[Congressional Record (Bound Edition), Volume 145 (1999), Part 18]
[Extensions of Remarks]
[Page 25502]
[From the U.S. Government Publishing Office, www.gpo.gov]



  RESTORE BBA-97 MEDICARE FUNDING CUTS TO HOME HEALTH, HOSPITALS AND 
                             NURSING HOMES

                                 ______
                                 

                         HON. NICK J. RAHALL II

                            of west virginia

                    in the house of representatives

                       Thursday, October 14, 1999

  Mr. RAHALL. Mr. Speaker, I am pleased to speak on the urgent matter 
of making restoration of Medicare funding to our home health agencies, 
hospitals and nursing homes, especially those that serve rural areas.
  We are here to again bring to the attention of the House, and the 
American people, the absolute urgent need to take action before the end 
of this session of Congress--to restore Medicare funding and make other 
administrative adjustments to cutbacks imposed under the BBA of 1997.
  The BBA-97, as it is called, proposed to cut $115 billion from 
Medicare by either terminating or massively reducing Medicare 
reimbursement to providers of health and medical care for senior 
citizens and the disabled.
  The effect has been that with only one-third of the mandated Medicare 
cuts having been implemented so far, the total cut is not $115 
billion--it already totals more than $206 billion.
  Imagine what will occur if the other two-thirds of proposed Medicare 
cuts are implemented in the coming year.
  In West Virginia, the hardest hit segment of our health care delivery 
system has been among home health agencies. We have seen the closure of 
18 of our home health agencies, and drastic reductions in staff and 
services at those still operating.
  Our hospitals--especially the rural hospitals--are suffering the same 
kind of financial crush--with many of them having already drastically 
reduced staff, and dozens that have had to curtail services for 
outpatient care.
  I just received word yesterday that the Appalachian Regional Hospital 
at Man, West Virginia, may be forced to close by the end of October--
due in part to the loss of Medicare reimbursement. Another local 
hospital nearby which is in financial difficulty also, may eventually 
close. These are the only two hospitals serving a large rural county in 
my district. It is obvious that the closure of one hospital is bad 
enough--closure of two would create critical access problems for my 
constituents in need of emergency room care, inpatient care, and 
outpatient clinic services.
  The same kind of burden has been placed upon nursing homes where the 
sickest, poorest and most vulnerable Medicare beneficiaries are cared 
for--and due to infirmities caused by age and disease--from heart 
problems to diabetes to stroke--they are the most costly of patients.
  We have reached this impasse tonight because, in my view, Congress 
balanced our Nation's budget on the backs of its elderly, disabled, 
homebound citizens whose only help comes from Medicare.
  It is my understanding--and if true I applaud him--that our colleague 
and friend, Representative Bill Thomas, Chair of the Ways and Means 
Health Subcommittee, will have introduced today--a plan to restore some 
of the BBA cuts to Medicare.
  The first words that occurred to me when I heard about the Thomas 
plan was: It's about time.
  But I genuinely applaud his effort because it is important to have 
our Health Subcommittee Chairman on record as having acknowledged the 
adverse impact of the Medicare cuts imposed on providers of this 
country's health care for our most needy, most vulnerable senior 
citizens.
  It wasn't that long ago that we were constantly admonished not to pay 
any attention to our home health agencies about the Medicare cuts--even 
as they closed over 2,000 of them nationwide--18 of them in my State.
  We were told that the cuts were not too deep, and that the impact was 
not so adverse as to require congressional action to restore them.
  And so again I greet Chairman Thomas' plan for restoring some of the 
BBA-97 Medicare cuts with genuine hope and lingering uncertainty, 
because we have not seen the details.
  I am also gratified to hear--after preaching on the subject for two 
long years--that the Administration is looking into ways that Medicare 
reimbursement cuts can be restored through administrative action.
  My colleagues here on the floor tonight will recall with me that we 
suggested this administrative action in a half-dozen letters to the 
Administration beginning over two years ago. But we were told that the 
BBA-97 was so tightly written that only legislative relief could help 
restore the Medicare cuts. We were told that the Administration had no 
``wiggle room'' to act on its own.
  Once the details of the Thomas plan are available to us for our 
study--we will know for sure whether he has sent the Fire Brigade to 
our rescue, or if we are being handed a pitcher of spit to try and 
extinguish the fires of neglect brought to our health care delivery 
system through the excessive Medicare cuts contained in the BBA of 
1997.
  Finally, Mr. Speaker, I say only what many of us have been saying all 
along--that we must work together to get this burgeoning loss of health 
services under control.
  Chairman Thomas has taken a first step in leading Congress to act 
before the end of this year.
  This is an important day--and I have every hope and expectation that 
Congress will move quickly and effectively to address the needs of our 
home health agencies, our hospitals, our nursing homes--providers who 
deserve our thanks and our support for this restoration of Medicare 
cuts imposed by BBA-97.

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