5,000 Baltimore Medicare recipients dropped from coverage, concerns legislator

Over the last few weeks, approximately 5,000 people in Baltimore City and Calvert County who were on the Johns Hopkins Medicine Medicare Advantage Plan received notice that their coverage ended. Their jurisdictions were removed from the program, seemingly leaving them with two choices: switch doctors and receive less coverage for services, or move to find Advantage coverage elsewhere. 

 

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Senator Cory V. McCray (D – Baltimore City) began receiving emails and calls from concerned constituents. He said the coverage drops would lead to urban Marylanders not receiving essential wraparound health services aimed at addressing social determinants of health.

“We know that in urban jurisdictions, people are dealing with significantly more health care challenges than other affluent jurisdictions. To be very specific, those with greater income levels. Folks in the city need this quality of care, this level of service, because of the challenges that we deal with, whether it’s lack of healthy food options, because they live in a food desert, maybe it’s the mental health piece because of the public safety issues that they’re dealing with, or maybe the homelessness. Whatever it is, this is only going to compound [and] exacerbate an already challenging jurisdiction by not offering up the service.”

In 2020, there were approximately 100,000 Medicare beneficiaries in Baltimore City, according to data from the Centers for Medicare and Medicaid Services (CMS). Based on his conversations with Hopkins leadership, the jurisdiction removal was in part due to low Medicare reimbursement rates. Maryland’s unique Total Cost of Care Model (TCOC) also caps how much a hospital can spend per capita. 

Since Medicare is under federal jurisdiction, McCray said the best he can do for his constituents is to make sure their voices are heard, as well as corresponding with U.S. Sens. Chris Van Hollen (D) and Ben Cardin (D). McCray said: 

“I know that negotiations are coming up with the [state Medicare] waiver, and I’m assuming that CMS and [the Center for Medicare and Medicaid Innovation] want to deal with these issues at that moment. But, that can’t wait. That needs to be dealt with right now because Baltimore City is indirectly impacted and being played with from a Russian Roulette standpoint.”

Johns Hopkins Medicine Medicare Advantage Plan did not respond to State of Reform’s request for comment.