The National Association for Home Care & Hospice (NAHC) last week voiced strong opposition to copayments on home health services included in President Obama’s proposed budget.

“Essential home health services are at risk,” Val J. Halamandaris, president of NAHC, said in a prepared release. “The Medicare homecare benefit, only $17 billion in 2009, has been cut by $77 billion over the next 10 years. As a result of these cuts, 53 percent of all Medicare participating agencies will be under water in 2012—that is, paid less than their costs by Medicare. Congress should therefore resist making additional cuts in homecare for any reason.”

With 78 million baby boomers reaching their 65th birthday at the rate of 10,000 per day for the next 19 years, the need for home health services will only increase, the NAHC reported. “Home health keeps families together and is overwhelmingly what patients prefer,” the NAHC said. “It is far more cost effective for Medicare than institutional options.”

The organization said deficit reduction should not come in the form of a “sick tax” on the poorest and sickest Americans.

The budget proposal also included a reduced Market Basket Index (inflation) updates in 2014 to 2021. The proposed update reductions of 1.1 percentage points each year would affect all post-acute providers. These reductions would be in addition to the 2014 home health rate rebasing and the productivity adjustments starting in 2015.

The Centers for Medicare & Medicaid Services cut home health payment rates by 2.75 percent in 2008, 2.75 percent in 2009, 2.75 percent in 2010, 3.79 percent in 2011, 3.79 percent in 2012 and 1.32 percent in 2013 — for total reductions of more than 16 percent, which was in addition to rate cuts included in the Affordable Care Act.