Hard Times

from Asclepios - Weekly Medicare Consumer Advocacy Update from Medicare Rights Center People, just like banks and insurance companies, sometimes fall on hard times. Sometimes, when the hardship is severe and not of the person’s own doing, we as a society decide, that the government should help out. (Banks and insurance companies get to play by different rules.) For example, people who are hit with an illness or injury that is severely and permanently disabling can qualify for Social Security Disability Insurance (SSDI) payments and, eventually, health coverage through Medicare. Working people all pay into these social insurance programs so that we have health coverage and economic security in the event we become disabled and cannot work. But the health coverage through Medicare does not kick in when we need it most. People with disabilities must wait two years from the day they receive their first SSDI check to receive Medicare benefits. There are currently about 1.5 million people in the two-year waiting period. The poorest receive comprehensive coverage through Medicaid. However, as tax revenues decline in tough economic times, states are often forced to tighten Medicaid eligibility, potentially denying health coverage to people with disabilities. About one quarter—375,000 people with disabilities—are without insurance for the entire waiting period. For many, that means going without care, going into debt or both. Many of the rest—about half of older SSDI recipients—receive coverage through their former employer under the COBRA program. For the first 18 months, they pay 102 percent of the total premium, including the portion their employer used to pay. For the next 11 months, the monthly premium goes up to 150 percent of the total cost. The average annual premium under employer plans is now $12,680 for a family, $4,704 for an individual. 150 percent of $4,704 is $7,056, or $588 per month, tough to pay when the average SSDI check is about $1,000. Besides the premium, many employer plans now carry hefty deductibles—more than one-third of employees in small firms have deductibles greater than $1,000—and many do not cover all the services that people with disabilities need. In short, even people in the waiting period who have coverage still cannot afford health care. But how can we afford to spend billions on health coverage for people with disabilities when we just spent over $1 trillion bailing out financial institutions that made stupid and risky investments with borrowed money? That is a very strange, some would say, backwards, question. The fact that we are even asking this question indicates the skewed priorities in Washington. Most lawmakers from both parties in Washington agree that we “have to” bail out Wall Street to prevent the economy from imploding. They disagree mostly over whether taxpayers can recoup some of their money from the companies we bail out, once they start turning a profit again. But only 23 senators have signed on to S. 2102, “Ending the Medicare Disability Waiting Period Act of 2007.” Senator Barack Obama, Democrat of Illinois, is among the cosponsors. Senator John McCain, Republican of Arizona, is not. Only 98 of the 435 members of the House of Representatives have signed on to HR 154, the House version of the bill. We need to work now so that next year Congress and the new President make it a priority to end the two-year wait for Medicare for people with disabilities. Urge your senators and representatives to cosponsor the “Ending the Medicare Disability Waiting Period Act of 2007.” Tell the story of your experience waiting for Medicare coverage or join the Medicare Rights Center’s effort to end the wait.