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Two million elderly Americans are paying hundreds of dollars a year for Medicare health coverage they are entitled to receive free, a health-care advocacy group has charged.

Families USA said in a report that the Bush administration has failed to act to ensure that eligible, poor elderly people apply for and receive the aid they are entitled to."What should be an important protection for the elderly poor is still a government secret," said Ron Pollack, executive director of the group.

The issue involves a law passed by Congress in 1990 increasing the number of senior citizens eligible for free Medicare coverage by exempting those with incomes below the poverty line from making payments.

The Medicaid program, which provides coverage to the poor, is to make their payments, including the $31.80 monthly premium and as much as $752 in deductibles and 20 percent of all doctors' bills.

The premiums for Medicare, which provides coverage to senior citizens, are deducted from Social Security checks. More than 4 million elderly are poor enough to qualify for free Medicare, but only half actually receive it, the group said.

Ray Gill, spokesman for the Health Care Financing Administration in the Department of Health and Human Services, said the agency would have no immediate comment.

The group's report was a follow-up to a similar report last June. After that report, some 150,000 elderly poor sought and received free Medicare, the group said.

"After our June report, the Bush administration pledged that they'd fix the problem swiftly," Pollack said. "That pledge has been broken, and 2 million elderly poor are still being shortchanged."