Policy Groups Ask Trump to Allow Medicare Opt-Out

Published December 19, 2018

In 1993 and again in 2002, the Social Security Administration (SSA) and the U.S. Department of Health and Human Services (HHS) made Medicare Part A enrollment a requirement for eligibility for Social Security benefits, resulting in a drastic loss of Social Security income for those who choose to opt out of Medicare.

The U.S. Constitution grants exclusive legislative power to Congress, which means SSA and HHS did not have the authority to impose the eligibility rule, the letter states. The Citizens’ Council for Health Freedom (CCHF) published the letter in November.

‘You Have the Authority’

The letter calls on Trump to restore the voluntary nature of Medicare. “[W]e write to you with a very specific request: to rescind, by executive action, the current administrative procedures that unlawfully condition seniors’ access to Social Security retirement benefits on Medicare enrollment,” wrote Twila Brase, the president of CCHF.

“These procedures effectively trap seniors in Medicare, but you have the authority to liberate them. Congress has made clear, in the statutory text, its understanding and intention that the program is voluntary. But current administrative procedures effectively defeat this intention.”

Arianna Wilkerson, a government relations coordinator with The Heartland Institute, which publishes Health Care News, says the coalition is right in asking the president to revoke the rule.

“This letter sends the message that the country has had enough of being forced by the federal government to buy into health care programs that some do not want to be enrolled in,” Wilkerson said. “Giving seniors the option to choose a different insurance plan is the right move.”

Considers Origins Dubious

Brase says the current rules for Medicare are unique.

“In many other entitlement programs, such as Medicaid, even if you’re entitled to it, even if you qualify for it, even if your income is a qualifying factor, you are not required to take it,” Brase said. “My guess is [the rule is] part of something the Clintons wanted as part of their universal health care system. It would solidify the program’s grasp on the seniors in ‘Medicare for All.'”

Brase says the mandate has no basis in the law.

“In this case, the language states that you have to take Medicare if you want to get your Social Security benefits,” Brase said. “But there is no law, no rule mandating that. There are people who have private health insurance that they would like to keep as their insurance, but in order to get their lawful Social Security benefits, which were taken from them all of their working lives, they have to go into Medicare.

“They don’t want to be dependent on Congress for what is and isn’t covered and what is or isn’t paid for, but if they decide not to use Medicare, they have to pay back all Social Security benefits,” Brase said.

‘The President to Do This’

Brase says the letter is a formal document following conversations the coalition has been having with the Trump administration.

“We have been in conversations with the Trump administration, trying to move the president toward removing this language,” Brase said. “It’s as simple as removing it. It’s not a law or rule. He can tell his administration to issue an executive order.

“I believe that President Trump is the president to do this,” Brase said. “I don’t know who the next president will be, but it’s hard for me to imagine any other president willing to strip it out of there just because it’s the right thing to do,” Brase said.