The lawsuit alleges that the 1997 Medicare+Choice law violates the due process clause of the Fifth Amendment on its face, and contends that the law has been administred in a manner that has caused disparate treatment among Medicare beneficiaries. The action states that though Congress has just passed a new Medicare bill that implicitly recognizes the inequalities complained of by present beneficiaries, it fails to eliminate it. The action goes on to allege that the inequities will continue until at least January 1, 2006, unless something is done to change the present system.

The problem arises from the allegation that Medicare+Choice reimbursements to HMOs do not sufficiently account for high-cost suburban regions, giving the HMOs incentive to leave those counties and their seniors behind. On Long Island, 85,000 seniors have lost coverage because of the HMO withdrawals, part of a two-million national total drawn largely from high-cost suburbs. The lawsuit complains that Medicare has approved plans for the suburban counties requiring premiums and various copayments, while approving plans for the five boroughs of New York City that offer an option with no premiums or copayments. This unequal administration has allegedly caused many Medicare HMOs to withdraw from the suburban counties while continuing to offer coverage in the city, because the HMOs allegedly receive substantially higher monthly payments per enrollee for operating in the city.

It all started with a petition circulated at senior centers and outside supermarkets in January 2003. Reeling from a $55-per-month increase in premiums for HMO coverage through Medicare, Suffolk seniors Joan Anderson and Vincent Rutkowski were galvanized to action when they found out New York City residents pay nothing for the same coverage. Though neither had considered themselves organizers, their group, Seniors Against Discrimination, got 8,000 fellow seniors to sign a protest letter and took its anger to the streets with a rally of more than 1,000 in March.

Under the current reimbursement rates, which are based on calculations of health care costs from 1997, HMOs in the Medicare Plus Choice program in Nassau and Suffolk receive $100 to $200 less per senior per month than those in the five boroughs. As a result, several HMOs dropped out of the plan on Long Island, and the two remaining companies, Empire Blue Cross Blue Shield and HIP, charge seniors monthly premiums of $140 and $119, respectively, to make up the cost of treatment.

The lawsuit drew immediate support from Senator Charles E. Schumer (D-N.Y.) and two Democratic congressional representatives from the city's Long Island suburbs, Representatives Steve Israel (D-N.Y.) and Tim Bishop (D-N.Y.). The three pledged to work on legislation and other means to address the disparities.

The law firm that filed the suit has done so on a pro bono basis.