[Congressional Record Volume 149, Number 107 (Friday, July 18, 2003)]
[Extensions of Remarks]
[Page E1515]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               THE SENIOR CITIZENS FREEDOM OF CHOICE ACT

                                 ______
                                 

                             HON. RON PAUL

                                of texas

                    in the house of representatives

                        Thursday, July 17, 2003

  Mr. PAUL. Mr. Speaker, I rise to introduce the Senior Citizens 
Freedom of Choice of Act. This act ensures that participation in the 
Medicare program is completely voluntary. I also ask unanimous consent 
to insert into the record a letter sent to my office from a citizen who 
is trying to receive Social Security benefits without being forced to 
enroll in Medicare Part A, along with a letter from the Social Security 
Administration admitting that seniors who do not enroll in Medicare 
Part A are denied Social Security benefits.
  When Medicare was first established, seniors were promised that the 
program would be voluntary. In fact, the original Medicare legislation 
explicitly protected a senior's right to seek out other forms of 
medical insurance. However, today, the Social Security Administration 
refuses to give seniors Social Security benefits unless they enroll in 
Medicare Part A.
  This not only distorts the intent of the creators of the Medicare 
system, it also violates the promise represented by Social Security. 
Americans pay taxes into the Social Security Trust Fund their whole 
working lives and are promised that Social Security will be there for 
them when they retire. Yet, today, seniors are told that they cannot 
receive these benefits unless they agree to join another government 
program!
  At a time when the fiscal solvency of Medicare is questionable, to 
say the least, it seems foolish to waste scarce Medicare funds on those 
who would prefer to do without Medicare. Allowing seniors who neither 
want nor need to participate in the program to refrain from doing so 
will also strengthen the Medicare program for those seniors who do wish 
to participate in it. Of course, my bill does not take away Medicare 
benefits from any senior. It simply allows each senior to choose 
voluntarily whether or not to accept Medicare benefits.
  Seniors may wish to refuse Medicare for a variety of reasons. Some 
seniors may wish to continue making their own health care decisions, 
rather than have those decisions made for them by the Centers for 
Medicare and Medicaid Services (CMS). Other seniors may have a favorite 
physician who is one of the growing number of doctors who have been 
driven out of the Medicare program by CMS's micromanagement of their 
practices and below-cost reimbursements.
  Forcing seniors into any government program as a precondition of 
receiving their promised Social Security benefits both violates the 
promise of Social Security and infringes on the freedom of seniors who 
do not wish to participate in Medicare. As the author of the submitted 
letter says, ``. . . I should be able to choose the medical 
arrangements I prefer without suffering the penalty that is being 
imposed.'' I urge my colleagues to protect the rights of seniors to 
make the medical arrangements that best suit their own needs by 
cosponsoring the Senior Citizens Freedom of Choice Act.
     Congressman Ron Paul
     U.S. Congress, Washington, DC.
       Dear Congressman Paul: I am writing to inform you about a 
     structural problem in Medicare of which you may he unaware 
     and that I believe must be remedied, all the more so now that 
     there are rumors that Medicare, Part A, might be combined 
     with Medicare, Part B.
       In brief; the problem to which I refer involves the 
     requirement that a Medicare eligible individual enroll in 
     Medicare, Part A as a condition of receiving Social Security 
     benefits to which he or she is entitled. In fact, the Social 
     Security Administration has combined the enrollment forms for 
     the two programs, so that an application for Social Security 
     benefits to which one is entitled automatically entails 
     enrollment in Medicare, Part A.
       I discovered this in June 2001 when I went with my husband 
     to apply for my Social Security benefits. I made it quite 
     clear that I would not enroll in Medicare, Part A due to my 
     objections to certain aspects of this program. (The 
     objectionable aspects include invasion of privacy and 
     limitation of medical choice.) In response I was told that I 
     then could not receive the Social Security benefits to which 
     I am otherwie entitled.
       Further communication with CMS by myself and by the office 
     of Senator Kennedy on my behalf confirmed that CMS and the 
     Social Security Administration take the position that ``the 
     Medicare program, Part A . . . [is] a benefit completely 
     linked to the monthly social security benefit for those age 
     65 or older.'' Indeed I was sent a copy of federal regulation 
     404.640 (entitled ``Withdrawal of an application''), which 
     states that anyone who enrolls in Medicare, Part A and then 
     decides later to withdraw will have to return all benefits 
     received. (Another document I received states that this 
     includes both medical benefits and social security benefits.)
       Upon receipt of a copy of the letter, dated October 12, 
     2001, sent to Senator Kennedy regarding my complaint. I 
     followed that letter's suggestion that I make an attempt to 
     file ``a restricted application for Social Security 
     benefits.'' This I did in a letter, dated May 15, 2002, to 
     the regional commissioner for Social Security, Manual Vaz.
       The response to my letter to Mr. Vaz came from the local 
     (Waltham) Social Security office. In that letter, dated May 
     29, 2002. I was told that it was impossible to make a 
     restricted application, i.e., an ``application for cash 
     social security retirement benefits only.''
       Thus I was left with no recourse. I could not appeal a 
     denial of my ``restricted'' application, because I was not 
     even permitted to make the application. Short of an expensive 
     lawsuit or an Act of Congress, there appears to be no remedy.
       This is no trivial matter for me. I have now lost two years 
     of Social Security benefits. It is not clear when or if I 
     will ever receive these benefits. All those with whom I have 
     discussed this problem, irrespective of their political 
     persuasion, have been shocked to hear about these 
     regulations.
       I believe that I should be able to choose the medical 
     arrangements I prefer without suffering the penalty that is 
     being imposed. I ask that you take steps to remedy this 
     situation. I shall be happy to supply documentation regarding 
     the facts outlined above, it you request it. I look forward 
     to hearing from you.
           Sincerely,______.
                                  ____

                                    SOCIAL SECURITY ADMINISTRATION
       Dear Ms.   :
        Enclosed please find the regulations which state that 
     there is no application for cash social security retirement 
     benefits only. If you file for cash benefits you MUST file 
     for the Medicare Part A (HI). -Therefore this can only be 
     translated, in one way at this time. If you do not wish to 
     file for Medicare Part A (HI) you must forfeit your right to 
     cash benefits.
       If I can be of any further assistance please feel free to 
     contact me at the above telephone number extension, 3016.
           Sincerely yours,
     Technical Expert.

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