Dems cut Medicare home health services to fund coverage of uninsured

Over the weekend, the Senate cut a key Medicare service aimed at invalids in an attempt to find the money to pay for ObamaCare.  On a 53-41 vote, Senate Democrats cut $43 billion from home health-care services.  Democrats insisted that they were cutting waste and abuse, but the end result will be less care for seniors.  The New York Times reports on the vote:

By a vote of 53 to 41, the Senate on Saturday rejected a Republican effort to block cutbacks in payments to home health agencies that provide nursing care and therapy to homebound Medicare beneficiaries.

Republicans voted against the cuts, saying they would hurt some of the nation’s most vulnerable citizens. Most Democrats supported the cutbacks, saying they would eliminate waste and inefficiency in home care.

The Democrats’ health care bill would reduce projected Medicare spending on home care by $43 billion, or 13 percent, over the next 10 years. The savings would help offset the cost of subsidizing coverage for the uninsured. …

Mr. Baucus, a principal author of the health care bill, noted that his mother was receiving home health care and said he would not do anything to hurt beneficiaries.

“We are reducing overpayments,” Mr. Baucus said. “We are rooting out fraud. We are getting the waste out. The savings go back in Medicare and extend the solvency of the trust fund.”

Baucus is wrong on both counts.  The money goes to funding coverage of the uninsured, which comes primarily through Medicaid, not Medicare, and federal subsidies in the exchange program.  The money will go out of Medicare and not come back, which should be rather obvious anyway.  If the money stayed in Medicare, it wouldn’t be cut out of it in an amendment — and be part of almost $500 billion in proposed Medicare cuts in ObamaCare proposals.

As for “reducing overpayments,” that’s Beltway speak for rationing.  Who defines overpayment?  It’s not the providers.  This is just another compensation cut that will force more providers out of the Medicare home health care market.  That means fewer choices, or none at all, for invalid seniors who rely on home health care to survive.  It’s no different than any of the other cuts to provider compensation that already has many of them refusing to take Medicare patients.

Gary Gross posts the transcript of an interview with Neil Johnson, executive director of the Minnesota Home Health Care Association:

JOHNSON: Well there’s no question & the bill’s over 2,000 pages & it’s very complex. We’re very concerned about the home health care aspects of it. We’re looking at, depending on which bill we’re talking about, the House bill cuts home health care by $56 billion over 10 years & the Senate bill, it’s something like $45 billion over 10 years. That’s about a 14.5% cut for home care & we’re about 4.5% of Medicare’s expenditures, so it’s a significant cut.

HAUSER: How many Minnesotans right now have home care?

JOHNSON: Well, we’re looking at…the estimates are 68,000-70,0000 people last year, in 2007 excuse me, & 28,000 received Medicare services & another 30-40,000 received medical assistance services.

HAUSER: And what’s gonna be the practical impact if these cuts were to go through?

JOHNSON: Well, certainly access is an issue & we’re certainly worried about that but the many agencies are hanging on the edge right now. Medicare has been a good payer for most providers in the state of Minnesota & combined with medical assistance & some waiver payments & some private payments & long-term care but Medicare has been a key factor in providing needed skill services to the citizens of Minnesota.

HAUSER: There seems to be a disconnect here because people look at home care as a way to bring down costs that are often associated with hospital stays. I know 60 Minutes just did a segment on this & they said it was a good way for people at the end of their lives of saving spending $5-10,000 a day so why’s that being targeted?

JOHNSON: Well, I think it’s an easy target because people don’t really understand what home care providers do. But, yeah, we think we’re the best alternative out there. It’s efficient. It’s productive & it’s where people want to spend the rest of their lives…

Jazz Shaw notes that Democrats used to scream that Republicans wanted to kill seniors through Medicare cuts.  Now …

This became something of a standard talking point during both the 2004 and 2008 presidential elections. As the story went, Democrats cared about seniors and their particular needs. Republicans wanted to cut Medicare and were plotting to kill your grandparents. My, what a difference one election makes, eh?

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