Let People Decline Medicare Benefits

Sometimes the most important bills in Congress are introduced at the end of a session, get lost in the shuffle, and are soon forgotten. Good government would suffer a blow, however, if that happens to the Medicare Freedom to Choose bill introduced Oct. 1 by Rep. Sam Johnson, R-Tex. As noted by our Quin Hillyer in his column on Tuesday, Johnson’s bill aims to restore common sense and original congressional intent to rules governing Medicare. The Texas lawmaker describes the problem his bill addresses in these words: “Presently Medicare’s bureaucracy prevents seniors from paying their own doctor out of pocket, mandates that seniors enroll to receive government benefits (even the wealthy ones who do not wish to participate), and prevents seniors from contributing to their tax-free health savings account (HSA) once they hit 65.” Yes, you read that correctly: Bureaucratic rules promulgated in 1993 and reiterated in 2002 actually force people to accept benefits they do not want – with the taxpayers picking up the bill – unless the affected people also agree to forfeit the Social Security benefits for which they have been paying their entire working lives.

To be clear, nobody is suggesting here that people should be able to opt out of paying their Medicare taxes. But some senior citizens who have paid their taxes want to voluntarily relinquish their benefits, in order to avoid the red tape and rationing they say Medicare entails. How can anybody with any sense object to that? Taxpayers would save money, doctors would escape paperwork headaches, and bureaucrats would have one less file to monitor. Medicare’s trustees estimates the system’s long-term unfunded obligations to be in excess of $31 trillion, so voluntarily reducing the number of beneficiaries is important to the nation’s fiscal health.

The Johnson bill, specifically, would do three things. First, it would allow patients to enter into private contracts with the doctors of their choice, without penalizing the doctor (as current law does) for doing so. Second, it would let seniors opt out of Medicare Part A benefits altogether. Third, it would allow seniors to continue building their HSAs. “If Warren Buffett wants to pay for his own medical care, I say we should let him,” said Johnson, in reference to the famous billionaire investor. Three plaintiffs filed suit last week against the existing rules, and their case at first glance appears strong. But Congress ought to make the suits unnecessary by passing Johnson’s eminently sensible bill – preferably in any post-election session that its leadership may call.