Senator's Column by Mike Johans

October 13, 2009 Flawed Health Care Plan Would Affect Many Nebraskans Dear Nebraskans, As I write to you, the Senate Finance Committee has acted on the latest version of health care reform. I continue to believe we need to reform our health care system to bring down rising costs and shore up our delivery system. Paying for this reform is a big part of the debate. While tough financial decisions will have to be made, they must be made wisely. Therefore, it's important to look beyond Washington to determine how these decisions will affect you and all Americans, and your ability to access quality health care. In particular, I'm concerned about the proposed Medicare and Medicaid program cuts being targeted to pay for this legislation. Specifically, the proposal passed by the Finance Committee outlines more than $517 billion in cuts to current Medicare and Medicaid programs. These cuts will affect the quality of care in Nebraska. For example, more than $40 billion in cuts would be made to home health care services. Home health provides skilled nursing care and other health care services in the home to individuals who have an illness or injury. Preliminary estimates reveal two-thirds of Nebraska's home health agencies will lose money if these cuts become reality. Rural areas would fare worse, where an estimated 80 percent of home health agencies would be operating in the red. According to the National Association for Home Care and Hospice, Nebraska home health agencies can expect to lose more than $126 million over ten years under this legislation. Hospice, which provides care for the terminally ill, is another Medicare program targeted for cuts. Currently, 97 percent of Nebraskans have access to 38 hospice programs across the state. However, under the proposed legislation, hospice programs nationwide could see $8 billion in cuts by 2019, an 11.8 percent reduction in hospice reimbursements. Nebraska hospice providers could be forced to reduce service areas, leaving portions of Nebraska without hospice care. These cuts would not be welcome news in Nebraska. A 2007 study shows nearly 100 percent of Nebraskans believed it was important that the terminally ill have the choice to die at home and 83 percent felt it was important to have health care professionals come to their home. Many Nebraska hospitals are in the Finance Committee's bullseye. $45 billion in cuts are outlined for hospitals that serve a disproportionate share of Medicare and Medicaid patients. This includes nearly half of all Nebraska hospitals, which are already underpaid by current government programs and are struggling to stay open. These facilities would face up to $145 million in cuts, which would undoubtedly affect health care for Nebraskans. If there is waste or fraud in the Medicare and Medicaid programs we must address it, but we must ensure access to quality care and services is not compromised. Savings found by eliminating waste or fraud should be reinvested in the programs to address their pending bankruptcy. I'll continue to examine these proposals, carefully assessing how Nebraskans are impacted by the decisions made in Washington.