Soon you seniors may be able to remove yourselves from Medicare, still maintain your Social Security, and be able to choose a private insurance plan that fits your needs.
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Soon you seniors may be able to remove yourselves from Medicare, still maintain your Social Security, and be able to choose a private insurance plan that fits your needs.
A lawsuit, Hall versus Sibelius. Was filed on October 9 charging the Social Security Administration, (SA), and the Department of Health and human resources, (HHS), from continuing illegal and coercive policies that deny you your rightful Social Security benefits, if you want to quit Medicare.
Government lawyers argue that seniors have not been harmed by the current policies, and none of the plaintiffs in the lawsuit exhausted administrative remedies that were available to them.
The court denied the motion of the government to dismiss the case. The court can now has a chance to void the five other rules (created by the Clinton Administration in 1993) that made individual Social Security a requirement benefit contingent upon your enrollment in Medicare.
The federal court said that federal law requires no such thing, and the SSA created this retirement ruling out of thin air without public notice in the Federal Registry, and without public comments.
The court asserted that since the POMS (Program Operations Manual) determines the plaintiff's rights and obligations, it must be subject to judicial review. They added that the plaintiff’s failure to exhaust administrative remedies would be futile.
Plaintiff Hall tried to exhaust administrative remedies but was stalled for more than three years and was forced to roll into Medicare. He was told he could not get out of Medicare part D. and keep his Social Security. The court said that this show the government had no intent t to change the POMS.
The judge ruled, when an agency demonstrates an unwillingness to reconsider its position, and there is certainty of an adverse decision, and where the challenge to the agency's policy and practice were systematic failure to comply with the federal law, exhaustion of administrative remedies must and will be excused. It's impossible to get legal recourse in the federal courts, it the system will not move you through the administrative appellate process.
Since there is no policy found in the Social Security act or federal regulations created by the SSA, that expressed exhaustion of appeals would be futile, the court denied the government's motion.
The POMS, (Program Operation Manual), determines the plaintiff's rights and obligations and is the source from which legal consequences flow.
THE FIVE POMS RULES CAN NOW BE CHALLENGED
The POMS manual requires enrollment in Medicare part D., as a condition to getting Social Security retirement benefits. It mandates, if you want to do remove yourself from Medicare part A, you must surrender all the Social Security retirement benefits you received.
The POMS manual violates the social securities statute that Congress enacted making federal programs completely involuntary. No federal agency has the authority, either statutorily or constitutionally, to legislate requirements that deal with a person's entitlement to Social Security retirement benefits that are not specifically enacted by Congress.
THE FIVE PLAINTIFFS SUING ARE:
Former US Rep for Texas, Dick Armey the lead plaintiff Hall (a former HUD employee), John J. Kraus was (an aerospace and defense industry engineer, who retired in 2007 from the
U.S. Naval Air Systems Command), Lewis Randall (a private investor who served on the board of directors for E*Trade), and Norman Rogers (a UC Berkeley grad and founder and CEO of Rabbit Semiconductor).
PLANTIFF CLAIMS
Plaintiffs claim that the Social Security act and Medicare act clearly state that applying for Social Security monthly benefits and enrolling in Medicare are both voluntary. The application for one of these programs is not dependent on the application for the other. The Social Security Act, and the Medicare Act are violated since the new SSA rules make enrolling in Medicare mandatory. This SSA also violates Article I, Section 1 of the Constitution.
To be forced to participate in Medicare, infringes on their right to privacy, and their right to make necessary choices about their own health care. It also violates the First, Fourth, Fifth, Ninth, and Fourteenth Amendments to the Constitution.
The plaintiffs claim the new SSA rules violate the administrative procedure act. The new social security rules were put into place without the required notice and comment rulemaking requirements. The policy should also have been published in the Federal Register, and open to comment by the general public, before the SSA rules were implemented.
Dick Armey, former congressman, had a government tax supported healthcare plan as a congressman and now as a retired government worker. When his Medicare kicked in, he wanted to keep his own congressional taxpayer subsidized insurance, and SSA and Medicare prevented him from doing that.
Medicare said: “If you give up Medicare, you give up your social security retirement plan”. He could not get out of Medicare without losing his Social Security benefits. He charged he was denied the government option to choose the medical services that best meet his needs.
By having a new government option for health insurance claims, the government would compete on a level playing field with private insurers. The lawsuit claims that seniors were coerced into enrolling in a Medicare program rather than purchasing private insurance. The government decreed, “those who opt out of Medicare for private insurance, must also forfeit all past and future Social Security benefits”.
Because of this enforcement of the POMS, plaintiffs lose their superior federal private healthcare benefits and health savings accounts, under their Federal Employee Health Benefits program.
Two of the plaintiffs had private health insurance and also health savings arrangements. Both would be disrupted by the POMS when they applied for their Social Security retirement benefits. They claim that the POMS violated the Social Security Statute that Congress enacted which makes both federal programs completely voluntary. No federal agency has the authority to legislate requirements that link it with an individual's entitlement to Social Security retirement benefits, which was not enacted by Congress.
None of the plaintiffs wanted to be enrolled in Medicare, since they believed it restricted their senior access to health care. They argued that since the retirement funds that were paid into the system for decades are threatened, they are forced to accept inferior care to what they can purchase. They want to avoid rationed care that promises reduce services under the current health reform proposals. By being forced into Medicare, they have each lost many of their federal employee health benefits, that amount to a price tag loss of about $30,000 to each of them.
COURT DECISION IS COST-EFFECTIVE FOR MEDICARE
The waste that is piled onto Medicare patients with a cumbersome competitive bidding process, results in longer hospital stays and blocks more cost-effective homecare. If only 1% of Medicare eligible seniors choose not to participate, Medicare costs would decrease by about 1.5 billion each year. These savings would continue to increase for several decades as baby boomers retire.
You current seniors and boomers, have a choice to have Medicare forced down your throats or be robbed of your Social Security benefits. In 2030, the older population, will be twice as large as it was in 2000 (growing from 35,000,000 to 71,000,000), and representing nearly 20% of all Americans.
HISTORY
The current law says if you're getting a Social Security check, you're getting Medicare part A.
The Clinton Administration in 1993 said that the only way to avoid health insurance would be to withdraw from the monthly benefit application. No person could elect to withdraw only to Social Security claim This change in Social Security regulation to those over 65, gave everyone a choice to enroll in Medicare, or wave their Social Security retirement benefits. If you apply for Social Security at 62, and received Social Security payments, you would have to pay all this money back if you opt out of the Medicare health insurance program.
The SSA also added two substantive rules in 1993 to it's POMS (program operations manual), covering those people who asked to waive hospital insurance because of religious or philosophical reasons, or preferred other health insurance.
These rules were as follows:
Individuals entitled to monthly benefits which makes them eligible for health insurance, may not waive health insurance entitlement. The only way to avoid HIA entitlement is by withdrawing your monthly benefit application. This then required repayment of all retirement, survivors, and disability insurance, and all health insurance benefits payments. If you withdrew from the health insurance program, you must submit a written request for withdrawal and must refund any benefits paid on your behalf.
The Bush administration, in May of 2000, added to the social security POMS (program operations manual), that a claimant can withdraw an application for retirement or survivors insurance Social Security, cash benefits. However, if you are entitled to monthly Social Security benefits, you cannot withdraw only from Medicare part coverage, because entitlement to Medicare part A. is based on entitlement to monthly Social Security benefits.
MEANING TO SENIORS
Government bureaucracy prevents you seniors from paying your own doctor with out-of-pocket money. It also forces you seniors to enroll in Medicare if you want to get Social Security and other government benefits. Even if you have money, and want to get out of Medicare and a government program, you currently are stuck.
Recently a bill was sent to Congress, called the Medicare Beneficiary Freedom to Choose Act, HR 3356. This act would put you in control of their health decisions by allowing you to choose your own doctors in Medicare. We'll see where this Bill will go.
COMMENTARY
With a new health reform bill being planned, it would be nice if you seniors could have the freedom to make your own personal health decisions. For the last 16 years, you thought that the only choice you had was between substandard medical care and getting Social Security retirement funds. Now all that may change with the Hall versus Sibelius decision.
A fiscally unsustainable and unaccountable plan, with price controls regulate health policies that can harm your care, makes most of us want to get out of Medicare or other proposed government controlled healthcare programs.
Price controls prohibit you from using your own money to pay for any extra services or get better service that you may want from a doctor. You can't maintain a confidential doctor patient relationship and can’t offer a doctor any out-of-pocket money to achieve a better treatment program.
If you're smart enough to ask what the best treatment is for your particular ailment, you'll find that your umbrella policy will not cover your better alternative treatment since Medicare will pay for a less effective treatment. Lawyers in congress, who, unlike your doctor, know nothing about your specific medical situation, will tailor all the services and treatments you need.
The White House is attempting to convince you that by seizing control of your health care, they will better manage your medical costs. All indications show otherwise.
If you want better care, which you can afford, Medicare, will not allow you to offer your doctors any additional money. If you would pay the doctor more, you might get you better care. Currently if he accepts any money, he could go to jail.
Under these health reform plans, everyone has to be treated the same. If you need an operation you might be told: “We'll get to you in six months”.
You the reader must evaluate the valid points raised here, and realize that the health reform package has everything to do with power and political control, and absolutely nothing to do with controlling medical costs.
Soon your healthcare options will be stripped away, unless of course, you are a member of Congress that is currently writing this reform bill. CONGRESS will not accept for themselves, the plan tailored for you.
Don't expect the government to settle this Hall v. Sebelius lawsuit before new health-care reform is law.
What do you think? Your comments are always appreciated.
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