Medicare waiting period leaves over 1.2 million seriously disabled without secur

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Medicare waiting period leaves over 1.2 million seriously disabled

without secure health insurance, USA

17 Jul 2005 Medical News Today

Over 1.2 million seriously disabled Americans under age 65--including

as many as 400,000 without health insurance--are currently in the two-

year waiting period for Medicare coverage, according to a new report

from The Commonwealth Fund. Eliminating this two-year waiting period

would provide stable health insurance to a vulnerable group of adults

who are unable to work. Some disabled adults in the waiting period

qualify for state Medicaid programs. The report finds that dropping

the two-year Medicare wait would save cash-strapped states an

estimated $1.8 billion a year in Medicaid costs.

" At a time when Congress is considering major reforms to Medicare

they should not forget some of the most vulnerable of all potential

beneficiaries--seriously disabled adults who are unable to work, "

said , president of The Commonwealth Fund. " Individuals in

the waiting period for Medicare suffer from a broad range of

debilitating diseases and are in urgent need of appropriate medical

care to manage their conditions. Eliminating the two-year wait would

ensure access to care for those already on the way to Medicare. "

Currently, 1.26 million seriously disabled Americans are in the

waiting period for Medicare coverage, and as many as one-third of

them (400,000) have no health insurance, according to the report,

Expanding Health Coverage for Seriously Disabled Adults by

Eliminating Medicare's Two-Year Waiting Period, by Berg Dale

and M. Verdier of Mathematica Policy Research, Inc. These

disabled adults under age 65 must first qualify for Social Security

Disability benefits by satisfying the work history requirements and

proving that they are too disabled to work, wait five months for

these benefits to begin, and then wait an additional two years for

Medicare. Adults under 65 who qualify for Medicare based on

disability suffer from a range of chronic illnesses: more than nine

of 10 have one or more chronic diseases including arthritis, heart

conditions, lung disease, cancer, and severe mental illness. All are

unable to work. By the time they reach Medicare, most (77%) are poor

or nearly poor.

Based on reports from several states, the authors estimate that 40

percent of those in the waiting period are enrolled in Medicaid

programs, having qualified as disabled and poor. Eliminating the two-

year waiting period for Medicare would benefit states by reducing

their costs for Medicare-covered services. The report finds that

states would save an estimated $1.8 billion per year if the Medicare

waiting period were eliminated. Federal Medicaid expenditures for the

disabled would also be reduced, by $2.5 billion, offsetting some of

the $8.7 billion increase in federal Medicare expenses that would

result from the change.

" At a time when states are considering steep cuts in essential

services, eliminating this hurdle to Medicare could make a real

difference in states' ability to maintain insurance coverage, " said

Verdier. " Our analysis illustrates that savings could help states

maintain Medicaid coverage for children and families or the safety

net for elderly and disabled for services not covered by Medicare. If

Medicare included prescription drugs, state Medicaid savings could

potentially be even greater. "

In addition to insuring as many as 400,000 uninsured disabled adults,

eliminating Medicare's waiting period would improve the financial

security of disabled adults paying high premiums to maintain private

coverage after losing jobs due to disability. The report notes that,

to the extent that disabled adults rely on coverage through their

prior employer or their spouse's employer, eliminating the waiting

period would also produce savings to employers who provide this

coverage.

The Commonwealth Fund is a private foundation supporting independent

research on health and social issues. To read or download

publications, visit our website at http://www.cmwf.org.