The specter of government bureaucrats denying medical care to the elderly is a step closer to reality with the recent ruling by a federal judge that seniors may not disenroll from Medicare without forfeiting their Social Security benefits. Medicare, the judge determined, is a “mandatory” entitlement.

“Mandatory”? Did we hear that right? Can the government actually tell older Americans, “You may not drop out of this government-run health care program, even if you want to – even if you feel your very life depends on it”? The answer, at least for now, is: “Yes, government can tell seniors that. And it does.” 

We already knew about the mandate to purchase health insurance under President Obama’s controversial health care law, also known as ObamaCare. But many of us had assumed that Medicare, at least, is voluntary. That naïve assumption has now been dispelled. 

Can this really be happening in America, the land of the free?  

Here’s the reasoning behind the judge’s ruling. Although Medicare and Social Security are technically separate programs without any statutory ties between them (other than both being part of the massive Social Security Act), federal officials have determined that Medicare will be more “stable” and “work better” if no one is permitted to obtain health coverage outside of it. And what better way to pressure people to stay enrolled than to hold their Social Security checks hostage? For this reason, in 1993 the Clinton administration decided that the two programs should be tied together and issued a rule to that effect; and the Bush administration continued this policy. This was all done without the permission of the people’s elected representatives in Congress.

While some Members of Congress did express concerns about the policy change at the time it occurred, they did nothing about it; and it wasn’t until years later that a few concerned senior citizens decided to challenge the coercive Clinton-Bush policy in court. Fighting to regain their lost freedom, the plaintiffs in the case include several retirees who do not want to be forced into Medicare, or have to remain in Medicare. One of the plaintiffs is former House Majority Leader Dick Armey, who is also the Chairman of the FreedomWorks Board of Directors. 

As Judge Brett Kavanaugh of the D.C. Appeals Court summarized the case, “Plaintiffs here have sued because they don’t want government benefits. They seek to disclaim their legal entitlement to Medicare Part A benefits for hospitalization costs. Plaintiffs want to disclaim their legal entitlement to Medicare Part A benefits because their private insurers limit coverage for patients who are entitled to Medicare Part A benefits. And plaintiffs would prefer to receive coverage from their private insurers rather than from the Government.”

Unfortunately, Judge Kavanaugh (an appointee of President George W. Bush) rejected this claim, essentially taking a hands-off policy to the case. “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,” he wrote -- and left it at that. In other words, it’s a mandatory entitlement. 

This regulation is both bad policy and a bad fit for a free society. Defenders of the regulation claim that if seniors were free to opt out of Medicare, then the healthy and wealthy would do so while leaving behind a pool of high-risk participants, which would therefore drive up costs. This just isn’t the case. 

For one thing, before 1993 Medicare didn’t implode.

For another, Medicare is a great deal for seniors, all things considered. It’s an enormous subsidy to them and thus relatively very cheap. To be sure, it’s not a very modern or high-quality insurance plan, in many respects; but it is relatively affordable. As a result, even if retirees were to be given the freedom to opt out of Medicare without losing their Social Security benefits, very few would. The doomsday scenario of Medicare imploding is nothing more than a fantasy.

If you have a superior health care option on the table, why should you be forced to take Medicare instead? Right now, we are forcing seniors to accept mediocre health care or lose the Social Security benefits that, during their entire working lives, they’ve planned on receiving. In other words, they’re trapped. Americans want to live in a free society, and most of us believe that we do live in one. But this kind of regulatory trap just doesn’t square with the idea of a free society. 

So, why do we have it? Very simply, certain federal technocrats (of both political parties) have a utopian dream. They envision a society that ensures economic security. As things are today, this economic security takes the form of entitlements such as Medicare and Social Security. Together, these programs are meant to ensure that economic hardship does not strike, from the cradle to the grave. These federal bureaucrats believe that they are concerned only with the public good and are acting above any form of self-interest. As enlightened administrators, they want to design this society of perfect economic security. Ensuring that the vast majority of seniors realistically lack the freedom to opt out of Medicare is part of that. There is little room for freedom in a designed society centrally planned by government technocrats.

If the courts won’t protect seniors, Congress should. Last year, Senator Jim DeMint (R-SC) and 12 of his colleagues introduced the Retirement Freedom Act (S. 1317), introduced in the House by Congressman Sam Johnson (R-TX) (H.R. 2435).

As federal law now stands, by opting out of Medicare, you lose your Social Security benefits. The Retirement Freedom Act would solve this problem by simply decoupling Medicare from Social Security. It would allow seniors to opt out of Medicare without losing their Social Security benefits, and would also allow those who opt out of Medicare to opt back in without penalty. Isn’t that how things should work in a free country? 

Rationing and denials of care are already a very real threat in Medicare, thanks to President Obama’s new denial-of-care board. Fifteen unelected bureaucrats collectively known as IPAB (Independent Payment Advisory Board) will soon begin making decisions about which treatments the government is financially able to afford. The fact that Medicare has now been declared “mandatory” – that seniors are trapped in it, with no avenue of escape – makes the advent of this care-denial board all the more troubling, and the enactment of the Retirement Freedom Act all the more urgent.

This issue boils down to a simple question: In a free society, who should make personal health care decisions? You, or the government?

TAKE ACTION: Tell your Congressmen and Senators to cosponsor Sen. DeMint’s “Retirement Freedom Act”.