Kaiser Daily Health Policy Report

Medicare | Lawmakers, Advocacy Groups Call for Elimination of Two-Year Waiting Period Before Disabled U.S. Residents Can Qualify for Medicare

[Nov 13, 2008] http://www.kaisernetwork.org/daily_r...fm?DR_ID=55536

Lawmakers and more than 75 disability advocacy groups have begun lobbying Congress and the future administration of President-elect Barack Obama to eliminate the wait time the disabled face in qualifying for Medicare, the AP/San Francisco Chronicle reports (Alonso-Zaldivar, AP/San Francisco Chronicle, 11/12). Current rules require a two-year waiting period for people the Social Security Administration has deemed too ill or disabled to work before they are eligible for Medicare benefits (CongressDaily, 11/12).

According to the AP/Chronicle, at any given time, about 1.5 million people who are disabled are waiting to qualify for Medicare coverage. About 40% are uninsured at some point during the waiting period and 25% are uninsured during the entire two-year period, the AP/Chronicle reports. While some people rely on Medicaid in the interim, others "end up depleting their savings on private insurance and medical bills," according to the AP/Chronicle (AP/San Francisco Chronicle, 11/12). In some cases, "the gap in coverage leads patients to forgo treatment, resulting in more expensive care after insurance kicks in," according to Lee Grossman, president of the Autism Society of America (CongressDaily, 11/12).

Among the groups supporting the elimination of the wait period are the American Cancer Society, the Alzheimer's Association, the National Association of People with AIDS, the National Multiple Sclerosis Society and the Medicare Rights Center. In addition, Senate Finance Committee Chair Max Baucus (D-Mont.) has said he supports ending the waiting period (AP/San Francisco Chronicle, 11/12).

Legislation
Rep. Gene Green (D-Texas) and Sen. Jeff Bingaman (D-N.M.) are sponsoring companion bills (HR 154, S 2102) that over 10 years would gradually eliminate the waiting period and would establish a system to immediately grant coverage to people with life-threatening illnesses, the AP/Chronicle reports. Green said, "Every year, we'd reduce it by a few months, so we get down to a level that's manageable for folks."

Bingaman and Green are hoping to get their bills included in a larger health care overhaul package that Obama likely will pursue once in office. If attaching the bill to a larger package is unsuccessful, Green and Bingaman plan to introduce the bills independently, according to the AP/Chronicle (AP/San Francisco Chronicle, 11/12).

Green said that funding is the largest impediment, adding, "We haven't crossed that bridge yet to see where we'll get the offsets. That will be something we'll have to deal with" (CongressDaily, 11/12). According to the AP/Chronicle, researchers estimate that eliminating the wait period in one step would cost about $9 billion annually, which is why Green and Bingaman have proposed a gradual elimination. The AP/Chronicle reports that the cost would be offset in part by a $4 billion savings from Medicaid (AP/San Francisco Chronicle, 11/12).