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End the Wait
November 16, 2006 • Volume 6, Issue 46Every year, many of the approximately 800,000 people who become disabled due to illness or injury are quietly denied access to needed health care. Five months after the Social Security Administration deems someone to be severely disabled, an individual can begin receiving disability insurance. But she must then endure an additional 24-month waiting period before receiving Medicare coverage.
Twenty-four months. That means that when the next presidential election rolls around, people who were deemed disabled in June of this year will finally have affordable, reliable medical insurance. Will our elected leaders have acted to remedy this injustice by then?
A bill to end the 24-month waiting period, sponsored by members of Congress from both parties, stalled last year. When fresh faces arrive on Capitol Hill in January, though, they will have another opportunity to stand up for people with disabilities.
It is imperative that they do. Legislation delaying needed health coverage for people with disabilities remains unchanged, at a time when the number of uninsured Americans continues to increase and medical bills have become the leading cause of personal bankruptcy.
The two main options now available for people with disabilities—COBRA coverage and Medicaid—have become increasingly untenable Under the COBRA program, workers who must leave their jobs under certain circumstances, such as a disability, can keep their health benefits for 18 months. But many people cannot afford the rising cost of coverage on their limited, fixed incomes: the average disability payment from Social Security is around $900 a month.
Others never even had access to employer-based insurance in the first place. The number of employers providing health benefits has been declining steadily over the past several years, particularly among those with high proportions of lower-wage workers.
Medicaid is also becoming a less viable safety net for people left without coverage, as states cut back on eligibility to curb spending. This year, 18 states reduced or restricted eligibility as a cost-containment strategy, and 45 states in total have done so in at least one of the past five years.
It’s clear that looking to COBRA and Medicaid is not the right solution. Eliminating the 24-month waiting period is.
Several of the candidates who were newly elected to Congress last week told the Medicare Rights Center during the campaign season that they will cosponsor legislation eliminating the 24-month waiting period. They are Senators-elect Ben Cardin, Democrat of Maryland; Claire McCaskill, Democrat of Missouri; Sherrod Brown, Democrat of Ohio; and Representatives-elect Ed Perlmutter, Democrat of Colorado; Ron Klein, Democrat of Florida; Patrick Murphy, Democrat of Pennsylvania; and Peter Welch, Democrat of Vermont.
It is time Congress abolishes this unjust and harmful two-year delay in Medicare coverage. People with disabilities have waited long enough.
Medical Record
“Once individuals are approved for SSDI [Social Security Disability Insurance] and receive their first disability check five months later, their two-year wait for Medicare coverage begins in earnest. Nearly all say they are forced to pay out-of-pocket for most services and almost all prescription medication; put off doctor’s visits, or visit much less frequently, or not at all (some opting to use the emergency room instead); and, in many cases, forego necessary medications, tests, and rehabilitation therapy. Because of lack of coverage, these individuals say they access services sporadically at best, and inconsistent care is taking a toll on their health” (“Waiting for Medicare: Experiences of Uninsured People with Disabilities in the Two-Year Waiting Period for Medicare,” available through The Commonwealth Fund, October 2004).
“Eligibility reductions are among the most difficult cost containment measures undertaken by states to constrain Medicaid costs because they negatively affect low-income and vulnerable populations who rely on Medicaid for access to needed health and long-term care services. However, due to the length and severity of the economic downturn that began in 2001, a total of 45 states made restrictions or reductions to Medicaid eligibility in at least one of the five years from FY [fiscal year] 2002 to FY 2006” (“Low Medicaid Spending Growth Amid Rebounding State Revenues: Results from a 50-State Medicaid Budget Survey State Fiscal Years 2006 and 2007,” Kaiser Commission on Medicaid and the Uninsured, October 2006).
“Sixty-one percent of firms offer health benefits to at least some of their employees…Sixty-five percent of higher wage firms (less than 35% of workers earn $20,000 or less annually) offer health benefits, compared with 42% of firms with a greater percentage of lower-wage workers” (“Employer Health Benefits 2006 Annual Survey: Summary of Findings,” Kaiser Family Foundation and Health Research and Educational Trust, September 2006).
“Between spring of 2005 and spring of 2006, premiums for employer-sponsored health insurance rose by 7.7%, a slower rate than the 9.2% increase in 2005 and 11.2% increase in 2004. Despite this slowdown, premiums continued to increase much faster than overall inflation (3.5%) and wage gains (3.8%)” (“Employer Health Benefits 2006 Annual Survey: Summary of Findings,” Kaiser Family Foundation and Health Research and Educational Trust, September 2006).
***** The Medicare Rights Center (MRC) needs to hear about all the problems with the Medicare Part D benefit, whether they happen to you or someone in your community. With this information, we will be armed with the needed evidence to push for a Medicare-administered drug benefit.
Fast Relief: Part D Monitoring Project
Submit your story at www.medicarerights.org/partdstories.html
*****
The Louder Our Voice, the Stronger Our Message Asclepios — named for the Greek and Roman god of medicine who, acclaimed for his healing abilities, was at one point the most worshipped god in Greece—is a weekly e-newsletter designed to keep you up-to-date with Medicare program and policy issues, and advance advocacy strategies to address them. Please help build awareness of key Medicare consumer issues by forwarding this action alert to your friends and encouraging them to subscribe today.
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