The Delaware General Assembly will hold a special session later this month to vote on adding more oversight over the transition of the state’s retiree health care plan to Medicare Advantage, a move that has been protested across Delaware in recent weeks.
However, retirees are still looking to reject this plan outright, as a lawsuit seeks to prevent a transition to Medicare Advantage, a type of Medicare plan offered through a private insurance company.
The special session, which has bipartisan support in both houses, will take place on October 26, just two days after the deadline for retirees to opt out of a Medicare Advantage plan. If retirees do that, they will miss out on state-funded health care, which state officials vehemently urge retirees not to do.
The retirees hope the court will issue a ruling before the deadline later this month. The plan will enter into force on January 1, 2023.
my knowledgeDelaware plans to change its health care plan for retirees. Old people are angry and fighting
The legislature will not vote to block this contract with Highmark Blue Cross Blue Shield Delaware. Lawmakers said they did not have the strength to do so.
Instead, they will vote to create a subcommittee of the state’s Employee Benefit Commission that will “add more oversight to the transition process.” It will be made up of state retirees, seated legislators and union representatives who will “monitor Highmark’s performance over the current three-year contract term,” according to a press release.
Senate Bill 348, which has not yet been introduced, will create an ombudsman in the Human Resources Department, tasked with helping the state’s retirees transition under the new plan.
RISEDelaware, a nonprofit organization formed to advocate for retirees and fight against this change, described the special session as “a pathetic distraction to please retirees and pretend that the new Medicare Advantage plan is in any way similar to our current plan.”
“An actual reading of the plan documents will show lawmakers all the real serious problems retirees will face,” the group said in a statement.
Delaware officials decided, earlier this year, to move to a Medicare Advantage plan as a way to reduce the state’s bloated, unfunded liability. It is estimated that it could grow to $33 billion by 2050.
These types of private plans have come under intense public scrutiny. The US Department of Health and Human Services’ Office of Inspector General published a report this spring that found there were “widespread and persistent problems with improper denial of services and payment.”
New York Times investigation Posted this week It found that health insurance companies have taken advantage of this program in order to increase their profits by billions of dollars. The New York Times reported that they do this by creating systems that make their patients appear sicker — while not providing additional treatment.
In Delaware, many retirees are concerned about being forced to sign up for health insurance that may deny or delay care. Many say they have worked in the country for decades in order to get a solid state pension package. Now, they feel betrayed.
The decision to move to Medicare Advantage surprised retirees and many lawmakers this summer. Lawmakers previously voted on this resolution to transition to Medicare Advantage in June as part of the state budget. But Representative John Kowalko, one of the fiercest critics of the plan, said lawmakers have been misled.
Qualco will retire in January and will depend on the state’s retirement benefits. He said in an interview on Monday that he would not support his legislation.
“It’s a deliberate engagement process,” he said.
Qualco said the bill is a way to justify “the General Assembly’s neglect by passing something that does not reflect any kind of legitimate reform of what retirees face.”
He believes the GA could have done something to block Medicare Advantage weeks before the contract was signed. He said lawmakers have now decided to take some kind of action when their hands are tied.
The Senate Democratic Caucus asked the Carney administration to delay implementation of the contract — which officials declined to mention contractual obligations already in place. In response to the outrage, the state and High Mark also agreed to a four-month delay in pre-authorization requirements, among other perks.
Kowalko most recently helped found RISEDelaware, which stands for Delaware Social Equity Retirees Investing. The organization is part of the lawsuit.
The lawsuit, filed in Delaware Supreme Court, alleges that the state failed to follow administrative procedures when implementing this change, specifically by not allowing retirees to provide input.
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New York retirees are suing to fight a similar change to Medicare Advantage. In March, a judge ruled that the city must allow retirees to opt out of a Medicare Advantage plan and keep their current health care plan.
At a rally last week, a few dozen retirees gathered inside New Castle County Council rooms, in the rain, to protest the changes. Many expressed frustration at the lack of response by their representatives and senators and the lack of action. There will be another rally in the Legislative Hall on October 12.
Marsha White, the retired attorney general, said: “I spoke for the state, who speaks for us?”
“The idea that this was done behind our backs, without us at the negotiating table and finding out randomly – a lot of people still don’t know about it – is complete nonsense,” she said during the rally.
Retirees also came up with their own marks. Someone read: “We are not dead yet! We are voting.”