Democrats’ Reform Plan Hits Power Wheelchairs Purchase Option

WASHINGTON — House Democrats revealed a draft version of their health care reform bill on Friday, and while the massive 852-page proposal would cover nearly all Americans, it lacked two major components: a price tag and the means to pay for it.

However, the American Association for Homecare reported that one “pay-for” would be the elimination of the first-month purchase option for power wheelchairs.

“A discussion draft of a health care reform bill released today by House Democrats would eliminate the first-month purchase option for all power wheelchairs,” AAHomecare officials said.

“The House package does contain a provision that would eliminate the first-month purchase option for power wheelchairs, effective for wheelchairs purchased on or after Jan. 1, 2011,” Elyria, Ohio-based Invacare confirmed on its Web site. “We expect the Senate to have a similar provision, but expect the Senate proposal to exempt complex rehab power wheelchairs.”

AAHomecare said no cut to oxygen was mentioned in the House bill. However, the association added, “AAHomecare believes that a cut will emerge later in the legislative process as a way of paying for health reform. The association believes a similar threat of reductions in oxygen reimbursement exists in Senate proposals.”

And that may not be all, the association said.

“In hopes of delaying the inevitable protests from affected health care sectors, legislators in both the House and Senate have not tipped their hands about all of their proposed cuts and financing options. We anticipate that more details on financing options to pay for health care reform will be released after the July 4th congressional recess,” AAHomecare told its members.

“They are taking the early versions of the [Medicare Improvements for Patients and Providers Act] that had more pay-fors in them, and those they didn’t use they’re putting on the table this year,” said Seth Johnson, vice president of government affairs for Pride Mobility Products, Exeter, Pa. “They’ll throw everything they can at it and see what will stick.”

Passed last July, MIPPA delayed competitive bidding but mandated a 9.5 percent cut to 10 product categories to make up for the savings Medicare would have gained through the program.

While the Democrats did not say how much their plan would cost, they did say they would likely pay for it by slicing Medicare and Medicaid costs and perhaps by bumping up taxes on alcohol and soda pop.

Among other things, the bill would require all Americans to purchase health insurance and would establish a government-run health plan that would go head-to-head with private insurance companies. In unveiling the plan, House Education and Labor Committee Chairman George Miller, D-Calif., acknowledged it would not please everyone. However, he added, “If there is one thing off the table, it is saying no to health reform.”

While stakeholders are concerned about the House bill, they are even more troubled by the $1.6 billion Senate version, now going through markup. Members of that chamber have been clear they consider the first-month purchase option for PWCs a viable cut, Johnson said, with lawmakers looking to shave the bill’s price tag.

“The odds are that the Senate bill will be the one that ends up moving at the end of the day, and that’s why we are putting more emphasis on the Senate at this time,” he explained, adding that the Senate draft will likely not be released until after Congress’ July 4 recess.

With more than 90 percent of beneficiaries choosing the purchase option because of long-term needs, Johnson said he is hopeful the industry might dodge the cut again.

“When you look at the industry’s success at keeping this out of Medicare packages for the last four years, I would say we have more good arguments this year than in the past — tighter credit markets, the effect on small business and, for any size business, reduction in jobs,” Johnson said. “The cuts they are looking to make to this industry simply are not sustainable and seem counter-intuitive to the objectives of the administration.”