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
“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 (