I have written in amazement about this lawsuit before.Several plaintiffs are attempting to assert what they believe to be their right to refuse Medicare Part A without losing their social security benefit payments.See here. The case is Hill v. Sebelius.Of course,I agree you should be able to decline Medicare without penalty.But the trial court and now the appellate court see things differently.
The case has proceed slowly through the legal system and now a three judge panel has ruled against the plaintiffs. It seems that there is a CMS rule book regulation that states if a person refuses Medicare Part A he will not receive the social security benefits he would have otherwise be eligible for. If one accepts Medicare A and then later decides to decline this "entitlement"he will stop receiving SS payments and have to repay what he had previously received. Earlier a judge in the case said in effect that Medicare benefits were a "mandatory entitlement".
Note this draconian rule was not written into the Medicare law or anything else that should have statuary power and came into existence in something called the Program Operations Manuel System (POMS) which apparently is simply advice for the program administrators and never went through any formal rule making process.
See here for the latest development in this case.