Letter to the Editor: State retiree Medicare proposal outcome ‘a cruel mistake’

Editor’s note: The following was sent to Gov. John Carney on April 30.

I am a Delaware retiree on Medicare parts A and B, with the Medicfill Supplement and Part D provided as a part of my Delaware retirement plan. I just viewed your town hall held in Dover on April 27. I am very concerned by many things that you said there.

I have been looking at health care issues intensely ever since I realized, last August, the implications of what the State Employee Benefits Committee was doing to us retirees by forcing us into Medicare “Advantage.” I have learned enough about it by now to know that it is a bad option for all of us who retired with the expectation of living to the end of our lives with the good health care that was promised us.

If I heard you correctly, you still intend to continue your effort to get retirees into Medicare “Advantage.” You seem to believe that, if only you could explain it to us well enough, we would be willing to submit to it.

You seem to think that the contract with Highmark is special and, essentially, the same as the supplement and that we retirees just don’t understand. The contract has service delays caused by 40 pages (over 2,000 items) of preapprovals, an 8% denial rate, in-network provider limitations and new sources of needless uncertainty and contention for aging consumers. It isn’t the same as traditional Medicare, and we do understand. If you were to read the judge’s stay order from last October, you would see that it is spelled out very clearly how Medicare Advantage is not the same. As I heard you speak extensively about this issue in the town hall, I came to worry that you are not receiving good advice on the subject because so many of your statements are at odds with how we retirees understand this issue.

I also heard you express concern for the future solvency of the entire Medicare system, and you quoted someone who expressed the concern, when you served in Congress, that the U.S. would eventually become a giant health care provider with a small army and nothing else. Solvency of Medicare is certainly a concern for all Americans.

You may not have seen the latest report issued by the Medicare Payment Advisory Commission, submitted in March. (The Medicare Payment Advisory Commission is an independent congressional agency established by the Balanced Budget Act of 1997 to advise the U.S. Congress on issues affecting the Medicare program.)  I have shown below some information from their report (Chapter 11), addressing Medicare Advantage programs. They find numerous problems. The issue salient to your concern about Medicare solvency is that Medicare Advantage costs the federal government more than traditional Medicare. This is yet another reason for Delaware to avoid Medicare Advantage and stick with traditional Medicare. Here is the report:

March 2023 Report to the Congress: Medicare Payment Policy

Chapter 11: The Medicare Advantage program: Status report medpac.gov/wp-content/uploads/2023/03/Ch11_Mar23_MedPAC_Report_To_Congress_SEC.pdf

Summary points:

• Mandated report — Historical comparison shows Medicare Advantage payments consistently above fee-for-service spending (costs more than traditional Medicare).
• Coding differences increased payments to Medicare Advantage plans by $17 billion in 2021 and generated rebate inequity across plans (upcoding is the tool used by MA companies to generate more income).
• Quality in Medicare Advantage is difficult to evaluate (it is hard for enrollees to be able to compare their MA plan to other options).

I voted for you twice, and I don’t like having to oppose you on this issue. However, I think that you have not been well served by some of your advisers and that your administration has made missteps at virtually every step of rebidding Medicare retiree health care. The outcome was a cruel mistake.

I hope that you will reconsider your advocacy of Medicare Advantage for retirees.

Lynda Hastings

Hockessin