- - Friday, February 28, 2014

President Obama’s mendacious political promise, “If you like your health care plan, you can keep it,” continues to cast a long and disturbing shadow of doubt and confusion over millions of Americans who have lost coverage as a result of Obamacare. As 2014 unfolds, the most vulnerable senior citizens — those who receive home health care services — are about to learn they are out of luck. Obamacare opens a trap door under them, leaving this elderly population in freefall — with many citizens losing access to home health care.

Add another compelling reason to reverse Obamacare. Whether by accident or intention, the “Affordable Care Act” empirically strips America’s oldest and poorest cohort, all part of the World War II generation, of this basic coverage. Here is how.

On Jan. 1, Medicare’s home health care services, formerly serving 3.5 million elderly beneficiaries across the country, were cut under Obamacare. The cut deleted exactly 14 percent, or an estimated $22 billion, from these lowest-income Americans over four years. News of the forthcoming cut only trickled out the Friday before Thanksgiving, yet another stunning attempt by the Obama White House to reduce Medicare benefits without attracting notice.

Guess what? We noticed. This cut does irreparable damage to recipients of Medicare’s home health care services, those who are aged, homebound and sicker than the average Medicare population. Indeed, nearly two-thirds of Medicare home health care users live at or below the federal poverty level, meaning they are the most economically compromised of America’s precious senior citizens.


This cut is an indictment of White House policies. Home health care agencies have always provided services to homebound Medicare beneficiaries. No hoopla, but when these Americans needed skilled care, they got it. In contrast to expensive hospital care, critical health care services got into millions of American homes via clinicians. Home health care was — and still is — vital. It is also now effectively gone for these Americans.

How did home health care save money for taxpayers? Using 2009 as a reference year, Medicare’s average Part A and Part B payment for a home health care visit was $145, compared to $373 per day in a skilled nursing facility or a whopping $1,805 per day in a hospital. In addition, according to one leading expert, skilled home health care services saved the Medicare program $2.8 billion during the most recent three-year period. Approximately $670 million of that savings is attributable to 20,000 fewer hospital readmissions.

Given these facts, one would conclude that the value of home health care in driving down Medicare costs should be obvious, if this — and not a single-payer system — were the real goal of Obamacare. How did we lose sight of common sense? Just keep patients in a familiar surrounding — their homes, not in an expensive hospital — keep sound disease management programs that deliver better and more cost-effective outcomes, and continue to coordinate care for patients. That was working. Now we have the reverse — markedly higher medical and insurance costs, with absolutely no institutional connection, support or continuing benefits for these especially needy Americans, the ones who depended — with their families — on critical home health care benefits. The president and his Democratic surrogates in the House and Senate have done it again: They have wiped out another critical, working system with this Obamacare monstrosity.

What else will this home health care cut achieve? It will hit the small businesses that provide home health care nationwide, and is already doing so. More than 90 percent of those providing home health care are small businesses. According to the U.S. Center for Medicare and Medicaid Services, 40 percent of these companies will be operating “at a loss” — that is, they will likely fold or end up in bankruptcy — by 2017 as a result of the cut. What does that mean? It means nearly 5,000 more Medicare home health care providers may go out of business, and nearly 500,000 more jobs within this flogged industry may be wiped out to fund Obamacare. Those who care about such things should put that into their future unemployment calculations — and then thank Mr. Obama and his congressional friends, who all got a waiver and probably do not worry about home health care anyway.

Attacking our weakest senior citizens is no way to run a country. It is, in a word, reprehensible. This abomination devastates another existing and essential Medicare promise, while throwing one more gut-wrenching punch at this job sector. Does the truth no longer matter? Do these lives no longer matter? Do these businesses and jobs no longer matter? When will Mr. Obama and his allies in Congress let up and allow Americans to look after themselves again, as we used to quite well?

Dan Weber is president and founder of the Association of Mature American Citizens.