Delaware Liberal

Fighting Against Medicare Advantage

Guest post by Representative John Kowalko (25th District, retired)

Over the past year and a half, I have dedicated much of my energy to exposing the fraudulent and dishonest Medicare Advantage Plans for what they are.

This issue has now become the focal point of thousands of ads on television promoting the private insurance industry’s attempts to continue draining billions of dollars of Medicare funding from the system into the insurers’ coffers.

During these commercials, these grifters deliberately omit the realities of harm to the program and the patients who subscribe to it. The truth is that in many if not most situations these plans restrict health care access, restrict, and often deny necessary tests, treatments, pharmaceuticals, and doctors. There are often insurmountable hurdles imbedded in these Medicare Advantage (Disadvantage) plans.

Scores of emails that I’ve received and testimonials that have been documented record the horror stories that many Medicare Advantage enrollees have experienced.

Make no mistake about it. All Medicare Advantage plans displace those who enroll from the government program of Medicare. All Medicare Advantage plans are “privatization” of Medicare and are administered and run by private health care insurers who enjoy immense profits at the expense of those enrolled in their plans.

While we, at RISE, continue to focus our attention on the immediate problem of Governor Carney’s appointees trying to mandate a Highmark Medicare Advantage for all State retirees with no other options, we intend to continue our efforts to displace Medicare Advantage plans as an option nationally.

In Delaware the Governor’s appointees, Claire DeMatteis, Cerron Cade and Rick Geisenberger have lied and deliberately spread misinformation about the Highmark-crafted Medicare Advantage plan. They have lied about the timing of contracts that were allegedly signed and they have tried to perpetuate the falsehood that Highmark’s Medicare Advantage program is not only equal to but better than the existing Medicare supplement plan known as Medicfill that retirees currently enjoy. Their efforts to cheat retirees out of their contractually earned benefits and renege on Delaware’s promises to those retirees should and must be exposed.

The reality that these plans were contrived and conceived in secret meetings outside the public’s view and then presented as a fait accompli demonstrates a serious dishonesty and callous disregard for state retirees. Only the lawsuit filed by RISE enabled a stay of the mandate and a reconsideration of a Medicare Supplement as the retirees’ option. Now the Delaware Legislature must act on behalf of the State employees, teachers, University of Delaware and Police and others to keep those promises made to all of those who have diligently and faithfully served all Delawareans’ best interests over the years.

Medicare Advantage plans will cost retirees money, health care access, and in some cases their lives, needlessly lost.

This Administration tried to impose a Medicare Advantage program on its employees that has over 2,000 impediments to health care access that are not in the current Medicfill supplement program. These include limiting access to your current doctor, specialists, necessary tests, treatments, and pharmaceuticals. These preauthorization requirements and denials of treatments would directly impact the health and well-being of thousands of retirees in Delaware.

This is not some exercise in histrionics or unsubstantiated conjecture. You can see for yourselves by viewing the Highmark Medicare Advantage contract with Delaware, allegedly signed September 28, 2022, at this link.

To date, RISE, hundreds of volunteers, and attorneys retained by RISE at significant expense have managed to ferret out the lies and misinformation presented by this Administration and secured a court ordered temporary stay to this mandate, but it will take more money and a definitive effort by the legislature to secure the promises made to its retirees.

Contributions to the legal fund may be sent to RISE Delaware, PO Box 7262, Newark DE 19714.

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