You Can't Opt Out of Medicare Without Losing Social Security, Judge Rules

Retirees cannot disenroll from Medicare Part A without also losing their Social Security benefits and refunding all the money paid to them, a federal judge has ruled.

The judge dismissed a case, Hall v. Sebelius , brought by three retired federal employees who have reached age 65 and are receiving Social Security Retirement benefits, but who would like to drop their Medicare Part A coverage, which pays for care in institutions like hospitals.

Anyone who has reached age 65 and who is entitled to Social Security benefits is also automatically entitled to Medicare Part A without charge. However, the three plaintiffs, one of whom is former Republican House Majority Leader Dick Armey, wanted to drop their Medicare coverage because they claimed it threatened their coverage under the Federal Employees Health Benefit (FEHB) program, which they said was superior. They argued that the Medicare law allows them to drop out of the program without losing their Social Security benefits.

In her March 16, 2011, ruling, Judge Rosemary Collyer of the U.S. District for the District of Columbia acknowledged that the three retirees had a legitimate point that the law does not specifically say that avoiding Medicare Part A means losing Social Security benefits. But in examining the law that Congress enacted in 1965 creating the Medicare program, Judge Collyer found that "[r]equiring a mechanism for Plaintiffs and others in their situation to 'dis-enroll' would be contrary to congressional intent, which was to provide 'mandatory' benefits under Medicare Part A for those receiving Social Security Retirement benefits." [emphasis in original]

The judge also pointed out that the plaintiffs would not gain much by renouncing their Medicare coverage. Even if they were to forego and repay all Social Security benefits, under the law "their FEHB-paid benefits would be no more, and no less, than what Medicare Part A would provide," Collyer wrote.

The ruling could have implications for the current court cases challenging the new health reform law. A central basis of these challenges is that the "individual mandate," the reform law's requirement that all Americans have health coverage, is illegal because the government can't compel citizens into economic activity. Judge Collyer's ruling suggests that the government may already have been doing this in the area of health care for the past 46 years. Indeed, the Washington Times notes in an editorial that on February 22, "D.C. federal district Judge Gladys Kessler cited preliminary rulings in Hall v. Sebelius to conclude that the [individual] mandate is allowable."

The plaintiffs plan to appeal the decision.

To read the court's decision, click here.

For an article on the case in The Blog of Legal Times, click here.