"Plaintiffs want something more than just the ability to decline Medicare payments," the court explains in its decision. "They seek a legal declaration that Medicare Part A benefits cannot be paid on their behalf — a declaration, in other words, that they are not legally entitled to Medicare Part A benefits."
The law, the court concluded, does not provide a mechanism for beneficiaries to opt out.
"If you are 65 or older and sign up for Social Security, you are automatically entitled to Medicare Part A benefits," Kavanaugh wrote. "You can decline those benefits. But you still remain entitled to them under the statute."