Bay to Bay News | by Joseph Edelen
Lawmakers from both sides of the aisle gathered on the east steps of Legislative Hall Wednesday to call on the state to halt its implementation of a new Medicare Advantage plan for pensioners.
Just over a week after a rally against the state’s move to a Medicare Advantage plan was held in Wilmington, more than 150 state retirees and others opposing the change gathered. Both events were led by Retirees Investing in Social Equity Delaware, or RISE Delaware, which is an organization formed by retiring state Rep. John Kowalko, D-Newark, and New Castle County Councilwoman Lisa Diller.
In addition to the RISE Delaware co-founders, the rally was attended by retiring Sen. Bruce Ennis, D-Smyrna; Sen. Dave Lawson, R-Marydel; Sen. Dave Wilson, R-Lincoln; Sen. Bryant Richardson, R-Seaford; Rep. Franklin Cooke, D-New Castle; Rep. William Carson, D-Smyrna; former Rep. Raymond Seigfried; and former Sen. Karen Peterson, who on Sept. 25 joined RISE Delaware in filing a lawsuit against the state to stop the plan’s implementation on Jan. 1, 2023.
During the rally, Rep. Kowalko said the state’s process for considering the change was a “classic example of deceptive and abusive government overreach.” He said the move was a “betrayal of retirees” before declaring his opposition to recent legislation that would establish oversight to the state’s Medicare Advantage plan.
The General Assembly will consider the legislation Oct. 26, and Rep. Kowalko urged his colleagues to vote against that bill and instead support legislation to stop the plan from going into effect at all.
Following Rep. Kowalko’s remarks, Mr. Seigfried said what was happening was “not right.” In addition to representing the Claymont area in the House of Representatives, Mr. Seigfried has served as House Health & Human Development committee vice chairman, taught health care policy at Arcadia University, and was senior vice president of administration for Christiana Care.
Mr. Seigfried gave warning to what can happen under the coverage of a Medicare Advantage plan, such as “upcoding,” which refers to health care providers intentionally selecting more expensive diagnosis and procedures.
“In America, our health care system is pluralistic, and by that, I mean it’s built on choice. This means that you have a choice in the doctor, in the hospital that you need. This means that you have a choice in the medical decisions that should stay between you and your doctor, not an insurance provider,” Mr. Seigfried said.
While the move to Medicare Advantage was approved by lawmakers within the budget process, a majority of lawmakers were unaware of the scope of the changes, including Sen. Ennis, a retired Delaware state policeman, and Rep. Carson, a Department of Transportation retiree.
Both men sit on the Joint Finance Committee responsible for crafting the budget and Sen. Ennis expressed concern with how the change was outlined within this year’s budget bill. In Section 116 of the 2023 operating budget epilogue, all references to Medicare Supplement are struck through and inserted with Medicare Advantage.
“Since the state operates on a fiscal basis, I’m wondering why we’re starting a new program in the middle of the fiscal year?” Sen. Ennis said. “I cannot imagine why any of us sitting in the General Assembly would want to put the stress that we’re putting on seniors. The second thing is with the midterm elections coming up, why would anyone want to give any inference of disloyalty for the obligation we have to our pensioners?”
Proponents of the state’s Medicare Advantage plan have said it will provide more value than the current Medicfill plan while cutting the cost of premiums in half for the state, as well as addressing the state’s $10 billion unfunded liability for state retirees’ healthcare.
Sen. Lawson, a retired Delaware state policeman who has served as senator since 2010, was “delighted” to see lawmakers coming together across the aisle to stand up for retirees, he said, adding that what the state was doing was “wrong” and that they could “not let this go down like it’s going.” Sen. Lawson said the slight change within the budget bill would “not cause one to stand up and take notice,” and called the bill to implement oversight to the state’s Medicare Advantage plan “two-handed butt-cover legislation.”
Additionally, Sen. Lawson questioned the motivation to make the change in order to reduce the state’s $10 billion unfunded liability. The state formed a committee to address the liability back in 2005 and has since begun carving out 1% of the prior year’s budget to fund the liability.
“We as seniors, we just want to be left alone. We worked for the benefits, just please, leave us alone. We don’t need to beat up on people who have served their time for the state and have earned it; why would we do that?” Sen. Lawson said. “Why would we want to do that other than for our own credit down the road to say, ‘Look what I did to reduce the state’s deficit.’ It’s an underfunded liability— there’s $650 million in it.”
While the state has made efforts to hold information sessions regarding their move to Medicare Advantage, several lawmakers have stated these sessions do not tell the whole story in regard to the plan. This includes Sen. Wilson, who called the meetings “a dog and pony show,” and said that when the plan was put out, “they told us what we wanted to hear, not what we needed to know.”
“You’re the retirees. You could’ve worked any private sector and probably made a third more all these years. Now you come down to your golden years and we say ‘Well, we’ve got a better plan for you’ If you’ve got a better plan, why wasn’t it implemented 10 years ago, 20 years ago?” Sen. Wilson said.
While the plan is set to go into effect Jan. 1, the state was able to negotiate performance bonuses related to prior authorization efficiency and a four-month delay on the start of prior authorization for care.
Delaware’s Medicare open enrollment is ongoing through Oct. 24. Pensioners can opt in or out of coverage, though Medicare Advantage will be the only state-provided coverage beginning Jan. 1.
While RISE Delaware does not have immediate plans for their next rally, Rep. Kowalko said the organization is awaiting the results of their expedited hearing in Delaware Superior Court on Oct. 17.