Friday, April 28th, 2017

2/3/10 John Kraus’s letter to Ms. Moss-Coane


February 3, 2010

Ms. Moss-Coane:

     When I called WHYY this morning and pointed out how the Social Security Administration (SSA) REQUIRED that monthly benefit recipients also enroll in Medicare Part A, Mr. Walker made the erroneous statement that Medicare Part A and Social Security are both mandatory.  What is mandatory is the payroll tax for these two programs, not participation in their benefits.  He went on about the Medicare Part A “premium” payments being deducted from monthly SS benefits, when it is Medicare Part B that requires a premium payment for coverage.  He certainly should have known these distinctions from his time in government. 

     My point about the, “REQUIREMENT”, to be enrolled in Part A in order to collect monthly retirement benefits is that it is merely a statement in the SSA’s Program Operations Manual System, (POMS), section HI 00801.002, (http:/
It is not a requirement found anywhere in legislation, U.S. Code, or other regulation.  It is thus not a legal requirement, since it was not promulgated through the legislative process.  However, the SSA continues to require Part A enrollment as a condition of receiving monthly retirement benefits, but not vice-versa.   With Medicare facing insolvency in the near future, why must we sue the federal government to remove ourselves from Medicare coverage without losing monthly SS benefits?  We are not asking to recover the Medicare taxes paid, only to not be forced into Part A coverage.  Furthermore, why must we sue to not have to pay back all monthly benefits collected up to the time that we want to subsequently withdraw from Part A? 

     The law suit has been given coverage in the media nationwide.  We have so far had a favorable opinion on the suit’s merits from the D.C. Federal District court, but the Health and Human Services Department (HHS) continues to waste taxpayer money by having the Justice Department pursue further appeals, presumably in the hope that we plaintiffs will be defeated by exhaustion.  The details of the court action are found at:

     I hope that you or another appropriate NPR venue address this issue by having someone from the SSA, the HHS, or Justice appear to explain why these agencies continue to oppose this action.  MY guess is that they will decline to do so.  As this suit enters its third year, we are still at a loss to understand why they continue to oppose being able to unconditionally remove oneself from Part A coverage.  Wouldn’t the Medicare program benefit by not having to pay medical procedure reimbursements for those who do not want to be in the program?

Thank you,
John Kraus
Plymouth Meeting, PA    

John Kraus is a plaintiff in The Fund for Personal Liberty’s Medicare Lawsuit.  Marty Moss-Coane is host of Radio Times on WHYY, an NPR affiliate in Philadelphia.  David M. Walker is President and CEO of the Peter G. Peterson Foundation.


2 Responses to “2/3/10 John Kraus’s letter to Ms. Moss-Coane”
  1. Sharon Cockle says:

    I was in a head on collision on June 19, 2007 the brake pedal went through my right ankle I applied for Soc Sec Disability, they sent me to their doctor and asked for release forms for all my doctors, I did both, They decided that I was disabled, but that they weren’t sure that it would be for a year. This was based on the records of my surgeon, they did not request the records of Dr. S who was treating me for all of the injuries and knew my history, they only got the records of the surgeon who only does surgery. They said it is required that we get all the records we don’t know how that happened, “that is why we have the appeal process” so you can appeal based on the fact that we did not do what was statutorily required of us. So I got the appeal and guess what it took until the day after my accident 1 year anniversary l to decide June 20, 2008,that I would now get my Soc Sec benefits, in the mean time I applied for DSHS they turned me down because I was living with my 18 yr old daughter who was making min wage and because she was family she was supposed to support me, I had to live with her I could not even take a shower by myself or do anything around the house, dishes, laundry etc. when I became homeless and applied again and told the worker that I had been turned down because I had to live with my daughter because I was bed ridden she said that was not right that because I could not do things for myself and had to live with her I was eligible for money but there was nothing they could do now. I received GU with medical for 1 month because I was then eligible for soc sec even though I would not receive it for 2 months so I had no income for the 2 months and they gave me $80 dollars in food stamps and I had to live on my friends couch, I was still disabled they cancelled my money and medical benefits but gave me $80 in food stamps based on the money I was supposed to be getting but would not receive for 2 months, now I was so depressed on top of everything else but managed to fight my way into subsidized housing, I moved in Sept 2008 after a few months I spoke to my worker at DSHS and asked if I qualified for an help with my medical she said no but she may be able to get me on some 6mo thing where they pay for anything over $900 that I would have to pay each month, I was paying $300.00 out of the $750 I got from Soc Sec each month and at least $130 a month in copays for Drs and meds. Then in I believe Aug. I requested help with my electric bill and my worker the same worker, looked again and said oh yea you do qualify for help with your medical to pay for you co payments because of the money I had to pay for medical, which what do you know, I was entitled to the whole time, oops! Oh well to bad for me. I have struggled for these 2 years paying for my medical coverage and have established a relationship with my doctor, she is the thread that I am holding onto to keep me going, and not give up, in the past year I have had fevers, my blood is showing infection in my body it should be 4 and it is 119, my sed rate had been elevated, I lost all my iron and my saturation rate got down to 3, now I am having seizures, I had one in Nov and when I fell I broke my left hand which is not healing my doctor is trying to do test after test to find out what is going on I have had every test and seen so many specialists we now are having surgery on my ankle to remove a couple screws and find out what is causing the swelling and pain in the leg if it is where the infection in it could get into my blood stream and kill me. And the state that has not followed or applied their own rules and regulations to my case want to now apply their rules and regulations on me and make me stop my medical care and get on Medicare and try to find a doctor and then start over and maybe die in the process, they are not required to follow their rules and regulations and I have outlined in this letter, 1 soc sec – they did not get the records of all my doctors 2 dshs – they denied me help because I was living with my 18 yr old daughter because I could not even take a shower by myself 3 dshs – they denied me medical coverage that I was entitled to, so you see they don’t have to follow their own rules and regulations so why is this different, and if they followed the law they would see that no where is the statutes can the state be denied from providing, or myself denied that right to choose medical insurance
    42 U.S.C. 1395b reads:
    Nothing contained in this subchapter shall be construed to preclude any State from providing, or any individual from purchasing or otherwise securing, protection against the cost of any health services (emphasis added).

    all I ask is for them to allow me to keep my insurance and stay on the plan with them to help me with my copayments or to let me keep my insurance with no help as I have been doing for the past 2 years, but to keep my insurance I can not be on medicare and if I opt out of Medicare A I loose my Soc Sec. benefits I have been told the biggest problem is the state requires me to be on Medicare D (which I have to be on
    A to receive) however in researching Medicare D it also states:

    Also under 42 U.S.C. § 1396u-5 : US Code – Section 1396U-5: Special provisions relating to medicare prescription drug benefit

    (3) Voluntary nature of program
    Nothing in this section shall be construed as requiring a
    discount card eligible individual to enroll in an endorsed
    discount card program under this section.

    It also states:

    ALSO UNDER 1395w-141
    42 U.S.C. § 1395w-141 : US Code – Section 1395W-141: Medicare prescription drug discount card and transitional assistance program
    section 1395w-141(f)(3)(B)(i)
    (f) Eligibility procedures for endorsed programs and transitional
    (3) Verification
    (B)The information described in this subparagraph is as follows:
    (i) Medicaid-related information
    Information on eligibility under subchapter XIX of this
    chapter and provided to the Secretary under arrangements
    between the Secretary and States in order to verify the
    eligibility of individuals who seek to enroll in an endorsed
    program and of individuals who provide certification under
    paragraph (2).

    Clearly the law states that we have a right to the insurance we choose to have, but the state does not have to follow the law and the only way to make them is to file a law suit and take it to Supreme Court, and they know that people who are disabled cant afford to do that so they can break the law and require them to be on Medicare.

    Even if I did get off of Medicaid and Medicare I could not opt out of A without loosing my only income of $750.00 a month and with being in any type of Medicare my insurance will not cover me. I also have a great Insurance I don’t want to loose. If I don’t keep paying them I will loose the coverage and when I am no longer disabled I will not be able to get the policy (all of my injuries will be preexisting) and the rate $300 I am paying, back and I will have to pay my doctor $250.00 out of my pocket to keep seeing her. You do the math, which leaves me $200 a month to live on.

    I can’t change doctors right now I could litteraly die as a result I am really sick.
    As we all know, the state can break the law until the courts say they can’t and that takes money and time which I don’t have and that is what they bank on.

  2. Richard Curtis says:

    My wife and I are directly affected by this lawsuit. We have an excellent group health insurance plan that has covered my wife’s serious health problems that hospitalized her twice last year. We don’t want Medicare Part A hospital insurance as our primary hospital insurance, but the SSA policy and procedural manual written during the Clinton and Bush administrations prevents anyone from opting out of Part A without also giving up their Social Security retirement benefits. It’s contrary to the Social Security and Medicare Acts and is not even in the CFR. Read the whole lawsuit website to appreciate the Kafkaesque absurdity of this bureaucratic ploy.* I’m contributing to the lawsuit’s fund and withdrawing my recently filed application for Social Security benefits until this is resolved. The government’s motion to dismiss was denied last October, but the Plaintiff’s Motion for Summary Judgment is still pending. Pundits agree the plaintiffs will probably win, but God knows how long it will be before the courts get it to a final judgment.

    * It’s absurd only when viewed in light of the fact that forcing people to take Medicare A from a bankrupt system is not rational. It’s not absurd in light of the probable true intent of the regulations — to coerce people into giving up their Social Security retirement benefits.