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Court halts state switch to Medicare Advantage

Charlie Megginson Government, Headlines

Medicare Advantage blocked by judge Delaware

Retirees say they were willing to accept lower wages during their careers because they were promised good benefits upon their retirement. (Charlie Megginson/Delaware LIVE)

The state’s plan to transition state government retirees’ health insurance from original Medicare to a privately-managed Medicare Advantage plan has been temporarily blocked. 

A Delaware Superior Court judge on Wednesday ordered the state to halt implementation of the plan until the case is fully adjudicated. 

The court will schedule a trial to make a final determination on the fate of the Medicare Advantage plan, according to the ruling.

RELATED: Change to state retirees’ health insurance prompts angst

“The court agrees that if the stay is not granted, plaintiffs will be substantially harmed by the denial of the stay because the deadline for switching benefits through Open Enrollment is Oct. 24, 2022,” wrote Judge Calvin Scott Jr. 

“This means retirees will be forced to enroll in the new Medicare Advantage plan or stay with traditional Medicare and give up their state-subsidized benefits within the next few days…”

Scott wrote that state retirees would suffer irreparable harm if he did not issue a stay, because their health insurance, “which they have a reasonable expectation of continuation, is at stake.”

RELATED: State retirees protest Carney admin’s Medicare Advantage plan

In a statement to Delaware LIVE News, Emily David Hershman, Gov. John Carney’s director of communications, said the governor’s office is reviewing Wednesday’s ruling and its appeal options.

“We are committed to providing state pensioners high quality, accessible and affordable healthcare benefits, which the transition to a custom-designed Medicare Advantage plan provides,” Hershman said.

The judge ordered that the state take “all necessary and proper steps” to ensure that the existing original Medicare plan “remain in full force and effect.”

In a news release, Delaware Senate President Pro Tempore Dave Sokola, Majority Leader Bryan Townsend and Majority Whip Elizabeth “Tizzy” Lockman said their “number one concern is the health and welfare of state pensioners.”

“We intend to use this opportunity to continue our efforts to work with State pensioners to ensure any changes to their healthcare benefits live up to our commitments to them, protect their health and welfare, keep the program solvent, and are properly communicated,” the Democratic leaders said.

House Speaker Pete Schwartzkopf and Majority Leader Valerie Longhurst followed with a statement of their own.

“Throughout this process, we have closely followed the court case regarding the move to the new healthcare system,” Schwartzkopf and Longhurst said. “The Superior Court ordering a pause injects uncertainty into this situation for our retirees, but we are committed to supporting them throughout this process.”

The Democratic House leaders said they’d “re-engage the administration” and retirees on potential next steps.

Earlier this month, the General Assembly unveiled a bill aimed at creating additional oversight.

Both chambers scheduled an Oct. 26 special session in Dover to debate and vote on the bill. It’s not clear if they’ll move forward with the session given the court’s ruling.

The lawsuit was brought by Retirees Investing in Social Equity Delaware, or RISE. 

The group represents former state employees, many of whom have said the reason they were willing to sacrifice private-sector wages and dedicate their working lives to the state was the promise of lucrative benefits upon their retirement.

Now they’ve made it to the finish line, and many feel the rug is being pulled out from beneath their feet at a time when the government claims record budget surpluses

RISE is helmed by outgoing Rep. John Kowalko, D-Newark, New Castle County Councilwoman Lisa Diller, former state Sen. Karen Peterson, D-Christiana, and others.

Medicare Advantage ruling


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