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New Letter to Rangel, Waxman, Miller from National Seniors Coalition Outlines Concerns With House Tri-Committee Health Reform Bill

Saturday, September 19, 2009 General News J E 4
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JOPLIN, Mo., July 8 In a new letter to the three key leaders shaping the developing U.S. House of Representatives' health reform bill - Ways and Means Chairman Charles Rangel (D-NY), Energy and Commerce Chairman Henry Waxman (D-CA) and Education and Labor Chairman George Miller (D-CA) - the Coalition to Protect Senior Care (CPSC) expressed concern that the legislative discussion draft, as now proposed, could harm seniors' care, cut thousands of key frontline care jobs, and undermine the ability to sustain quality improvement programs already benefiting patients nationwide.

"As front-line caregivers - those who provide nearly 80 percent of direct patient care in America's nursing homes - we at the Coalition to Protect Senior Care (CPSC) are writing to ask for your help in ensuring that the health care reform debate now at hand stay focused on the fact that adequate, stable Medicare funding and patient outcomes go hand in hand," says the letter to Reps. Rangel, Waxman and Miller. "From our perspective, what is at stake in this debate is the ability of facilities to maintain sufficient workforce levels, to sustain comprehensive quality improvement programs, and to continue caring for our patients and residents now, and in the future."

Lisa Cantrell, a co-founder of the National Association of Health Care Assistants (NAHCA), and a national spokesperson for the CPSC, pointed out that while the Coalition strongly supports comprehensive health care reform and shares the House leaders' goals for change, "We are concerned that the current discussion draft limits nursing homes' role in health care reform only to that of a 'pay for,' and that the impact of such drastic reductions will be felt all the way to the frontline of care for our nation's most vulnerable elderly." In its letter to Rangel, Waxman and Miller, the CPSC refers to a new analysis by Avalere Health LLC which finds the draft House legislation will cut Medicare nursing home funding by $44.9 billion over ten years.

Continues the letter: "Compounding the impact of health care reform cuts is the proposed rule that the Centers for Medicare & Medicaid Services (CMS) is expected to finalize by August 1, which will cut $16 billion in Medicare funding over 10 years. The interactive effects of the Tri-Committee draft and CMS' proposed regulation would effectively drop Medicare payments by as much as $53 billion over ten years, an average loss of more than two years' worth of Medicare revenue for every nursing home in America. We worry that Medicare funding cuts in the proposed rule could turn back the clock on the quality improvements that we have worked so hard to achieve."

Cantrell said it is highly noteworthy that there is widespread, bi-partisan support for rescinding the proposed CMS rule as evidenced by effort led by U.S. Reps. Shelley Berkley (D-NV), Earl Pomeroy (D-ND) and Shelly Moore Capito (R-WV) -- which garnered 122 signatures from U.S. House members who wrote to Health & Human Services (HHS) Secretary Kathleen Sebelius urging the Administration to reject the proposed Medicare regulation. "We are asking you to keep what is best for patients and caregivers in mind and to consider together the impact of legislative reform policies and regulatory policies that could have serious, albeit unintended negative consequences," Cantrell continued.

The CPSC spokeswoman also said a key underlying reality surrounding the funding debate is the fact that seventy percent of nursing home costs are labor related, and Medicare cuts of the magnitude proposed would risk 50,000 nursing home-specific jobs in 2010 alone, according to a recent analysis by the American Health Care Association (AHCA). "Since women fill 95 percent of long term care jobs and minorities comprise 30 percent of our workforce, the proposed cuts would heavily affect minority workers, inhibit ongoing quality improvement efforts, and also limit providers' ability to offer valuable benefits to employees, including subsidized health insurance coverage," she continued. "Reforming the nation's healthcare system cannot possibly include jeopardizing the quality of care delivered to America's seniors by greatly reducing an already stretched workforce that has more than 50,000 vacancies needing to be filled today."

Cantrell said adequate funding for Medicare is made more urgent by the fact that two thirds of nursing home elderly are Medicaid beneficiaries and Medicaid is chronically underfunded by as much as $4 billion a year. "This gap has widened despite Congress' efforts to provide additional Medicaid funding in the stimulus bill, since many states slashed or froze payments to nursing homes anyway," she pointed out. "From a frontline caregiver standpoint, the challenge of caring for patients with increasingly complex medical conditions in a healthcare setting that stands to lose billions upon billions in funding is daunting at best."

Concludes the letter: "We are now asking that as Congress and the Administration attempt to overhaul our nation's healthcare system that you remain aware of the noble and worthy mission caregivers in nursing homes fulfill each day in effectively caring for the needs of America's seniors and people with disabilities. We respectfully ask that final House healthcare reform legislation enhance and improve on the current long term care system in our country through adequate funding that supports sufficient staffing levels -- achievements that cannot be realized with the currently proposed Medicare cuts to nursing homes and CMS' proposed rule."

The complete text of the letter to Reps. Rangel, Waxman and Miller is available at www.coalitiontoprotectseniorcare.org.

The Coalition to Protect Senior Care consists of the American Association for Long Term Care Nursing (AALTCN); the American College of Health Care Administrators (ACHCA); the American Association of Nurse Assessment Coordinators (AANAC); the National Rural Health Association (NRHA); The American Association of Nurse Assessment Coordinators (AANAC) the American College of Health Care Administrators (ACHCA); the American Physical Therapy Association (APTA); the American Society of Health Care Administration Executives (ASHCAE); ASHCAE state affiliate members representing Arizona, Arkansas, Colorado, Idaho, Iowa, Kansas, Maine, New Hampshire, New Mexico, New York, North Dakota, Oregon, Texas and Utah; the American Health Care Association (AHCA); the American Health Quality Association (AHQA); the National Association for the Support of Long Term Care (NASL); the National Association of Health Care Assistants (NAHCA); the Alliance for Quality Nursing Home Care; and the Senior Clinician Group.

SOURCE Coalition to Protect Senior Care
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