People who have retired from the state of Delaware and are now on Medicare will pay 5% more for the state’s special Medicfill insurance plan, a committee decided on Monday. The change starts Jan. 1.
The State Employee Benefits Committee had voted in March to increase premiums 9.4% for those on the group health insurance plan but not on Medicare.
“I’ve lost sleep over this,” said state Insurance Commissioner Trinidad Navarro. “I’d like everyone to know that. I think other members of the SEBC have as well because we know the challenges of living on a fixed income. But I think probably the most prudent thing to do is to recommend the 5% increase.”
The problem, from the committee’s perspective: not increasing premiums would add to the state’s projected deficit.
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The 5% increase would add $3.6 million to the projected $77.2 million deficit for fiscal 2024, compared to a $7.6 million increase to the deficit if rates don’t increase.
The 9.4% increase in premiums for current employees and retirees under 65 will give the state a projected $61.7 million and $8.9 million in fiscal 2024 respectively.
Rates would need to increase by 9.6% for fiscal 2025 and 2026 to address the growing deficit, which would increase to $476.7 million by fiscal 2027 assuming rates increased by 9.4% each year for all three groups, which include active employees, pre-65 retirees and retirees on Medicare.
People speaking during the public comment part of the meeting disagreed.
“Medicare retirees are not the problem,” Mary Graham said. “The problem, if you want to call it that … is the substantial deficit year after year after year after year of the non-Medicare retirees, and that dwarfs the surpluses of Medicare retirees.”
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Marca White, a retired state employee, said it isn’t fair to increase costs for retirees by any percent. “What fairness is there to increase this cost of this particular group’s healthcare by 9.4%, or even 5%, when it is already overfunded?” White said. “There is no fairness. I say there is none. Medicare with Medicfill and prescriptions are therefore not a problem. There is no fairness to further burden this particular Medicare group, who also has to pay between $165 and $188 a month to federal Medicare, where the other groups do not.”
The committee also voted to increase costs for prescription drugs for everyone.
The approved plan increases the cost of drugs purchased at the pharmacy to $10 for generic, $32 for brand formula and $60 for brand non-formulary, with each cost doubled for mail-order drugs, and keeping the same price for specialty drugs. This option would save the state $600,000 on the group health insurance plan.
Three other options presented by a consultancy called Willis Towers Watson would have kept the original cost for drugs purchased at pharmacies and through the mail, but increase the cost of a 31-day supply of specialty drugs to a max of $50, $75 and $125, with those costs doubled for a 90-day supply.
These plans would have saved the state an estimated $1 million, $2.7 million and $3.4 million respectively.
While the vote to raise rates by 5% was unanimous, committee members Thomas Brackin (executive director of the Delaware State Trooper Association) and Shaun O’Brien (policy director of the American Federation of State, County and Municipal Employees) voted against increasing prescription prices.
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