29 Del.C. § 5202 (d)(4) and (d)(5) and will work within the terms of the 2021 Medical Third-Party Administrator RFP and executed contracts.”
In last year’s budget bill, epilogue language changed “Medicare Supplement” to “Medicare Advantage” to enforce the plan, which opposers have claimed was done to pass the measure under the radar and without a public process or hearing.
RISE Delaware members now claim the language of “2021 Medical Third-Party Administrator RFP and executed contracts” is meant to include the previous contract between the state and Highmark for its curated Medicare Advantage plan, which came as a result of the 2021 request for proposals.
The organization also contends that the language, if included, would “use a two-year old bid from a two-year old Request for Proposals without a new bid process, thereby bypassing the requirement in law that ‘free forces of market competition’ must be permitted ‘to operate to the benefit of the state employee benefits coverage programs.’”
In Thursday’s letter, Ms. Peterson added, “If the legislature allows Section 101 of the epilogue to be passed, the Carney administration will once again shift blame to legislators for approving Medicare Advantage. This time, the legislature will deserve the wrath of 30,000 State retirees.”
Pensioners will continue receiving their Medicare Medicfill Supplement plan coverage for the remainder of the calendar year as a result of the Superior Court’s Oct. 19 ruling.