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NOSSCR Topic Archive

Medicare Waiting Period: Reform Legislation

Bills have been introduced in the House of Representatives and the Senate to phase out, over the next ten years, the Medicare 24-month waiting period. S. 700, introduced by Sen. Jeff Bingaman (D-NM), and H.R. 1708, introduced by Rep. Gene Green (D-TX), also would, upon enactment, eliminate the waiting period for those individuals with "life-threatening conditions."

Claimants' representatives know all too well the hardships faced by their clients if they are caught in the 24-month waiting period once cash benefits are awarded. Those individuals found eligible most quickly usually have the most serious medical conditions, yet they will need to wait for Medicare coverage at the time when they need it the most. There have been indications that the waiting period will be an issue in the expected debate over health care reform. Nevertheless, Sen. Bingaman and Rep. Green, long-time advocates for elimination of the waiting period, decided to re-introduce their legislation.

The bills would phase out the 24-month waiting period over the next 10 years. In 2010, it would be reduced to 18 months and then reduced by 2 months each year until January 2019, when it would be totally eliminated.

Under current law, the Medicare waiting period does not apply to only two conditions: (1) end-stage renal disease and (2) amyotrophic lateral sclerosis, (ALS or "Lou Gehrig's disease"). The bills would extend the exception to all "life-threatening conditions." These are not delineated in the bills, but defined as conditions that are "fatal without medical treatment." The Secretary of Health and Humans Services would be responsible for compiling a list of such conditions, with regular updates. To compile the list, the Secretary would be required to consult with various federal health agencies and to annually review the SSA "compassionate allowances" list.

NOSSCR is a member of the 120-member Coalition to End the Two-Year Wait for Medicare and signed on to a letter supporting the bills. The sign-on letter is available from NOSSCR. Additional information about the bills, including the text, is available at http://thomas.loc.gov.