Press Release
FOR IMMEDIATE RELEASE
Contact: Deane Beebe
Communications Director
212-204-6219
Medicare Rights CenterApril 11, 2007
Americans with Disabilities Suffer without Health Care and Incur Debt During Two-Year Wait for Medicare Coverage, Report Finds Dozens of Patient Advocacy Groups Call on Congress to Eliminate Two-Year Medicare Waiting Period Restriction New York, NY - Some 600,000 Americans with severe and debilitating disabilities are uninsured and go without health care or into debt while waiting the required two years for their Medicare coverage to begin, according to a report released today by the Medicare Rights Center.
“Congress must eliminate the cruel and arbitrary two-year wait for Medicare which punishes Americans who are hit by severe illness or injuries that make it impossible to keep working,” said Robert M. Hayes, president of the Medicare Rights Center, a national consumer service organization.
“This report chronicles the devastating health and financial toll that the waiting period takes on the lives of hard-working Americans who are stranded without health coverage after they become disabled,” said Mr. Hayes, an author of the report published by The Commonwealth Fund.
People who are deemed disabled by the Social Security Administration due to incapacitating health problems rendering them unable to work are not eligible for Medicare until 24 months after they receive their first Social Security Disability Income benefit.
Nearly seven million people under age 65 qualify for Medicare because they have severe and permanent disabilities. About 1.5 million Americans are in the Medicare waiting period. Twelve percent of people in the Medicare waiting period die each year while waiting for their coverage to begin.
In “Too Sick to Work, Too Soon for Medicare: The Human Cost of the Two-Year Medicare Waiting Period for Americans with Disabilities,” 21 people with disabilities share their experiences while waiting for Medicare after leaving work due to a variety of reasons including cancer, chronic cardiac conditions, a car accident and debilitating injuries.
These real-life stories illustrate how people with disabilities waiting for Medicare struggle to pay for health care. Some pay premiums for COBRA coverage but soon find the premiums unaffordable on disability income. Others qualify for Medicaid coverage initially but lose eligibility when their disability income begins (five months after being deemed disabled by the Social Security Administration). Other people interviewed spend their savings to pay for private health insurance but quickly discover that the premiums are unaffordable or private insurers will not cover someone with a pre-existing condition.
During the year-long interviewing process some of the “Too Sick to Work, Too Soon for Medicare” project participants finally get Medicare and express tremendous relief that they will at last have coverage and be able to see health care providers of their choice. Others never live to get their Medicare coverage.
Analyses have shown providing men and women with Medicare at the time that Social Security certifies them as disabled would cost $8.7 billion annually. This cost would be partially offset by $4.3 billion in reduced Medicaid spending by Medicaid, which many individuals get for some time during the waiting period.
In a letter sent to Congress today, patient advocates including the United Cerebral Palsy, National Multiple Sclerosis Society, Easter Seals and Paralyzed Veterans of America join the Medicare Rights Center in calling for Congress to eliminate the Medicare waiting period (letter below).
The two-year waiting period was originally established in 1972 when Medicare was extended to people with disabilities. Today there are two exceptions: people who are disabled due to amyotrophic lateral sclerosis (ALS) or end-stage renal disease.
“Too Sick to Work, Too Soon for Medicare: The Human Cost of the Two-Year Medicare Waiting Period for Americans with Disabilities,” was made possible with support from The Commonwealth Fund and is available online at the Medicare Rights Center at http://www.medicarerights.org/Too_Sick_To_Work_Too_Soon_For_Medicare.pdf.
Medicare Rights Center
April 11, 2007
Honorable Max Baucus
Chairman
Committee on Finance
U.S. Senate
Washington, DC 20510Honorable Chuck Grassley
Ranking Member
Committee on Finance
U.S. Senate
Washington, DC 20510Honorable John D. Rockefeller, IV
Chairman
Subcommittee on Health Care
U.S. Senate Committee on Finance
Washington, DC 20510Honorable Orrin G. Hatch
Ranking Member
Subcommittee on Health Care
U.S. Senate Committee on Finance
Washington, DC 20510Dear Senators:
The rising cost of health insurance and the increasing ranks of the uninsured are among the top domestic priorities for the 110th Congress.
The undersigned organizations work to ensure access to health care for people with disabilities, individuals who are extremely vulnerable to the loss of coverage under our current, fractured health care system. As Congress addresses America’s health care crisis, we urge you to place a high priority on closing the gap in coverage that affects a group of Americans most in need of guaranteed access to health care—people with severe disabilities who are waiting to become eligible for Medicare coverage.
In 1972, Congress extended Medicare coverage to individuals determined by the Social Security Administration (SSA) to have a disability that prevents gainful employment. Since then, Medicare has provided access to health care for millions of people with disabilities, allowing them to access the health care they need to lead lives as healthfully as possible. In extending Medicare coverage, however, Congress mandated a two-year waiting period for Medicare coverage from the date of eligibility for Social Security Disability Insurance benefits.
Over the decades, the rising cost of private insurance coverage has put COBRA coverage out of reach for Americans living on Social Security Disability Insurance. In addition, many people who qualify for disability income become ineligible for Medicaid, especially with budget pressures forcing states to restrict eligibility criteria. The waiting period has forced people with severe disabilities to endure two years during which treatment and care of their condition are put at risk. There are an estimated 1.5 million Americans with disabilities stuck in the waiting period for Medicare. Between one quarter and 40 percent of these individuals do not have health coverage.
The two-year Medicare waiting period affects more than those individuals who are now struggling to survive until their Medicare coverage begins. Every American is at risk of a severely disabling illness or accident. For individuals with progressive illnesses that all but guarantee that they will one day have to file for disability, this built-in gap in coverage is a virtual certainty.
We urge you to take action in this Congress to eliminate the two-year Medicare waiting period for people with disabilities. After being deemed disabled by SSA, Americans with disabilities should receive Medicare coverage as soon as they begin receiving Social Security Disability Insurance benefits.
ACCESS-DSPA Alliance
Alzheimer’s Association
American Association of People with Disabilities (AAPD)
American Council of the Blind
American Dance Therapy Association
American Medical Rehabilitation Providers Association
American Network of Community Options and Resources
The Arc
Arthritis Foundation
Association of Assistive Technology Act Programs (ATAP)
Bazelon Center for Mental Health Law
Brain Injury Association of America
Center for Medicare Advocacy, Inc.
Coalition for Pulmonary Fibrosis
Cystic Fibrosis Foundation
Easter Seals
Epilepsy Foundation
Families USA
Lupus Foundation of America
Medicare Rights Center
Mental Health America
National Association of State Directors of Special Education
National Council for Community Behavioral Healthcare
National Disability Rights Network
National Down Syndrome Society
National Multiple Sclerosis Society
National Respite Coalition
NISH
Paralyzed Veterans of America
Rehabilitation Engineering and Assistive Technology Society of North America (RESNA)
RESULTS
Title II Community AIDS National Network (TIICANN)
United Cerebral Palsy
United Spinal Association