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Consumer Affairs

Lawsuit Says New Medicare Program a "Calamity" for Poorest Americans


November 14, 2005
Organizations from Maine to California representing the interests of impoverished older and disabled Americans with Medicare have filed suit in federal district court in Manhattan seeking an order assuring that people do not lose access to life-preserving medication on January 1st.

Under Bush Administration plans, 6.4 million people enrolled in both Medicare and Medicaid will be denied their existing Medicaid drug coverage on January 1st. The Bush Administration is then required to provide coverage to these men and women through the new Medicare Part D program under the 2003 Medicare Modernization Act.

The lawsuit seeks protections for people who are not seamlessly and immediately transitioned to the Medicare drug program.

The poorest, sickest, and oldest Americans face grave risk of losing their life-saving medications once the clock strikes twelve on New Years, said Robert M. Hayes, president of the Medicare Rights Center, a national consumer service group. This lawsuit seeks to force creation of an essential safety net to protect the health and lives of the frailest Americans.

The suit warns that countless numbers of poor men and women will fall through the cracks of this massive program transition, and that these impoverished people will face the loss of medicines needed to function or survive.

It also says that the characteristics of the people at risk -- nearly 40 percent are cognitively impaired and only 39 percent have a high school diploma -- will prevent up to a million poor seniors from immediately mastering the complexity of the new Medicare drug benefit so they can maintain their access to needed medicine.

To be eligible for Medicare, one must be severely disabled or age 65 or over. To be eligible for Medicaid, most states require that people have incomes well below the poverty level and have virtually no assets. About 43 million Americans are enrolled in Medicare, and about 6.4 million of them are also enrolled in Medicaid.

Among the organizations who have filed the suit are: Action Alliance of Senior Citizens of Greater Philadelphia, Congress of California Seniors, Massachusetts Senior Action Council, National Alliance for the Mentally Ill: Maine, New York Statewide Senior Action Council, The Coalition of Voluntary Mental Health Agencies, Inc., United Senior Action of Indiana and the Medicare Rights Center. The organizations are being represented by volunteer attorneys with the law firm Paul, Weiss, Rifkind, Wharton & Garrison LLP, and the Medicare Rights Center.

Protecting the oldest, poorest and sickest Americans through this transition is a legal and moral imperative, Hayes said. If the government transitions 99 percent of these men and women flawlessly, there will still be 64,000 people without their medicine come January. That cannot be allowed.

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