NAHC Submits Testimony for Ways and Means Health Subcommittee Hearing on Medicare Reform
May 30, 2013 04:31 PM
Last week the House Ways and Means Subcommittee on Health held a hearing that focused on several different proposals on ways to reform Medicare – with the key focus being on proposals to modify beneficiary cost-sharing within the Medicare program, including the proposal contained in both the Bowles-Simpson plan as well as President Obama’s budget that would add a home health copay in certain instances.
The hearing, entitled “The President’s and Other Bipartisan Proposals to Reform Medicare” included three witnesses: (1) Joseph Antos, Ph.D., Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute; (2) Alice Rivlin, Ph.D., Senior Fellow, Economic Studies, Brookings; and (3) Joe Baker, President, Medicare Rights Center. NAHC submitted written testimony for the record, as well as provided a set of questions for Members of Congress to ask during the hearing.
The hearing largely focused on the President’s Fiscal Year (FY) 2014 budget proposal to change the structure of Medicare beneficiary cost sharing – with one of the main areas of discussion being the proposal to add a home care copayment for certain episodes of care. For more, please see NAHC Report, April 16, 2013, for additional coverage of the President’s copay proposal.
Other key areas of focus included plans to increase Medicare Parts B (outpatient services) and D (prescription drug benefit) premiums for higher-income beneficiaries and increasing the Medicare Part B deductible.
Although there was general agreement between both the witnesses and members of the Subcommittee that reforms must be made to Medicare, when such reforms should be implemented and what types of reforms should be pursued was debated. Dr. Rivlin believed that the three proposals in the President’s budget should all be implemented together by 2016, including the President’s copay proposal.
To counter-balance Dr. Rivlin’s support of reintroducing a home health copayment, Joe Baker of the Medicare Rights Center emphasized in his testimony that, “The notion of reintroducing a home health copayment is most alarming because its implications would be most damaging for the most vulnerable: the poorest, the oldest and the sickest. Among home health users, 30% are age 85 or older, compared to 13% among the general Medicare population, and 63% are women.”
In its testimony, NAHC reiterated its opposition to the home health copay, stating that, “Congress eliminated the home health copayment in 1972 for the very reasons is should not be resurrected now…Reinstating the home health copay today would undo the progress made in reducing unnecessary hospitalizations and nursing home stays.” Mr. Baker cited this point as well – both in his written testimony as well as during the hearing.
Both Republicans and Democrats on the Subcommittee championed NAHC’s arguments opposing the home health copayment. Congressman Tom Price (R-GA), a former physician, stated that, “home health care provides some of the highest-value care for patients…this proposal and others disincentivizes the use [of those services.]”
Jim McDermott (D-WA), the Ranking Minority Member of the subcommittee, indicated that the cost-shifting proposals under consideration were merely an additional tax on beneficiaries, while Congressman Mike Thompson (D-CA) questioned the witnesses on the topic of how a home health copayment could lead to higher - and not lower - costs to the Medicare system. “I’m worried about the idea that we’ll be cost-shifting [to Medicare beneficiaries],” said Mr. Thompson. “If this copay discourages folks from doing what they should be doing…it could end up costing us a lot more” through increased hospitalizations and more expensive care settings.
NAHC is encouraged that more and more members of the committee that has jurisdiction over Medicare are questioning the wisdom of adding a home health copayment. Despite more members becoming educated about the true threats and costs that a home health copay will have to the Medicare system as well as its beneficiaries, the idea of a home health copayment is still supported by many on Capitol Hill.
NAHC urges all of its members to contact their elected officials and ask them to oppose the Medicare home health copay.
NAHC also urges all of its members to attend this year’s Annual Meeting and Expositionin Washington, DC, where this message can be conveyed directly to Members of Congress and their staffs by their constituents.