[Congressional Record (Bound Edition), Volume 149 (2003), Part 5]
[Senate]
[Page 6300]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        POST-BALANCED BUDGET ACT

  Ms. COLLINS. Mr. President, I want to discuss the upcoming budget 
resolution and its impact on home health agencies. According to the 
Congressional Budget Office, the Post-Balanced Budget Act reductions in 
home health care have totaled more than $72 billion between fiscal 
years 1998 and 2002. This is more than four times the $16 billion that 
CBO originally estimated for that time period and it is a clear 
indication that the Medicare home health cutbacks have been far deeper 
than Congress ever intended.
  As a consequence of these reductions, cost-efficient home health 
agencies across the country have experienced acute financial 
difficulties and cashflow problems which have inhibited their ability 
to deliver vital care. Home health spending has been cut in half since 
1997. More than 3,400 home health care agencies have either closed 
their doors or stopped serving Medicare patients. Moreover, the number 
of Medicare patients receiving home health care nationwide has dropped 
by 1.3 million, more than a third. This points out the most central and 
critical issue: Cuts of this magnitude simply cannot be sustained 
without ultimately affecting patient care, without ultimately 
diminishing the provision of care to some of the most vulnerable 
citizens in our Nation.
  It, therefore, is my intent to offer an amendment to the budget 
resolution this week calling on the Senate to stabilize and promote 
fairness in Medicare home health reimbursements by avoiding further 
cuts in home health spending, preserving the full market basket update, 
and restoring funding for this important benefit, including the 
extension of the 10 percent rural add-on reimbursement I have discussed 
today. I hope all of my colleagues will join me in supporting this 
amendment.
  I yield the floor.
  The PRESIDING OFFICER. The Senator from Wyoming.
  Mr. THOMAS. Mr. President, I will make a few comments in morning 
business. I agree with the Senator from Maine. As cochairman of the 
Rural Health Caucus in the Senate, we have been working for a very long 
time and will continue to work for equity payments between urban and 
rural areas. In this instance, in-home health care costs are often 
higher in rural areas.

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