News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Recent federal court case and a columnist in the Weekly Standard illustrate how Boomers are ready to challenge existing Medicare laws they don’t like

Will the oldest Baby Boomers, now turning 65 years old this year, accept enrollment in the Medicare program or will they challenge it—as they have challenged many other institutions in American society over their lifetimes? News outlets are already reporting instances of Baby Boomers fighting to keep their existing private health insurance, for example.

If this is a trend that sets down deep roots, it can also trigger significant changes in the clinical laboratory testing marketplace. Were Baby Boomers to file lawsuits in federal courts that are settled in their favor, for example, it could pave the way for Boomers to retain private health insurance in lieu of enrollment in fee-for-service Medicare or the Medicare Advantage Plans.

In fact, these types of lawsuits have already been filed! In recent months, current and former members of the federal government have either directly attempted to opt out of Medicare or questioned why they can’t do so. That’s a pretty big deal. It’s one thing when John Q. Public wants out of a government entitlement program—but Congressmen?

When seniors turn 65, they are required to drop their existing healthcare coverage and go on Medicare. But as Jeff Bergner states in his Weekly Standard column, reprinted on titled: “Old Enough to Opt Out of Medicare,” he—no doubt like many senior Americans—would choose to “not join” Medicare if he were able to do so. Bergner has worked in the private sector as well as in the Legislative and Executive branches of the U.S. Government.

Bergner and his wife are nearing 65 years of age and thus will be eligible for Medicare benefits. His arguments are compelling and raise many issues facing Baby Boomers reaching the age when federal law mandates that they enroll in Medicare and only get their medical services through that program.

“Why must turning 65 be so different from turning 63 or 64?” Bergner asked in his column. “Why is our health insurance plan adequate and appropriate when we are 64 but not when we turn 65?”

The reason Bergner wants to opt out of Medicare is simple: his private insurance offers superior coverage and is simpler to manage. Given those circumstances, who wouldn’t want to opt out? In fact, other “pubic servants” have already attempted it.

Judge Rules against Congressman Suing to Opt Out of Medicare Part A

Earlier this year, a judge ruled on a lawsuit filed by former House Majority Leader Dick Armey and two other plaintiffs—Brian Hall and John Kraus—in which the plaintiffs wanted out of Medicare.

Former House Majority Leader Dick Armey (R-TX) on NBC’s “Meet the Press.” Image sourced from

In “Brian Hall, et al. (Plaintiffs), v. Kathleen Sebelius, Secretary, Department of Health and Human Services, et al., (Defendants),” U.S. District Judge Rosemary Collyer found that, under the law, the plaintiffs did have “standing to bring this lawsuit.” She also found, however, that since “entitlement” to Medicare was automatic for those who had previously joined Social Security at age 62—which the plaintiffs had done—they could not opt out of Medicare without first opting out of Social Security, something none of the plaintiffs had expressed any interest in doing, since they would have to repay all benefits already received.

Judge Collyer dismissed the case on March 16, 2011. In her concluding remarks, she stated that the “Plaintiffs are trapped in a government program intended for their benefit. They disagree and wish to escape. The Court can find no loophole or requirement that the Secretary provide such a pathway.” Pathologists and clinical laboratory managers are likely to find the judge’s choice of words interesting—“trapped”…“loophole.”

It is not likely that this judge’s ruling in a case where American citizens wanted to opt out of Medicare will be the final word on this subject. For the moment this decision seems to put to rest any future debate over whether seniors who are already on Social Security can opt out of Medicare, and whether the Department of Health and Human Services will be compelled to provide a method to do so.

But what if Baby Boomers reaching the age of 65 opted out of Social Security first? Could they then opt out of Medicare altogether and retain their private health insurance? Are there senior citizens who, after decades of paying into the Social Security system, will choose to not enroll in Social Security and not take those benefits in order to opt out of Medicare as well?

This is an interesting debate and it is not likely that this judge’s ruling will be the definitive answer to these questions. As more Baby Boomers like Jeff Bergner of the Weekly Standard ask for the right to keep (and pay for) private health insurance coverage and not participate in the Medicare program, Congress may well feel enough lobbying pressure to take up this issue and change existing legislation.

Were this to happen, it would be the latest example of “me first” Baby Boomers insisting on their right to make their own choices about how to live their lives. For those pathologists and clinical laboratory managers who are nearing the age of 65, any major reforms to federal Medicare legislation will likely have personal as well as professional consequences.

—Michael McBride


Related Information:

Weekly Standard: Old Enough To Opt Out Of Medicare ( article)

Cutting Off Granny: Medicare? Thanks, But No Thanks (Original Bergner Weekly Standard article)

Judge Dismisses Suit Brought by Plaintiffs Seeking to Opt Out of Medicare

Civil Action No. 08-1715 (RMC), Brian Hall v. Kathleen Sebelius, Department of Health and Human Services, (Judge’s Opinion)