On Wednesday, a Delaware Superior Court judge temporarily blocked an effort to move the state’s retirees to a Medicare Advantage health care plan.
Judge Calvin Scott ruled that the state must “take all necessary and appropriate steps” to ensure that current retiree health insurance and benefits “remain in full effect.”
On the way to trial
A trial will be held to make a final decision on the future of the Medicare Advantage plan, the decision said.
THE STORY :Delaware Legislature to hold special session amid outrage over Medicare Advantage plan for retirees
The temporary lockdown is a major victory for a group of state pensioners, who have been protesting the change in recent weeks. The deadline for the state’s 30,000 retirees to opt out of the Medicare Advantage plan, and therefore lose state-sponsored health care, has been set for Oct. 24.
The lawsuit, filed earlier this month, argued that the state failed to follow administrative procedures when implementing the change, particularly regarding transparency and the ability for retirees to give their opinion.
Karen Peterson, a former state senator and Department of Labor employee, was one of the complainants.
“I took no pleasure in prosecuting state agents with whom I worked for many years,” she said in a statement. “But retirees are entitled to the medical coverage they were promised during their years working for the state, and someone had to fight back.”
Emily David, spokeswoman for Gov. John Carney, said the administration is “reviewing today’s interim decision and our appeal options.”
“We are committed to providing state retirees with the high quality, accessible and affordable health care benefits that transitioning to a custom-designed Medicare Advantage plan provides,” she said.
Earlier this year, the Carney administration moved to transition state retirees to a Medicare Advantage plan to reduce the state’s unfunded liability. Estimates show it could reach $33 billion by 2050.
Medicare Advantage plans are Medicare plans offered by private insurers. The Delaware plan, offered by Highmark Blue Cross Blue Shield Delaware, was scheduled to go into effect in January.
After realizing this change this summer, retirees were alarmed and outraged. Many have worried about being forced to purchase health insurance that could deny or delay care. The state has long had a reputation for providing an illustrious benefits package.
A handful of lawmakers, Democrats and Republicans, spoke out against Medicare Advantage, saying they felt misled by the Carney administration. Ahead of Wednesday’s decision, the Delaware General Assembly was scheduled to meet Oct. 26 to vote on legislation to better oversee the process of transitioning to Medicare Advantage.
Lawmakers previously said they had no power to block implementation of the new plan. It is unclear if the special session will still take place next week.
Senate Democratic leaders said in a statement that “they intend to use this opportunity to continue our efforts to work with state retirees to ensure that any changes to their health care benefits are living up to our commitments to them, protecting their health and well-being, keeping the program solvent.” , and are properly communicated.
Medicare Advantage plans have come under intense scrutiny in recent months. The U.S. Department of Health and Human Services’ Office of Inspector General released a report this spring that found there were “widespread and persistent issues related to inappropriate service and payment denials.”
The New York Times recently published an investigation that revealed that health insurers were exploiting this federal program to increase their profits by billions of dollars.
This isn’t the first time a court has ruled against Medicare Advantage plans. New York retirees filed a similar lawsuit, and in March a judge ruled the city must allow retirees to opt out of Medicare Advantage and maintain their current health care plan.
Contact Meredith Newman at mnewman@gannett.com.
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