Gray Matters: Armey of one marshals forces against Medicare

I met Richard Armey in 1995. Speaker Newt Gingrich had taken over the House. He was Gingrich's top lieutenant as House majority leader and told me of their plans to "wean our old people away from Medicare."

Well, he's still at it.

Under Gingrich and Armey, the Republican Congress gradually privatized much of Medicare, luring millions of beneficiaries into private insurance, now called Medicare Advantage, by diverting billions from Medicare as subsidies for insurance companies.

And in 2003, Republicans added the Part D drug program, all of which is privately insured. Medicare has so little control of Part D, it cannot negotiate the best drug prices.

Now Armey, who left Congress a few years ago to join a Washington lobbying firm, has found a new way to undermine Medicare. He is one of several plaintiffs behind a lawsuit and a federal court ruling that could give Medicare Part A beneficiaries the right to withdraw from the program without penalty.

The Sept. 29 decision by U.S. District Judge Rosemary Collyer in Washington dismissed the government's objections, clearing the way for the plaintiffs to challenge five Clinton administration rules that required enrollment in Medicare Part A as a condition for receiving Social Security benefits. Ordinarily, a person who reaches 65 and is eligible for Medicare is enrolled in Part A at no extra charge. Part A covers most hospitalization costs.

The issue is in the rules of the Social Security "Program Operations Manual," not the law, says Vicki Gottlich, an attorney with the Center for Medicare Advocacy.

She explained that the POMS, as they are known, include a "provision that says if you want to decline Part A you must return all Social Security benefits and decline Social Security."

She added that "if the plaintiffs prevail . . . then we might see an unraveling of the universality of Medicare . . . if wealthy people decide they want to decline Medicare for something else. Of course, they can do that now by not taking Social Security."

Armey has not given up his Social Security, although he favored its privatization. And a spokeswoman for the plaintiffs said they "are able to provide for their own health care needs and do not want to apply for or participate in Medicare," which they consider "inferior" to their private coverage.

She did not elaborate and declined to say how much the plaintiffs are paying for their coverage. She also denied that the suit poses a threat to Medicare, noting that their withdrawal would save the program money and the plaintiffs are not seeking a return of the taxes they paid.

Armey, who was forced to resign from the lobbying firm because of his right-wing activities, is also the head of FreedomWorks and associated groups sponsored by corporate funds, which organized the so-called Tea Parties, the Teabagger protests against President Barack Obama and the disruption of town hall meetings to discuss the proposed health care reforms. In 2005, FreedomWorks flew to Washington and brought to the White House groups of "spontaneous" supporters to cheer for President George W. Bush's plan to turn Social Security into millions of 401(k)s.

Despite the plaintiffs' rejection of Medicare, Part A and Part B, which covers most outpatient costs, remains the most popular choice for older Americans, according to an August report of the Government Accountability Office.

"Medicare beneficiaries experienced few problems accessing physician services . . . Very small percentages . . . less than 3 percent, reported major difficulties in 2007 and 2008."

The continued opposition of Armey and most of the current House Republicans to Medicare prompted the longest-serving House member, John Dingell, a Michigan Democrat, to review the program's political history. He recalled the day, April 4, 1965, he presided over the House when it passed Medicare.

It "was one of the proudest moments in my 53 years serving in Congress," he wrote for the Politico Web site. "I wish I could say we had a strong bipartisan effort to get it done. Only 13 Republicans in the Senate and 70 in the House voted for the bill that created Medicare. Since then, my Democratic colleagues and I have spent 44 years protecting seniors against Republican proposals to cut or eliminate Medicare."

Today, virtually every House Republican opposes a Medicare-like public option in any of the proposed health care reforms. And a group of 100 conservative House Republicans has introduced legislation permitting beneficiaries to opt out of Medicare.

This is Saul Friedman's last Gray Matters column. He can be reached via e-mail at saulfriedman@comcast.net.