Health

Older Americans Need More Health Freedom

And they can get it, on Day 1, if the president-elect rights a 23-year wrong

Are you aware of how few options your aging parents have when it comes to their health care?

On Aug. 30, 1993, the Social Security Administration (SSA) under President Bill Clinton added two new rules to its “Program Operations Manual System (POMS)” regarding disenrollment in Medicare Part A (or HI). It did so without public notice or comment.

The only way out of Medicare is to say goodbye to one’s Social Security payments.

“Individuals entitled to monthly [Social Security] benefits which confer eligibility for HI may not waive HI entitlement. The only way to avoid HI entitlement is through withdrawal of the monthly benefit application. Withdrawal requires repayment of all Retirement, Survivors, Disability Insurance (RSDI) and HI benefit payments,” the rules state. RSDI includes Social Security retirement benefits.

In short, the only way out of Medicare is to say goodbye to one’s Social Security payments — all those dollars taken out of every paycheck all throughout one’s working life — and to pay back any Social Security and Medicare benefits a senior citizen has already received. Seniors are not allowed to separately drop out of Medicare. As the SSA emphasizes, “The individual may not elect to withdraw only the HI claim.”

In 2002, the SSA under President George W. Bush strengthened this prohibition by issuing another rule — again without public notice or comment. It states that citizens can only withdraw from: 1.) RSDI cash benefits; 2.) RSDI cash benefits and HI insurance; or 3.) Medicare Part B only. It also states Americans entitled to Social Security benefits “cannot withdraw HI coverage only since entitlement to HI is based on entitlement to monthly benefits.” In other words — because Medicare (HI) entitlement is attached to Social Security benefits, the SSA claims you can’t “un-entitle” yourself.

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A lawsuit on the matter was filed in 2008. Former U.S. Senate Majority Leader Dick Armey was one of several plaintiffs in Hall v. Sebelius. The case made it all the way to the U.S. Supreme Court, which in January 2013 opted not to hear it.

Earlier, on Feb. 7, 2012, the D.C. Court of Appeals ruled against the plaintiffs. Federal Judge Brett Kavanaugh, who wrote the decision, acknowledged the plaintiffs “have suffered injuries in fact from their reduced private insurance” due to curtailment of private coverage and reduced benefits, but he ruled there was no statutory way to “disclaim their legal entitlement to Medicare Part A benefits.”

Related: Our Real Opportunity to Restore Health Freedom

Judge Karen LeCraft Henderson disagreed. She said the regulations gave the SSA power that Congress never provided, and nothing in the law prohibits citizens from receiving their Social Security benefits if they opt out of Medicare Part A. Yet the mandate still stands.

Senior Citizens Need Freedom to Buy Private Insurance
Medicare has a $43 trillion unfunded liability and rationing strategies are being imposed on Medicare patients under the Affordable Care Act (aka Obamacare) and the Republicans’ Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

President-Elect Trump can strike these rules from the Social Security Administration’s program operations manual with a simple executive order.

One page. One pen. One signature. On Day 1.

Related: Home Health Care: 5 Urgent Questions to Ask

Under this new wave of freedom, a new market for private insurance for all citizens would emerge — starting with senior citizens who choose to keep their private health insurance to the end of their days. All citizens need the freedom to find a private policy that meets their personal needs and isn’t vulnerable to the political winds and budgetary restrictions of Congress.

There’s no better day to deliver this long overdue health freedom to Americans than Inauguration Day, Jan. 20, 2017.

Twila Brase, R.N., named one of the “100 Most Powerful People in Health Care,” is co-founder of Citizens’ Council for Health Freedom, a national patient-centered health freedom organization in St. Paul, Minnesota, and of a patient-focused initiative called The Wedge of Health Freedom.

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