[Congressional Record (Bound Edition), Volume 145 (1999), Part 3]
[House]
[Pages 3947-3948]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            HOME HEALTH CARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Vermont (Mr. Sanders) is recognized for 5 minutes.
  Mr. SANDERS. Mr. Speaker, I would like to talk about an issue which 
is of great importance to my State of Vermont and to I believe 
virtually every State in the country, and that is the crisis that is 
currently occurring with regards to home health care.
  As you know, Mr. Speaker, in 1997 the Congress, against my vote, 
without my vote, passed the so-called Balanced Budget Act which cut 
$115 billion from Medicare, including $16 billion from home health 
care. Of course, those savings were used to provide tax breaks, most of 
which went to the very wealthiest people in this country. So we cut 
Medicare, we cut home health care, and we gave tax breaks to the rich 
and to the very rich.
  The result of that is that since 1997, cuts in home health care 
agencies have forced about 20 percent of those agencies to close, and 
agencies that are still open such as the 13 efficient nonprofit 
agencies in the State of Vermont are now struggling to meet the home 
health needs of their constituents with fewer resources.
  Last year, we put a band-aid on the problem and passed limited home 
health relief. We took a small step forward, but clearly nowhere near 
enough. Right now we have got to stop the upcoming 15 percent across-
the-board cut in home health care. We need to increase home health care 
per visit cost limits, we need to reform per beneficiary limits so that 
the sickest patients who need many home health visits have access to 
them. I am hopeful that Congress this year will do the right thing and 
pass comprehensive home health reforms this year that will truly help 
our agencies and equally as important Medicare beneficiaries who need 
home health care.
  There is one particular aspect of the debate about home health care 
that concerns me very, very much, and, that is, that the Medicare 
commission is proposing a 10 percent copayment for home health care 
which would result in out-of-pocket payments for the average senior of 
$470 a year. Now, some people may say, ``Well, $470 is not a lot of 
money.'' Well, it is a heck of a lot of money if you are an elderly 
person, if you are frail, and if you have an income of $8,000 or $9,000 
or $10,000 a year. That is 4 percent or 5 percent of your total income. 
At a time when many of our seniors cannot afford the prescription drugs 
that they need, when their out-of-pocket health care costs are soaring, 
it would be an absolute outrage to ask the elderly, sick, poor people 
to be paying $470 a year more for a program which they now receive for 
nothing and which they should continue to receive without cost.
  It is beyond my comprehension, Mr. Speaker, that at this moment at 
the same exact time that people are talking about imposing an 
horrendous copayment on low-income, sick senior citizens, these same 
people are talking about tax breaks for millionaires and billionaires. 
In other words, in all essence you raise taxes for the poor, the sick 
and the elderly, those people who are too frail to leave their homes, 
and you take that money and you give tax breaks to millionaires and 
billionaires. That is unconscionable and it is beyond my comprehension 
that any Member of

[[Page 3948]]

the United States Congress would support such a regressive and 
reactionary approach. What kind of country are we if we would do that?
  I would hope, Mr. Speaker, that we will not go that route. I am proud 
to say that I will be sending a letter to the Medicare commission which 
contains the names of 69 Members of the House who are going to say to 
that commission, ``Don't impose a copayment on the elderly and the sick 
and the frail.''
  Let us support home health care, let us understand that home health 
care is an integral part of long-term care, that it is something that 
is vitally needed, that it is something that is cost effective. If 
people do not receive the home health care that they need, they are 
going to end up in the hospital at far greater expense to Medicare.
  I would hope, Mr. Speaker, that this body will go on record as saying 
no to any copayments and let us protect some of the most fragile people 
in our country, and, that is, those people who cannot leave their home, 
who are old, who are sick and who are poor.

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