Archive for April 27, 2009

What Kind of Help is That?

Medicare beneficiaries are fighting back against decades of delays in processing benefits that have caused them to make hard choices between health care and other necessities of life. 

66 year old Narcisa Garcia, a resident of Pennsylvania, lives on $695 a month, just about 75% of the federal poverty rate.  Paying her Medicare Part B premium reduces her tiny income to $599 per month.  Yet Ms. Garcia should not have to pay her Part B premium; she is one of millions of low income Medicare beneficiaries entitled to help from one of the programs that pays for Medicare cost-sharing.  Although she is eligible for benefits from Pennsylvania going back to November 2008, six months later, in April 2009, she is still paying her Part B premium.  Some people may be able afford to float loans to the federal government, but not those living on less than $700 a month.

On April 24th, Ms. Garcia and another Medicare beneficiary, together with two advocacy organizations filed suit against the federal government and the state of Pennsylvania claiming that the harmful and illegal delays in processing enrollments for benefits denied them their rights under federal law. Narcisa Garcia, et al. v. Charles E. Johnson, et al. 2:09-cv-01747 (AB) E.D. Pa. (Complaint filed April 24, 2009). 

The programs to help low-income beneficiaries have existed since the beginning of Medicare and Medicaid, in 1965, but were beefed up in the late 1980s and early 1990s when Medicare cost-sharing increased significantly. For decades, they have suffered from serious delays in processing enrollments that leave people footing their own bills for months or even years after they have been found eligible for the benefits. 

The Center for Medicare Advocacy and the Philadelphia-based Community Legal Services are representing the plaintiffs.

The plaintiffs are asking the court to recognize the case as a class action, to declare the government’s practices illegal, to require that benefits are provided promptly, to notify beneficiaries of delays in processing, and to notify beneficiaries that they might be entitled to a refund of back benefits.  They are asking, in other words, that the programs do what they are supposed to do: help people.

April 27, 2009 at 5:38 pm 2 comments

From the Desk of Judith Stein….

Update: Real reform still possible

Apparently the President will support use of the Senate “Reconciliation” process to move health care reform if the super-majority of 60 votes needed to avoid a filibuster can’t be garnered to pass a good plan. We heard this last week from a senior senator – he hoped a bipartisan vote would be possible, but indicated that certain principles need to be met by any health care bill, and that Reconciliation would be considered if those principles would otherwise be sacrificed.  Amen to that.

Let’s not accept “something’s better than nothing” again!  That mantra helped pass the 2003 law that gave us private Medicare Advantage, Part D, and windfalls for corporations – at the expense of Medicare participants and taxpayers. Been there, done that.  This time we need a good plan with a solid public option that puts people above profits.


April 24th

CMA Health Policy Consultants’ contacts in DC indicate that a public option in health care reform is in jeopardy. Is it possible that after all the problems Medicare has had with private plans, and the plans’ exorbitant additional costs, that we will actually let corporate greed trump the interests of sick people and taxpayers once again?

April 27, 2009 at 11:11 am 2 comments

Health Policy Expertise

We provide effective, innovative opportunities to impact federal Medicare and health care policies and legislation in order to advance fair access to Medicare and quality health care.

Judith A. Stein, Executive Director

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April 2009


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