[Congressional Record Volume 144, Number 143 (Sunday, October 11, 1998)]
[Extensions of Remarks]
[Page E2071]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 MEDICARE HOME HEALTH AND VETERANS HEALTH CARE IMPROVEMENTS ACT OF 1998

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                               speech of

                           HON. PATSY T. MINK

                               of hawaii

                    in the house of representatives

                        Friday, October 9, 1998

  Mrs. MINK of Hawaii. Mr. Speaker, although I am an original cosponsor 
of the original version of H.R. 4567, the Medicare Home Health Care 
Interim Payment System Refinement Act, I am rising in reluctant support 
for the bill.
  The Balanced Budget Act of 1997 implemented a poorly designed formula 
for Medicare payments to home health agencies which devastated home 
health agencies around the country. Reimbursements were slashed across 
the board and more than a thousand home health agencies either closed 
or began refusing to accept Medicare beneficiaries. The number of 
Medicare-Certified Home Health Agencies in my home state of Hawaii went 
from 28 in October 1997, to 22 in August 1998. A 22 percent decline in 
ten months.
  For every agency that is closed, there are several hundred patients 
who are abandoned. The situation compels immediate action and I am very 
pleased the House is addressing this problem. Nonetheless I believe 
more can be done.
  I am distressed that this bill is not retroactive. Many agencies have 
continued to operate in the red for the past year clinging to the hope 
that Congress would enact retroactive legislation to fix the payment 
problem. Agencies will not get assistance for losses they took this 
year and because of this, many will close even with the additional 
payments provided by this bill.
  Furthermore this bill does not address the additional problems that 
would be created by the impending home health payment reduction 
scheduled for September 1999. Unless we address this problem we will be 
in the same situation next September, as we are in now.
  Since H.R. 4567's introduction, numerous unrelated provisions have 
been added to the bill. One of my main objections to this bill is the 
inclusion of language expanding the Roth IRA limit from $100,000 to 
$145,000. This is a tax shelter for the wealthy and will cost U.S. 
taxpayers almost $5 billion over 10 years while providing little, if 
any, benefit to the majority of the population.
  I am pleased that the bill will enable Medicare to reimburse the VA 
for services provided to Medicare eligible Veterans by VA facilities. 
This change is fiscally responsible and is predicted to save the 
Federal Government money in the long run. However, I am concerned that 
services previously paid for by the VA would now be extracting scarce 
resources from the Medicare Trust Fund.
  In conclusion, although the meager home health payment increase is 
not at the level I would have liked, this is a step in the right 
direction and I am relieved that struggling home health agencies will 
receive some assistance.

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