A Delaware Superior Court judge on Wednesday temporarily blocked an effort to move state retirees to a Medicare Advantage health care plan.
Judge Calvin Scott ruled that the state shall “take all necessary and proper steps” to ensure that retirees’ current health care insurance and benefits “remain in full force and effect.”
Headed to trial
A trial will be held to make a final determination on the future of the Medicare Advantage plan, the ruling stated.
THE BACKSTORY:Delaware Legislature to hold special session amid outrage for retiree Medicare Advantage plan
The temporary block is a major win for a group of state retirees, who have been protesting the switch in recent weeks. The deadline for the 30,000 state retirees to opt out of the Medicare Advantage plan, and as a result lose state-sponsored health care, was 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 allowing retirees to offer input.
Karen Peterson, a former state senator and Department of Labor employee, was one of the plaintiffs.
“I took no pleasure in having to sue state officials 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 of working for the state, and somebody had to fight back.”
Emily David, a spokeswoman for Gov. John Carney, said the administration is “reviewing today’s interim ruling and our 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,” she said.
Earlier this year, the Carney Administration decided to move state retirees to a Medicare Advantage plan as a way to decrease the state’s ballooning unfunded liability. Estimates show it could grow to $33 billion by 2050.
Medicare Advantage plans are Medicare plans that are offered by private insurers. The Delaware plan, being offered by Highmark Blue Cross Blue Shield Delaware, was set to go into effect in January.
Once realizing this change this summer, retirees were alarmed and outraged. Many became worried that they would be forced to sign up for health insurance that could deny or delay care. The state has had a long reputation for providing an illustrious benefits package.
A handful of lawmakers, Democrats and Republicans, have come out against Medicare Advantage, saying they felt they were misled by the Carney administration. Prior to Wednesday’s ruling, the Delaware General Assembly was set to meet Oct. 26 to vote on legislation to provide more oversight to the transition process of moving to Medicare Advantage.
Legislators previously said they didn’t have the power to block the implementation of the new plan. It’s unclear if the special session will still be held next week.
Senate Democratic leadership said in a statement that ” they 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.”
Medicare Advantage plans have received intense scrutiny in recent months. The U.S. Department of Health and Human Services Office of the Inspector General published a report this spring that found that there have been “widespread and persistent problems related to inappropriate denials of services and payment.”
The New York Times recently published an investigation that found that health insurers exploited this federal program in order to increase their profits by billions of dollars.
This is not the first time a court has ruled against Medicare Advantage plans. New York retirees filed a similar lawsuit and, in March, a judge ruled that the city must allow retirees to opt out of the Medicare Advantage plan and maintain their current health care plan.
Contact Meredith Newman at mnewman@gannett.com.
