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Monday, June 17, 2024 | Back issues
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Circuit Rejects Demand for Fewer Benefits

(CN) - Senior citizens who receive Social Security benefits cannot refuse Medicare benefits, the D.C. Circuit ruled in a strange case where citizens sued the government seeking fewer benefits.

In a 2-1 decision, the District of Columbia Circuit disagreed with the senior citizen plaintiffs, who would rather get better coverage from their private insurers. They said their private insurers limit their coverage because they are eligible for Medicare.

In a majority opinion, joined by Judge Douglas Ginsburg, Judge Brett Kavanaugh wrote that the "plaintiffs' lawsuit faces an insurmountable problem: citizens who receive Social Security benefits and are 65 or older are automatically entitled under federal law to Medicare Part A benefits. To be sure, no one has to take the Medicare Part A benefits. But the benefits are available if you want them. There is no statutory avenue for those who are 65 or older and receiving Social Security benefits to disclaim their legal entitlement to Medicare Part A benefits."

Part A covers inpatient care in hospitals, nursing facilities, hospices and home health care.

Kavanaugh wrote that he sympathizes with the plaintiffs' desire for better private insurance coverage.

The plaintiffs included former Republican House Majority Leader Dick Armey, 71, of Dallas.

Ginsburg and Kavanaugh are both Republican nominees to the court.

In dissent, Judge Karen LeCraft Henderson wrote that the court has held that an agency cannot exercise regulatory power without congressional grant, and that Social Security cannot make law.

"As we explained, 'if we were "to presume a delegation of power" from the absence of "an express withholding of such power [in the statute], agencies would enjoy virtually limitless hegemony,"' Henderson wrote (emphasis and brackets in original). "If the Congress had intended to impose the 'death penalty' on [Social Security Retirement Benefits] for anyone declining Medicare, Part A coverage, it would not have hidden the imposition in the non-germane phrase 'shall be entitled.' By using the word 'entitled,' the Congress made plain that the 'legal right or title' to Medicare, Part A coverage, while available by operation of law, is not unwaivable, much less waivable only by sacrificing benefits for which an individual has paid."

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