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Letter to The Honorable Nancy Pelosi, Speaker of the House of Representatives, United States House of Representatives: Congressman Kissell's Letter To Speaker Pelosi On The Health Care Reform Plan

Floor Speech

Location: Washington, DC

Congressman Kissell's Letter To Speaker Pelosi On The Health Care Reform Plan

The Honorable Nancy Pelosi
Speaker of the House of Representatives
United States House of Representatives
H-232 United States Capitol
Washington, D.C. 20515

Dear Madame Speaker,

I am gravely concerned about the proposed cuts in home health care reimbursements in the current House health care reform plan. I am worried that the impact of these cuts will deny life saving care to seniors and will also devastate home health care and hospice programs, especially in rural communities, where they are a vital part of the business and social fabric.

The National Association for Home Care & Hospice suggests that a combined 1 million home health care and hospice recipients could lose these important services under the current House plan. Not only is this deeply troubling for our seniors and disabled citizens, but it would have a crushing impact on home health care agencies, forcing them to close their doors, costing desperately-needed jobs. The unintended impact of this so-called reform will be costly hospitalizations and longer periods of nursing home care for senior citizens. Subjecting seniors to frequent emergency room visits, repeated trips to the hospital and forcing them to move into nursing homes years before they wish to is not a compassionate, practical, or cost effective way to care for our aging citizens.

One-third of home health care agencies have a negative Medicare margin. Agencies which are part of hospitals or skilled nursing facilities suffer from an average 6.19 percent negative margin. If we force the profitable agencies to operate under these conditions, many community-based providers will be left with no choice but to go out of business, leaving their patients with no reasonable, affordable options and costing thousands of jobs.

Among the most expensive services associated with Medicare and Medicaid are those connected to nursing home care. A recent study suggests that using Medicare dollars for home health care reduces costly hospitalizations and nursing home care. In treating patients with chronic diseases an estimated $30 billion can be saved by expanding access to home health care. Home health care professionals keep senior citizens healthier while allowing them to stay in their homes; and they do it for far cheaper than do the alternative treatments. Again, it makes no sense to force out of business through governmental meddling people who do a good work, save the overall health care system billions of dollars, and create jobs.

I believe it is crucial that comprehensive health care reform not include cuts in home health care and hospice services, but instead must use Medicare and Medicaid funding wisely to allow more access to home health care with a focus on wellness and independent living. If we seek true reform, we should apply common sense and compassion by letting home health care providers continue to offer vital services to senior citizens while remaining an important part of the economy of countless communities. There is no accomplishment in health care reform which punishes the competent while ignoring the needs of the sick and aging.

Our senior citizens have earned the right to be treated with love, dignity and respect as they enter and navigate the twilight of life. That journey is sufficiently challenging and stressful without the government making it worse by denying home health care to those who need it most. Home health care and hospice services are indispensable to the families of senior citizens in rural communities. Additionally, the home health care industry provides much-needed jobs and economic activity in the parts of our nation hardest hit by current economic circumstances.

Madame Speaker, it is never the right time to shortchange seniors the care and dignity they are due; and this is certainly not the time to gut an industry that is one of the few still hiring people in our rural communities. I urge you to join me in the fight to eliminate cuts in Medicare and Home Health care as exist in the current House health care reform plan.


Larry Kissell
Member of Congress
North Carolina's 8th District

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