Focusing on Health Care

Currently in Congress, the focus on health care policy will likely continue to be Social Security followed by Medicaid and Medicare, in that order. The House Ways and Means Committee Chairman Bill Thomas has mentioned rethinking all of these important government programs and the way in which they are funded by American taxpayers. But there has been a storm of concern not only among the public but members of Congress about possible changes to these programs.

President Bush accelerated his efforts to sell the need for Social Security reform throughout the month of March by reaching seniors and near-retirees during several personal appearances to capture their support for change. Most members of Congress would like to see this year utilized as a plan to examine the crisis in Social Security and to educate their constituents, coming back to Social Security reform in the next congressional session. It's essential that our home care community follow this issue, because Congress may look to adding long-term care (including home care) as a factor in the financing of this program.

During the National Governors Association's winter meeting in Washington, the debate continued over the federal and state burden-sharing of Medicaid. President Bush and the governors worked hard to find common ground, focusing on cost-effectiveness, increased patient access, improved outcomes for beneficiaries and advances in health care technology.

One great point that all parties seem to agree on is a recognition that home care and community-based care are a preferred alternative to nursing homes. It's obvious to us that home care is patient-preferred and cost-effective. There was no disagreement among the governors and Secretary of Health and Human Services Michael Leavitt, a former governor of Utah, that change must take place in the current role for Medicaid in order to provide care for the more than 50 million beneficiaries in the United States.

Home care providers across the nation are already facing serious cuts in Medicaid payments. State home care associations, which champion home care before their state legislatures, governors and Medicaid agencies, report a broad array of challenges. While some states report favorable Medicaid policies, others report that severe cuts are possible.