A bill that would phase out the two-year waiting period for disabled people under age 65 to become eligible for Medicare benefits may have stalled in 2007 but now appears to be gaining momentum thanks to new efforts from a loose coalition of advocacy groups. The legislation, that would also nix the waiting period for those with life-threatening conditions, is now seen by some as likely to pass in the first months of an Obama administration.

The Ending the Medicare Disability Waiting Period Act of 2007, sponsored in the House by Rep. Gene Green (D-TX) and in the Senate by Sen. Jeff Bingaman (D-NM), drew wide, but not bipartisan support when introduced last year. The bill was introduced just a few months after an April 2007 Commonwealth Fund report highlighted the problem created by the 24-month waiting period faced by nearly 7 million people under 65 that qualify for Medicare because of severe or permanent disabilities before they're deemed eligible for Social Security Disability Insurance to receive the coverage.

Thus as many as 1.5 million people too disabled to work are put on hold to receive Medicare coverage, according to the Commonwealth Fund. The report adds that nearly 39 percent are uninsured for at least a portion of this delay and 26 percent have zero insurance during the entire waiting period. Some people are forgoing care they can't afford with the reduced availability and higher cost of employer-based coverage, which in turn complicates their condition and may in fact raise the cost of their care once they're eligible for Medicare.

The Senate's version of the bill was co-sponsored by Sen. Barack Obama (D-IL), who the most recent polls give a better than even shot at becoming president next year. The bill also saw co-sponsorship from Sen. Hillary Clinton (D-NY) and Sen. John Kerry (D-MA), among other Democrats. No Republican senators co-sponsored it, and only a handful of Republicans supported the House version despite roughly 100 total co-sponsors.

The waiting period would shrink to 18 months in the first year after passage beginning a steady slide in two-month steps for 10 years before dropping to nothing in the sunset year, which was 2017 in the original bill.

People with life-threatening conditions can skip all that under Bingaman and Green's legislation. It asks for HHS to work with the National Institutes of Health, the Centers for Disease Control and Prevention and other entities to craft a list of conditions that are fatal without medical treatment. Care would be given to those who suffer from those conditions within at least 90 days of the enactment of the bill.

Buzz about a collection of advocacy groups is real, according to patient advocates, who are looking to Obama to aid their cause, but suggest that "any new administration" could mount a policy push.

Groups encompassing many interests are coming together, said Gerald McIntyre, directing attorney at the National Senior Citizens Law Center in Los Angeles, including advocates representing Medicare, Social Security and low-income families.

“I would say this: It's too soon to say that anything is likely in the coming year but I would say this is something that would be close to the top of the list,” McIntyre said. McIntyre said that the odds of its passage would be expected to rise if comprehensive health care reform doesn't go through early in an Obama or McCain presidency.

“I think that would increase the pressure for it,” he said. “It is something that has possibilities as a standalone, which I wouldn't say for a lot of proposals.”

Advocates say that it is difficult to gauge whether there would be concerted ideological opposition, with any possible protest coming from those who dislike that it costs money, they say.

What makes this piece of legislation even more important to advocacy groups is that people who qualify for Social Security disability see a spike in medical expenses at the onset of that disability -- just when they're being forced to wait for coverage. “This period may be even more important to them than after 24 months has passed,” McIntyre said.

Also contained in the twin 2007 bills is a directive to the HHS secretary to request an Institute of Medicine study within two years to gauge the range of disability conditions that could be delayed or prevented if individuals get access to health care services and coverage before a condition reaches disability levels. The bill appropriates $750,000 for the NAS study.

The offices of Bingaman and Green did not return calls for comment. -- Seth Freedland ( This e-mail address is being protected from spam bots, you need JavaScript enabled to view it )