Wednesday, April 4, 2001

Mr. BOND. Mr. President, I rise to join with my colleague from Maine, Senator COLLINS, to offer an amendment on Medicare home health care. This amendment will give us the ability later this year to pass the Home Health Payment Fairness Act, a bill I have sponsored with the Senator from Maine and 31 other Senators, that tries to ensure that seniors and disabled Americans have appropriate access to high-quality home health care.

Home health care is a crucial part of Medicare through which seniors can get basic nursing and therapy care in their home. It is convenient. It is cost-effective. But more importantly, home health is the key to fulfilling a virtually universal desire among seniors and those with disabilities, to remain independent and within the comfort of their own homes despite their health problems.

Yet we have a crisis in home health , too many seniors who could and should be receiving home health are not getting it. This is tragic.

We all know the basic history, Congress made cuts in the Balanced Budget Act, the Health Care Financing Administration went too far in implementation, providers struggled or disappeared, and now patients are having a harder time getting care. This has been true for hospitals, for nursing homes, and for home health .

But there are two things that distinguish the home health crisis from all of the other Balanced Budget Act problems. First and most importantly, no other group of Medicare patients and providers, absolutely none, has suffered as much. The numbers don't lie: In 1999, two years after the Balanced Budget Act, almost 900,000 fewer seniors and disabled Americans were receiving home health care than previously. More than 3,300 of the Nation's 10,000 home health agencies have either gone out-of-business, or have stopped serving Medicare patients.

Medicare home health spending has actually gone down for three straight years, dropping by 46 percent from 1997 and 2000.

In my home state of Missouri, 27,000 fewer patients are receiving home care than before, a drop of 30 percent. And almost 140 home health care providers, almost half, have disappeared since the Balanced Budget Act.

The second thing that is unique about home health , the biggest cuts may be yet to come.

While other Medicare providers will still face some additional Balanced Budget Act cuts, nobody faces anything like the 15-percent across-the- board home cuts that are now scheduled for October of 2002. That's a 15-percent cut on top of everything else that has happened thus far.

I do not believe this should happen, and I actually don't know of anybody who believes the 15-percent health cuts should take effect. That's why Congress has already delayed the 25-percent cuts three separate times.

Our amendment would give us the room in the budget to fix this once and for all, no more mere delays, no more half-measures. This amendment will allow us to pass legislation later this year to permanently eliminate these 15-percent cuts.

Home health care has been through enough. Our Nation's dedicated home health providers deserve to be left alone and given a break so they can focus on patient care rather than survival. The last thing they need is more cuts. And that is all our bill tries to do, we try to spare home care patients and agencies additional cuts that threaten to make a bad situation worse. The seniors and disabled Americans who rely on home health for the health care, and for their independence, deserve no less.