July 26, 2011

Blue Dog Democrats Send Letter to President Obama Urging Continued Opposition to Home Healthcare Co-Payment for Seniors

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WASHINGTON — Representatives of the House Blue Dog Coalition recently issued a letter to President Obama urging preservation of home healthcare as discussions to reduce federal spending and strengthen the Medicare program continue. Specifically, the moderate Democrats encouraged the President to oppose a co-payment for services for the 3.2 million Medicare beneficiaries receiving home healthcare and expressed support for the home healthcare community’s reform proposal to strengthen the Medicare benefit. Lawmakers who signed onto the letter include Reps. Ben Chandler (D-KY), John Barrow (D-GA), Mike Ross (D-AR), Joe Baca (D-CA), Kurt Schrader (D-OR) and Dan Boren (D-OK).

The letter states, “We are especially concerned that the imposition of a co-payment for home health services could seriously impact frail seniors and actually result in increased Medicare spending that shifts considerable costs to state Medicaid programs.” A recent analysis by Avalere Health found that requiring home health co-pays could lead to increased use of alternative inpatient care services, as beneficiaries who are unable to pay their co-pays see their health deteriorate, forcing them into more expensive institutional care settings, such as hospitals.

In the letter, the Representatives also encouraged the President to instead look for Medicare savings by focusing on program integrity and rooting out fraud and abuse. They also credited the home healthcare community for its proposals of thoughtful reforms to strengthen the provision of quality, cost-effective care. These include measures to drive innovation, improve payment accuracy, enhance accountability, reduce costs and increase transparency, among other objectives.

“Home healthcare provides essential medical services to treat acute illness, long-term health conditions, permanent disability and terminal illness in homebound seniors who are not feasibly able to access treatment in other institutional settings,” said Billy Tauzin, senior advisor to the Partnership for Quality Home Healthcare. “On behalf of these seniors — many of whom are low-income and would struggle with affording this proposed co-pay — we thank these lawmakers for taking a stand by urging the President to preserve their access to preferred, clinically effective home health.”

The vast majority (78 percent) of non-dual eligible Medicare home health beneficiaries do not have secondary Medigap coverage and would therefore be responsible for the full co-payment for their care, estimated to be as much as $300 for a 60-day episode of treatment. According to the Avalere research, this additional financial responsibility would be a significant burden on patients, in that over 50 percent of the would-be affected beneficiaries have an income below 200 percent of the poverty line.

“As we all share the President’s commitment to reducing spending, we must also take care to protect our most at-risk seniors — those who have chronic conditions and severe disabilities, and whose incomes are substantially limited,” added Tauzin. “Instead of unfairly burdening these seniors with added costs that would be difficult to cover, we encourage the President to work with Congress and the home health community to enact common-sense reforms designed to weed out fraud and abuse, and reinforce — rather than limit — the Medicare program’s potential.”