Twila Brase: Will Trump Give Americans the Freedom to Opt-Out of Medicare?

Senior citizens, and those coming behind them, must be allowed to opt out of Medicare and purchase private health insurance that they can keep to the end of their days.

Twila Brase: President of Citizens' Council for Health Freedom

Medicare is failing.

The recent Medicare Trustees report warns Congress that the hospitalization part of the “Medicare Trust Fund” (which exists only on paper) will be depleted in 2026. In seven short years, there will no longer be any surplus funds allotted to Medicare Part A(hospitalization), and payroll taxes will be insufficient to cover the full cost of care. Currently 60 million people are enrolled in Medicare. Last year, spending under Medicare Part A was $741 billion, which exceeded payroll tax revenue by $1.6 billion!

The Trustees “project deficits in all future years until the trust fund becomes depleted in 2026.” The fund began 2019 with just $200.4 billion, which would cover only 62 percent of projected 2019 expenditures. They call for “substantial changes” and ask for reforms sooner rather than later to give sufficient time for “affected individuals and organizations—including health care providers, beneficiaries, and taxpayers—to adjust their expectations and behavior.”

Medicare is failing because it was set up to fail. It began in the red. Despite never paying a dime, 19 million Americans were automatically eligible when Medicare began in 1966. Doctors and hospitals that had offered services affordably and charitably suddenly raised their prices. And many seniors chose to access services they may have not paid for on their own. It was a free-for-all.

Medicare recipients also receive about three times as much in benefits as they paid in taxes. For example, those who retired in the year 2000 paid $82,000 in payroll taxes but will receive $320,000 in Medicare benefits. Those dollars come from their grandchildren’s wages. This Ponzi scheme may have worked when there were more children than seniors, life spans were shorter, and the baby boomers hadn’t yet retired. But now 10,000 baby boomers become eligible for Medicare every day.

Patients have the most to lose. Unless payments for care increase, the Trustees expect seniors to experience reduced quality of care and access to care, particularly physician services, compared to those with private health insurance.

This makes the solution obvious. Senior citizens, and those coming behind them, must be allowed to opt out of Medicare and purchase private health insurance that they can keep to the end of their days.

President Trump can do this with the stroke of a pen.

He doesn’t need Congress, but he does need to act. This past November, Citizens’ Council for Health Freedom (CCHF) and 37 other organizations nationwide urged President Donald Trump via a letter to allow senior citizens to voluntarily opt out of Medicare—without losing their Social Security benefits. Five more groups have now signed on.

The current practice of the Social Security Administration (SSA) prohibits Americans from receiving their Social Security benefits unless they enroll in Medicare Part A (hospitalization). If seniors disenroll from Medicare, they must also repay all Medicare and Social Security benefits received.

“This is neither a law or a rule,” we wrote. It’s a series of executive instructions added by previous administrations to the program operations manual system of the SSA—essentially an online handbook for SSA employees. It leaves most seniors stuck in this voluntary entitlement program, even if they want to keep private coverage or keep private insurance as their primary coverage.

Our coalition told President Trump, “These procedures effectively trap seniors in Medicare, but you have the authority to liberate them.”

Now, Senator Ted Cruz (R-Texas) and Congressman Gary Palmer have reintroduced the Retirement Freedom Act to free senior citizens from Medicare without losing their Social Security benefits. We believe these bills will encourage the President Trump to take quick action. There are several benefits beyond freedom of choice for seniors, including:

  • Protection against a single-payer Medicare for All program
  • Potential development of a market for lifelong private insurance
  • Reduced Medicare expenditures, improving stability for those choosing to stay in Medicare

The now 42 co-signers of our letter include the 60 Plus Association, Americans for Prosperity, Americans for Tax Reform, Association of Mature American Citizens, Competitive Enterprise Institute, Concerned Veterans for America, FreedomWorks, Goldwater Institute, Practicing Physicians of America, The Heartland Institute, and Texas Public Policy Institute.

Allowing seniors to voluntarily opt-out will have no impact on those who have already enrolled, wish to stay enrolled or want to enroll in Medicare in the future. It simply allows senior citizens to collect their rightful Social Security benefits without being required to enroll in, or remain enrolled in, Medicare. With Medicare imploding before our eyes, we believe President Trump must act now to set Americans free.


By Twila Brase, RN, PHN

President and Cofounder, Citizens’ Council for Health Freedom

Author, Big Brother in the Exam Room:

The Dangerous Truth About Electronic Health Records


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Twila Brase
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Twila Brase, RN, PHN, is president and co-founder of Citizens’ Council for Health Freedom, a national, patient-centered, privacy-focused, non-partisan organization located in St. Paul, Minnesota since 1998.