United States Court of Appeals
For the District of Columbia Circuit
Decided February 7, 2012
BRIAN HALL, ET AL., APPELLANTS
v.
KATHLEEN SEBELIUS, SECRETARY OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND MARK J. ASTRUE, COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION, APPELLEES
KAVANAUGH, Circuit Judge: This is not your typical lawsuit against the Government. Plaintiffs here have sued because they donāt want government benefits. They seek to disclaim their legal entitlement to Medicare Part A benefits for hospitalization costs. Plaintiffs want to disclaim their legal entitlement to Medicare Part A benefits because their private insurers limit coverage for patients who are entitled to Medicare Part A benefits. And plaintiffs would prefer to receive coverage from their private insurers rather than from the Government.
Plaintiffsā lawsuit faces an insurmountable problem: Citizens who receive Social Security benefits and are 65 or older are automatically entitled under federal law to Medicare Part A benefits. To be sure, no one has to take the Medicare Part A benefits. But the benefits are available if you want them. There is no statutory avenue for those who are 65 or older and receiving Social Security benefits to disclaim their legal entitlement to Medicare Part A benefits. For that reason, the District Court granted summary judgment for the Government. We understand plaintiffsā frustration with their insurance situation and appreciate their desire for better private insurance coverage. But based on the law, we affirm the judgment of the District Court.
Comment:
By Don McCanne, MD
Although the government requirement that an individual be required to purchase an unwanted private health plan is being challenged before the Supreme Court, it is reassuring that Medicare is so well established within our laws that an individual over 65 who is receiving Social Security cannot disclaim their legal entitlement to Medicare Part A benefits, even though they can refuse to receive those benefits.
It is unfortunate that Congress chose a model of reform that depends on an unpopular and possibly illegal mandate to purchase private health insurance, with a financial penalty for those who fail to comply. Medicare, one of the nation’s most popular programs and one for which there is no legitimate legal challenge, should have been selected instead.
An improved Medicare for all would have been much more effective and less expensive, and would not have had to face legal challenges. All of us can have Medicare, if we, as the people, demand it.