House, Senate to reconvene Oct. 26 for debate about Medicare Advantage oversight

Bay to Bay News | by Joseph Edelen

Delaware’s House of Representatives and Senate will reconvene Oct. 26 to consider legislation that would provide oversight to the state’s move to a Medicare Advantage plan for its pensioners.

The legislation, Senate Bill 348, would establish a State Medicare Advantage Accountability, Measurement and Reporting Subcommittee of elected officials who would be responsible for regular provision of the new plan. The group would also be tasked with releasing quarterly reports regarding the state’s compliance with its contract with Highmark Delaware, starting in April 2023.

Also with the bill’s passage, the position of a Medicare Advantage ombudsperson in the Department of Human Resources would be created. He or she would be responsible for assisting pensioners with the transition in coverage and helping them utilize the entirety of benefits under the Medicare Advantage plan.

While the final version of the legislation has not yet been filed, a draft was obtained by the Delaware State News. The proposal is sponsored by each member of the Democratic and Republican leadership in both chambers of the General Assembly and states that, while public meetings had been held by way of the Retirement Benefit Study Committee and the State Employee Benefits Committee, many pensioners were unaware of the change.

“Many of our colleagues heard the concerns retirees raised during these public hearings. These teachers, secretaries, engineers, troopers, administrators and other dedicated workers put in their service to the state and want to ensure that the state fulfills its commitment to them in their golden years,” said Speaker of the House Pete Schwartzkopf, D-Rehoboth Beach.

“We were able to win several concessions that will improve the current deal for retirees. And after several conversations and negotiations, we have crafted a bill that will add several layers of oversight to the process to protect the current agreement and assist retirees during this transition.”

Prior to the completion of the state’s three-year contract with Highmark Delaware for the new coverage plan, it was able to negotiate an expansion of out-of-network access, a four-month delay in required prior authorization for care and performance bonuses for prior-authorization turnaround.

As part of the ongoing effort to notify pensioners of the change, a number of informative meetings have been held statewide.

“In September, our caucus organized two town halls providing the opportunity for state pensioners and administration officials to come together and have questions answered about the new Medicare Advantage plan,” said Senate Minority Whip Brian Pettyjohn. R-Georgetown. “One thing became very clear: Retirees need a seat at the table for this and future decisions regarding their health coverage. They dedicated their careers to serving Delawareans, and we must do what we can to ensure their retirement health care is the best it can be.”

House Minority Leader Danny Short, R-Seaford, agreed.

“After attending the public forum that was held last month in Sussex County on the impending Medicare coverage changes, it became even clearer the need for additional oversight and monitoring of the transition to this new health care plan,” he said. “Our state retirees have dedicated their years of service to Delaware citizens, and, with that, the state should fulfill its obligation to ensure their health benefits will remain top-notch. I look forward to addressing some of their major concerns through the enactment of this important measure.”

While General Assembly leadership has officially planned on taking action, retiring Rep. John Kowalko, D-Newark, said the special session does not “absolve them of responsibility.” Last month, his organization, Retirees Investing in Social Equity Delaware (RISE Delaware), filed suit against the state in an attempt to halt the implementation of the Medicare Advantage plan.

Rep. Kowalko took exception to multiple aspects of Senate Bill 348. He stated that it ignores the privatization of Medicare; makes no attempt to reject or delay the proposal; condones Human Resources Secretary Claire DeMatteis’ misleading of the public; makes no attempt to extend existing Medicare supplement plans as an option; fails to acknowledge retirees’ involvement in the process; and sends a “chilling message” that legislators in support of the bill are only interested in “ensuring their own reelection, as opposed to their obligations to retirees.”

Once he heard rumors of the Oct. 26 session, Rep. Kowalko said he received a call from House Majority Leader Valerie Longhurst, D-Bear, informing him about the legislation. He said he told her that, if the bill made no attempt to halt the implementation of the plan, he could not support it. He added that he is “very disappointed” by the lack of response from various legislators in both chambers over the last few months and that Rep. Longhurst’s call was the first he had received from leadership regarding the matter.

“They have received a barrage of information, not only from me but from countless retirees across the state,” Rep. Kowalko said. “It was originally excusable in the context of not knowing about the change, but what excuse are they going to give for their silence over the last two months on this issue?”

Despite the lack of communication, Sen. Dave Lawson, R-Marydel; retiring Sen. Bruce Ennis, D-Smyrna; Rep. Sean Lynn, D-Dover; Rep. Mike Ramone, R-Newark; and Rep. Madinah Wilson-Anton, D-Newark, have all communicated their concern to Rep. Kowalko.

Starting Jan. 1, the state’s new Medicare Advantage plan will be the only health care coverage offered to pensioners. Medicare open enrollment is ongoing through Oct. 24 for those interested in opting out.

As the General Assembly reconvenes Oct. 26, the Senate will also consider the confirmation of several nominees from Gov. John Carney’s administration.

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