A New Congress?

By the time you read this column, the dust will have settled following the 2010 mid-term congressional elections. With numerous retirements by lawmakers, primary upsets and the election itself, we’re sure to see dozens of new faces in the 112th Congress, which begins in January.

What does all of this mean for the HME community?

Of course, we may well lose some members of Congress who are well-versed in the value of home care and who have supported HME interests on legislative issues in the past. But these losses are more than balanced by the opportunity to educate newly minted senators and representatives about the role that home medical equipment can play in delivering effective health care while holding down costs.

First let’s look at the big picture. Whatever the new proportion of Democrats and Republicans is, one thing is certain: Washington will have a highly partisan environment with a Democrat in the White House, a greater number of Republicans in the House with more influence and a closely divided Senate. Given that landscape, chances are that few major legislative initiatives will succeed in the 112th Congress.

In terms of health care legislation, there will be efforts to repeal or repair the health reform legislation enacted in March — the Affordable Care Act. And the sustainable growth rate formula will continue to give physicians heartburn, which Congress will try to relieve, at least in the short term.

The continuing, bleak deficit picture and intense budget pressure will make it hard for Congress to resist changes to Medicare that purport to save money, even when it comes to wrongheaded programs such as “competitive” bidding.

Other aspects of the big picture:

• Support for home care is bipartisan Fortunately, lawmakers on both sides of the aisle recognize the value of home care. Cosponsors on the bill to repeal the bidding program, H.R. 3790, include more than half of all Democrats and more than half of all Republicans in the House.
• New faces in Congress present new opportunities for HME Every new U.S. senator and representative represents thousands of home care users in his or her state or district. Each new elected official also represents an opportunity for HME providers to reach out to the new lawmakers in the months ahead to inform them about the role and value of home care in their community and our key issues.
• Independent consumer groups and economists agree with the HME sector on key issues Proponents of the Medicare bidding program and onerous restrictions on home care often suggest that we are alone in our opposition to those policies. Nothing could be further from the truth. Recently, 166 economists warned Congress about the serious design flaws in the CMS bidding program for home medical equipment, predicting that the program will fail and result in a “race to the bottom” for home care. Consumer groups including the ALS Association, the American Association for People with Disabilities, the Muscular Dystrophy Association and many others also support the bill to repeal the bidding program.
• Demand for home care continues to grow Everyone agrees that home- and community-based care provides the most cost-effective setting for post-acute care and an alternative to institutional care for millions of people. As our population ages, the demand for home-based care will grow. No forward-thinking policymaker would deliberately dismantle the nation’s home medical equipment sector. Yet, that is the net effect of recent Medicare policies targeting home care — from the bidding program to PECOS to the continuing wave of onerous audits.

So as HME continues down a bumpy path into 2011, let’s capitalize on the factors that favor home care: support from consumer and disability groups, economists and market experts, demographics — and the facts. We will need to bring all of these forces to bear during the year ahead.

Read more AAHomecare Update columns.

Tyler J. Wilson is president and CEO of the American Association for Homecare, headquartered in Arlington, Va. You can reach him at [email protected]. For more information on critical home care issues, visit the association’s Web site at www.aahomecare.org.