House Republican Debt Ceiling Proposal Contains Some Medicare and Medicaid Cuts; Does Not Include Home Care or Hospice Cuts or Copays

The House Republican Leadership released a debt ceiling package earlier this week that laid out their core principals for funding the government and raising the amount it can borrow through the end of the year.

While the plan outlines some of the main priorities for the House’s GOP leadership – such as a one-year delay of the Affordable Care Act (ACA) and moving forward with the Keystone Pipeline, it also offers some details on cost-savings from healthcare-specific proposals.

Proposals for savings from healthcare include Medicare means testing – such as the proposal that was also included in the President’s budget – and several cuts to Medicaid funding. While these provisions would be of concern to the home care and hospice community, the biggest threats to both beneficiaries and providers of such services – home care and hospice payment cuts and copays - were not included in the GOP’s debt ceiling proposal.  

The debt ceiling proposal is separate from the Continuing Resolution (CR) that keeps the government funded through October 1, and which has received significant attention recently. The former raises the borrowing limit the Federal Government is allowed to reach to pay for its current obligations while the latter authorizes spending to continue for government programs. The House originated both the debt ceiling package as well as the CR, which is currently being debated in the Senate.

If Congress does not pass the Continuing Resolution, the government will likely shut down on October 1 – the start of the Federal Government’s new fiscal year. If the debt ceiling is not raised, then the government will run out of money to pay for its current obligations on or around October 17, according to Secretary of the Treasury Jack Lew. 

The House debt ceiling proposal has already been declared a nonstarter by Senate Democrats, who have said they will not negotiate over the debt ceiling and have insisted on a “clean” bill with no added provisions.

NAHC is encouraged that neither home care nor hospice payment cuts or copays are included in the House GOP’s debt ceiling proposal, and looks forward to continuing to work productively with lawmakers from both parties to ensure access to quality home care and hospice services are not restricted for Medicare and Medicaid beneficiaries. 

The bigger fight for Medicare providers is expected to be over how to offset the cost of fixing the flawed Medicare physician payment formula, which Congress must address before the end of the year to prevent a 27 percent cut in physician payments (See NAHC Report, May 2, 2013). Home health copays and payment cuts have been discussed as possible offsets.  NAHC will continue its campaign to prevent this from happening.

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